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Archive for the ‘Glossary of Terms’ Category

mHealth

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February 12th, 2017 at 4:32 pm

Computerized Provider Order Entry (CPOE)

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Computerized provider order entry is a key component of health information system that allows the entry of clinical orders and instructions for the treatment of patients by a practitioners. The orders are communicated through a computer network to staff or other various departments responsible for fulfilling an order, including pharmacy, food services, radiology or laboratory.

CPOE:

  1. speeds order completion,
  2. reduces errors related to handwriting or transcriptions,
  3. allows order entry at point-of-care or offsite,
  4. provides error checking for duplicate or incorrect doses or tests, and
  5. simplifies inventory and posting of charges.

 

 

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December 14th, 2013 at 12:43 pm

Nursing Care Delivery Systems

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  • A nursing care delivery system defines how work is organized, how nursing staff are deployed, and who does what in providing nursing care.
  • Delivery systems identify who has the accountability for nursing care and clinical outcomes.
  • Delivery systems provide the organization, rules and structure that define responsibility and accountability (who does what).
  • Total Patient Care. The oldest system for organizing patient care. Commonly used in intensive care unit (ICU) and postanesthetic care unit (PACU). in TPC an RN is responsible for planning, organizing, and performing all aspects of nursing care. TPC provides a high degree of autonomy, clear lines of responsibility and accountability, holistic patient care, unfragmented care. TPC is not cost effective. It requires abundant availability of nurses.
  • Functional nursing. Specific tasks are assigned to nurses. The nurse assigned to a specific task has to carry it out at all patients. Registered nurses (RNs) carry out complex nursing tasks. The idea behind functional nursing is that there is a specialist for each task. The head of the ward assigns the different tasks to specific nurses based on the nursing care plans for the different patients.
  • Team nursing. Care is given by a team composed of registered nurses (RNs), Licensed Practical (or Vocational) Nurses (LPNs) and certified nursing assistants (CNAs). In this model, most direct bedside care is given by the CNAs while the RNs spend more of their time at the nursing station. When a ward is organized according to the team nursing system, the nurses are divided in a number of teams. Each team has to provide care for a fixed group of patients. By doing so nurses have a close relation with the patients they have to take care for. Each team has a team leader who is responsible for the performance of the team. Each ward has a supervisor, which is responsible for the whole ward. Nurses like working in teams.
  • Primary nursing. All nurses are RNs. They do personal care as well as care planning, documentation, etc. CNAs assist the nurses, but do not have autonomous roles in patient care. This approach can provide better continuity and more expertise than the Team Nursing model. Primary nursing is a method of nursing practice which emphasizes continuity of care by having one nurse provide complete care for a small group of inpatients within a nursing unit of a hospital.

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April 27th, 2013 at 10:59 am

Evidence-based Practice

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Evidence-based practice (EBP) is an interdisciplinary approach to providing quality health care. Its basic principles are that all practical decisions made should be based on research findings from studies fulfilling certain agreed upon criteria.

The most common definition of EBP is taken from Dr. David Sackett, a pioneer in evidence-based practice. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)

“The goal of EBP is the integration of: (a) clinical expertise/expert opinion, (b) external scientific evidence, and (c) client/patient/caregiver perspectives to provide high-quality services reflecting the interests, values, needs, and choices of the individuals we serve. ”

Videos:

  1. What is Evidence-Based Practice? Presented by Dr. Mark Ebell (52:43)

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June 11th, 2012 at 9:42 am

Average Daily Census

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  • The average number of staffed beds that are occupied each day.
  • The average number of hospital inpatients per day.
  • It is a measure of hospital’s inpatient service capacity.
  • ADC is an indicator of the volume of services provided in a hospital. Research shows that hospitals that treat a large number of patients tend to provide better care and have improved outcomes for treatments and procedures.
  • Average daily census provides a snapshot of how the hospital is using the available beds.

Calculation of ADC

  • The average daily census is calculated by dividing the total number of patient days during a given period by the number of days in that period.
  • or by dividing the total inpatient days during the year by 365 days.

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May 10th, 2012 at 10:19 pm

TeleHealth

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Telehealth is “the use of communications and information technology to deliver health services and exchange health information when distance separates the participants.”[Elford, 1998].

Many technologies are used for telehealth including: telephones, videophones, personal computers (PCs), videoconferencing systems, store and forward systems (S&F) and specialized telehealth workstations.

A telehealth system is made of the following components:

  1. Hardware, e.g. computer, workstation and peripherals. Peripheral devices are the devices that are connected to a workstation and allow the local health professional to capture clinical images, video, sounds and vitals, such as otoscope, electronic stethoscope, and general exam camera.
  2. Software installed on the workstation,
  3. Database to store patient information,
  4. Network or telecommunications link,
  5. Humans e.g. users, clinicians and patients,
  6. Policies and protocols.

Videos:

  1. Basic Introduction to Telehealth (4:12)
  2. Telehealth: VA Experience (9:08)
  3. A Demonstration of a Telehealth Mobile Solution (4:01)

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April 17th, 2012 at 5:01 am

Clinical Decision Support Systems

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  • A clinical decision support system (CDSS) is an application that analyzes data to help healthcare providers make clinical decisions.
  • “Clinical decision support systems are point-of-order decision aids, usually through computer order entry systems, that provide real-time feedback to providers ordering imaging tests, including information on test appropriateness for specific indications” [Blackmore, 2011].
  • Clinical Decision Support Systems are “active knowledge systems which use two or more items of patient data to generate case-specific advice”  [Wyatt J, Spiegelhalter D, 1991].
  • “Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making” [Hayness, R., 2010]
  • CDSSs typically integrate a medical knowledge base, patient data and an inference engine to generate case specific advice.
  • In the US. health care providers must implement CDSS before 2015 or …
  • Computerized provider order entry (CPOE) systems allow clinicians to electronically enter medication orders. These systems can reduce medication-related errors because they eliminate the need to decipher handwriting, improve communication between providers, and standardize care. When a clinical decision support system (CDSS) is added to a CPOE, it provides the added value of integrating a medical knowledge base, patient data, and an inference engine to generate drug alerts on the case at hand.

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March 27th, 2012 at 2:41 pm

mLearning

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mLearning stands for mobile learning.

It is a term describing the use of mobile devices to support learning and teaching.

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March 27th, 2012 at 2:37 pm

Cloud Computing

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  • Cloud computing is the use of the internet and remote servers to store data and use applications.
  • Cloud computing allows for the provision of shared resources, software, and information to local computers and other devices as a metered service over the Internet.
  • Cloud computing allows users to use applications without installing them on local computers.
  • Cloud computing allows users to access their data and files using any computer with internet access.
  • This technology allows for much more efficient computing by centralizing storage, memory, and processing.
  • Cloud computing provides computation, software, data access, and storage resources without requiring users to know the location and other details of the computing infrastructure.
  • An example of cloud computing is Hotmail or Gmail. Users only need a computer connected to the internet to start sending emails.

Videos

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February 26th, 2012 at 9:41 am

Web 2.0

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Web 2.0 is the term given to describe a second generation of the World Wide Web that is focused on the ability for people to collaborate and share information online. Web 2.0 refers to websites and applications that facilitate participatory information sharing,  interoperability, user-centered design, and collaboration on the World Wide Web.

A Web 2.0 site allows users to interact and collaborate with each other in a social media dialogue in contrast to websites where users are limited to the passive viewing of content that was created for them.

Examples of Web 2.0 include social networking sites such as Facebook, blogs like this site, wikis, and video sharing sites such as YouTube.

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February 13th, 2012 at 1:53 pm

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Google Speadsheets

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  • A free online spreadsheet program
  • Simple to use
  • Files can be shared and managed in collaboration with others, instantly.
  • Allows complex formulas, conditional formatting, automatic translation.
  • Functions. Perform a huge number of functions in the browser, from the common (sum, average, count) to the specific, such as engineering and math calculations or finance formulas.
  • Conditional formatting.  For example, a cell can be set to turn red if it exceeds a set figure.
  • Insert forms, drawings, scripts, images, gadgets and charts into a spreadsheet.
  • Add comments to a spreadsheet, a highly useful feature for collaboration.

Videos:

  1. Google docs spreadsheet tutorial (9:45)
  2. Create a new Google Spreadsheet (0:24)
  3. Using Google Spreadsheets (3:22)
  4. How to set up a Google spreadsheet (3:02)
  5. Freezing Rows and Columns in a Google Spreadsheet (4:23)a
  6. Insert a chart into a Google Spreadsheet (0:57)
  7. Google Spreadsheets Graphing Pt 1 of 4 (1:27)
  8. Google Spreadsheets Graphing Pt 2 of 4 (1:26)
  9. Google Spreadsheet More with Formulas pt 1 of 3 (2:13)
  10. Google Spreadsheet More with Formulas pt 2 of 3 (2:20)
  11. Performing Queries in a Google Spreadsheet (1:49)

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February 2nd, 2012 at 7:19 am

Information System

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An information system (IS) is defined as the organized combination of people, hardware, software, communication networks, and data resources that collects, stores, processes, transforms, displays, transmits disseminates and disposes information in accordance with defined procedures.

  • Disposition: the act or means of getting rid of something.
  • Dissemination: the distribution of information broadly.
  • Processing: the manipulation of data in accordance with established instructions, manually or by computer. Processing by computer is the manipulation of data in accordance with its instructions, or programming.
  • Transmission: the process of sending information from one point to another.

An IS may be automated (e.g., a computerized information system) or manual (e.g., a library’s card catalog).

Any IS is made of 6 components: hardware, software, data/database, network, policies and procedures and people.

An Information System (IS) consists of six components, namely:

  1. Humans, which consists of IT specialists (such as a Database Administrator or Network Engineer) and end-users (such as doctors, nurses, etc…).
  2. Hardware, which consists of all the physical aspects of an information system, ranging from peripherals to computer parts and servers.
  3. Software, which consists of System Software, Application Software and Utility Software.
  4. Networks, which consists of communication media and network support.
  5. Data, which consists of all the knowledge and databases in the IS.
  6. Policies and procedures that governs the utilization, use and management of the information system.

Videos:

  1. What is Information Systems? (1:38)
  2. Information Systems (0:59)
  3. Healthcare Information Systems (4:43)

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January 31st, 2012 at 10:15 am

Adverse Events (Medical Errors)

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Adverse Events are ‘instances which indicate or may indicate that a patient has received poor quality care’ [2].  An AE is defined as ‘an injury that was caused by medical management (rather than the underlying disease) and that prolonged the hospitalization, produced a disability at the time of discharge, or both’ [3].

The Quality in Australia Health Care Study revealed that 16.6% of admissions were associated with an ‘adverse event’, which resulted in either disability or a longer hospital stay for the patient and was caused by health-care management. In 13.7% of these cases the disability was permanent and in 4.9% the patient died [15].  In UK, a study found that 10.8% of admitted patients experienced an AE [16].

In UK and Australia, about half of AE cases were considered preventable [15, 16]. The Hospitals for Europe’s Working Party on Quality Care in Hospitals estimated in 2000 that 10% of patients in European hospitals suffer from preventable harm and adverse effects related to his or her care [17]. An Australian study found that 17% of postoperative cases in a teaching hospital experienced at least one serious AE and that 7% of postoperative cases ended in the death of patient [18]. In Canada, it is estimated that the overall incidence rate of AEs is 7.5% of hospital admissions and that 37% of these AEs are potentially preventable [19].

In France, the incidence of AEs was estimated at 6.6 per 1000 hospital days in 2004, from which 24.1% were Hospital Acquired Infections.20 In Germany, the Dutch Patient Safety Research Program showed that AEs affect 5.7% of patients in Dutch hospitals [21].

Videos:

  1. Adverse Events: Unreported Hospital Errors (10:11)
  2. Adverse Events in Hospitals, in Arabic (8:57)
  3. Adverse Events in Yemen, media report (5:08)

 

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2 Walshe K, Bennett J, Ingram D. Using adverse events in health care quality improvement: Results from a British acute hospital. International Journal of Health Care Quality Assurance 1995; 8: 7–14.

3 Brennan T, Leape L, Laird N et al. Incidence of adverse events and negligence in hospitalized patients: Results of the Harvard Medical Practice Study I. Quality and Safety in Health Care 2004; 13: 145–152.

15 Wilson R, Runciman W, Gibberd R, Harrison B, Newby L,Hamilton J. The Quality in Australia Health Care Study. The Medical Journal of Australia 1995; 163: 458–476.

16 Vincent C, Neale G, Woloshcynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ 2001; 322: 517–519.

17 WHO. Quality of Care: Patient Safety: Report by the Secretariat. 2002. Available from URL: http://www.who.int/gb/ebwha/pdf_files/WHA55/ea5513.pdf. Accessed 12 June 2008.

18 Bellomo R, Goldsmith D, Russell S, Uchino S. Postoperative serious adverse events in a teaching hospital: A prospective study. The Medical Journal of Australia 2002; 176: 216–218.

19 Baker G, Norton P, Flintoft V et al. The Canadian Adverse Events Study: The incidence of adverse events among hospital patients in Canada. Canadian Medical Association Journal 2004; 170: 1678–1686.

21 Zegers M, de Bruijne M, Wagner C, Groenewegen P, Waaijman R, van der Wal G. Design of a retrospective patient record study on the occurrence of adverse events among patients in Dutch hospitals. BMC Health Services Research 2007; 25: 7–27.

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January 27th, 2012 at 8:18 am

Electronic Health Record

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  • “The Electronic Health Record (EHR) is a secure, real-time, point-of-care, patient-centric information resource for clinicians. The EHR aids clinicians’ decision making by providing access to patient health record information where and when they need it and by incorporating evidence-based decision support. The EHR automates and streamlines the clinician’s workflow, closing loops in communication and response that result in delays or gaps in care. The EHR also supports the collection of data for uses other than direct clinical care, such as billing, quality management, outcomes reporting, resource planning, and public health disease surveillance and reporting.” HIMSS Electronic Health Record – Definitional Model Version 1.1 – 2003
  • “A longitudinal collection of personal health information of a single individual, entered or accepted by health care providers, and stored electronically. The record may be made available at any time to providers, who have been authorized by the individual, as a tool in the provision of health care services. The individual has access to the record and can request changes to its content. The transmission and storage of the record is under strict security.” Federal/Provincial/ Territorial Advisory Committee on Health Infostructure (2001)
  • Simply, it is a repository (collection) of information related to patient’s health in electronic (computer) form.

Videos:

 Benefits of Electronic Health Record:

Health information technology includes interoperable electronic records, e-prescribing, physician order entry systems, and clinical decision support systems. Health information technology can reduce errors, improve coordination, and diminish administrative inefficiencies. Properly implemented and widely adopted, HIT would save money and significantly improve health care quality. (RAND)

 

Public Health Informatics

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“Public health informatics is defined as] the systematic application of information and computer science and technology to public health practice, research, and learning.” Yasnoff et al. (2000).

Public health informatics is defined as the, “ science of applying Information-Age technology to serve the specialized needs of public health” (Friede, Blum, & McDonald, 1995, p. 239).

Yasnoff WA, O’Carroll PW, Koo D, Linkins RW, Kilbourne E. Public Health Informatics: Improving and transforming public health in the information age. J Public Health Management Practice 2000; 6(6):67-75.

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January 25th, 2012 at 3:57 pm

Audit Trail

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  • Audit Trail: Security system that tracks and records a user’s access, deletion or modification of data.
  • In information systems, an audit trail tracks and records the chronological sequence of activities pertaining to system resource usage, such as user logins and logouts and user’s activity in detail: what commands were issued to the system, what records and files were accessed or modified, etc.
  • Audit trails are a fundamental part of computer security, used to trace unauthorized users and uses.

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January 25th, 2012 at 3:50 pm

Admission

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Admission

  • The event of placing an individual (patient) under treatment or observation in a hospital or other health care facility.
  • A patient is admitted when he/she is provided with room, bed, board and continuous nursing care in an area where patients usually stay overnight.
  • Day of admission is the day on which a person is admitted to a hospital, occupies a bed and given a hospital number.

Admissions (statistic)

  • The total number (count) of patients admitted as inpatients during a 12-month period.
  • Patients admitted more than once during the year are counted separately for each episode.
  • Newborns are not included in this measure.

Videos:

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January 25th, 2012 at 3:37 pm

Location Based Technologies

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Smartphone and mobile devices (tablets and Netbooks) have built in geographical positioning technologies. This allows applications to know where the individual is and share that information with others. A location-based service (LBS) is an information or entertainment service, which is accessible with mobile devices through the mobile network and which uses information on the geographical position of the mobile device. LBS can be used in a variety of contexts including health care.

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January 24th, 2012 at 9:50 am

Systems Theory

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Introduction
The world we live in is a complex system composed of subsystems that interact among each other with each having clearly defined boundaries and coherent dynamics. Systems theory was developed by biologist Ludwig von Bertalanffy in the 1930s to simplify world complexity to human mind and make it more understandable (von Bertalanffy, 1962). The development of the theory came as a result of the author’s perceived need for a theory to guide research in multiple fields. His theory helped to provide a common framework that created shared and common language that scientists from different disciplines can use to communicate their findings. Simply put, systems theory is used to understand how things around us work.

Systems theory looks at the world as a system composed of smaller subsystems. Systems as a representation of life phenomena are used by humanity in every day life to describe the functioning of these phenomena. For example, a hospital is a system with inputs, processes and outputs. The hospital itself is a component of a larger system, health care system. The health care system, banking system, educational system, judicial system and other systems comprise the socio-economic-political system within which we live.

Significance of Systems Theory to Health Care Management
Systems theory can be used to clearly and concisely understand health care structures, processes and outcomes processes and their interactions within a health care system. Systems theory can be used as a framework to describe the components of systems and the relationships between these components, the boundaries of the system, the goals of the system, and system’s ability to change and adapt in response to internal and external forces. Systems theory and thinking can help us understand how health care organizations and systems behave and it allows us to clearly assess, visualize, analyze and understand the structure, processes, and feedback loops that make up the organization. This correct and clear understanding of the organization as a system is a necessity to be able to manage organizations effectively and efficiently and to achieve organization’s goals.

System Definition
A system is a collection of independent but interrelated elements or components organized in a meaningful way to accomplish an overall goal. The function of any system is to convert or process materials, energy, and/or information (inputs) into a product or outcome for use within the system, or outside of the system (the environment) or both.

Definition of Key Terms

Inputs include raw material, energy and resources processed to produce the outputs of the organization. Examples include information, money, nurses’ effort, physician’s time, fuel, energy, time, individual effort, & any raw material of some kind.

Elements or components are the things, parts, or substances that make up the system. These parts may be humans, material, equipment, etc. Elements have attributes or characteristics that can be measured or described such as size, color, volume, quantity, temperature, and mass.
Throughput is the processes used by the system to convert raw materials or energy (inputs) from the environment into products or services that are usable by either the system itself or the environment. Examples include, thinking, physical examination of patients, diagnosing, planning, decision-making, writing prescription, taking vital signs, operating on a patient, constructing, sorting, making a speech, sharing information, meeting in groups, discussing, melting, shaping, hammering, etc.

Output is the product or service which results from the system’s throughput or processing of technical, social, financial & human input. Examples include health services, better health, software programs, documents, decisions, laws, rules, money, assistance, cars, clothing, bills, etc.
Feedback is information about some aspect of data or energy processing that can be used to evaluate & monitor the system & to guide it to more effective performance. How many patients were are seen in 2 hours clinic? How man medical errors were committed in a hospital? Why were mistakes made? HealthCareReportCard.com is an example of how hospitals are doing with certain diagnoses. Hospital accreditation reports are an example as are patient satisfaction surveys, sales reports, and test results.

Subsystem is a system which is a part of a larger system. They can work parallel to each other or in a series with each other. Information system is an example of a subsystem in a hospital. Medical staff as an organization is a subsystem of the hospital.

Dynamic system is any system that continuously influences and changes its environment and is being influenced and changed by its environment. Dynamic systems are usually composed of components that are structured and interrelated in such a way that a change in one component necessarily affects other components of the system. A hospital in Amman is an example of a dynamic system where it influences and changes its environment (health, quality of life) and is being influenced by its environment (restructuring to provide new needed services). On the other hand, a static system is defined as any system that does not change over time in relation to environment. To survive, systems are better off being dynamic rather than static. Evidence based practice in health care is an example of how health care services are dynamic and not static.

Open system is defined as a system that interact with its environment exchanging raw materials and energy for services and/or goods produced by the system. Health care facilities, hospitals, families, humans, cardiovascular system, banks, etc are examples of open systems. A hospital produces health services through practice, health care professionals through training and knowledge through research. In return it receives money, raw materials, appreciation, and energy from its environment.

Any system must have a goal. The goal is the overall purpose for existence of the system. Examples include; treating patients, to educate student nurses, to produce knowledge, to manufacture candy, to make coffee, and so on.

System Characteristics
Most systems have the following common characteristics:

  • All systems have common elements. These are input, throughput or process, output, feedback, control, environment, and goal.
  • Systems have varying degrees of complexity.
  • The organized components of a system comprise a unified whole that is greater than the sum of its components.
  • To be viable and successful, a system must be goal-directed, able to adapt to changing environment, technology and circumstances, and be governed by feedback and must value continuous leaning and development, creativity and innovation. And to survive, a system must save some of its output to maintain itself.
  • The structure of systems is defined by its components (parts) and processes.
  • Various system components have functional and structural relationships between each other and are organized in a way to accomplish a specific function or set of functions.
  • Systems exchange material, information and/or energy beyond its boundary with other systems, through input and output processes.
  • To be part of the system any element must have a relationship with at least one element of the system. Any element which has no relationship with any other element of the system cannot be a part of that system.

Organization as a System
Human social groups (organizations) exist and interact to produce, consume and exchange goods and services. It is helpful for understanding to think of organizations as systems. A system is an organized collection of independent but interrelated elements or components to accomplish an overall goal. Simply put, an organization as a system has various inputs that are processed to produce outputs. A continuous feedback between the different components of the system ensures that the system is accomplishing the goals of the organization (system). A system can be the entire organization, or any of its departments, groups, or processes.

Organizations (systems) have inputs, processes and outputs. Inputs include resources such as human resources, equipment, computers, raw materials, money, technologies and information. Inputs are processed to produce the outputs of the organization. Outputs are the results of the processes of the organization. Outputs can be goods or services. Examples of goods are food, clothes, equipment and cars. Organizations produce services such as transportation services, education, and health care. Health care industry produces services such as providing health care, protecting against communicable diseases, and providing food services in hospitals. Feedback comes from multiple sources; from the managers, workers who perform processes, customers who use system services, newspapers and political leaders.

Organizations are composed of numerous subsystems, as well. Complexity of an organization is determined in part by the number of subsystems it has. Each subsystem has its own boundaries, inputs, processes and outputs with an overall goal for the subsystem. Common examples of subsystems are departments, units, projects, teams, or processes.

Organizations are defined by their mission, strategic plan, goals, policies and procedures, organizational charts, job descriptions and legal documents. Feedback within the organizational systems is maintained or controlled by its legal documents, policies and procedures, budgets and quality management programs. These managerial documents provide the standards and benchmarks for evaluating and improving organization’s and individual’s performance.

Hospital as a System
Systems theory concepts and principles can been applied to understand and explain hospitals and their operation. A hospital is defined as “any medical facility with an organized medical and professional staff and beds available for continuous hospitalization of patients formally admitted to it for medical observation, care, diagnosis, or surgical and non-surgical treatment” (Pan American Health Organization, 2004). Another definition is that a hospital is “an institution which provides beds, meals, and constant nursing care for its patients while they undergo medical therapy at the hands of professional physicians. In carrying out these services, the hospital is striving to restore its patients to health” (Miller 1997).

Hospitals are open systems that interact with the environment to complete necessary trades for survival of the system, growth, and fulfillment of systems’ goal. A hospital is a subsystem that exists within a hierarchy of other systems. King Abdullah University Hospital is a subsystem of the Jordanian health care system. Additionally, Hospitals are complex systems, since they contain large number of subsystems such as the radiology department, nursing services, housekeeping, food services, laundry, laboratory department and so. Each of these subsystems can be looked at as a system of its own.

Hospital systems consist of a pattern of organized relations where different components of the system are related to each other in a particular way. Organizational structures and charts constitute a graphical representation of these relationships. Hospital bylaws, rules, policies and procedures regulate these relationships.

Hospitals are subsystems of overall health care system of a nation. For example, hospitals in Amman are considered to be subsystems of the health care system in Jordan which is defined as the aggregate of all health care authorities and organizations that provide, finance, or monitor the provision of health care services to the inhabitants or visitors of Jordan and include hospitals, individual practitioners, health care centers, insurers, and other entities.

Information System: Another Example
An “information system” is defined as the organized combination of people, hardware, software, communication networks, and data resources that collects, stores, processes, transforms, displays, transmits disseminates and disposes information in accordance with defined procedures. An information system may be automated (e.g., a computerized information system) or manual (e.g., a library’s card catalog). Other examples of systems are health care system, hospital, and university.

References

  1. Pan American Health Organization, Health Analysis and Information Systems Area. Regional Core Health Data Initiative; Indicators Glossary. Washington DC, 2004.
  2. Miller, T.S. (1997) The Birth of the Hospital in the Byzantine Empire. Baltimore, MD: Johns Hopkins University Press.
  3. von Bertalanffy, Ludwig. General System Theory – A Critical Review. General Systems 1962; VII: 1-20.

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January 21st, 2012 at 7:09 am

System

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A system is an organized group of independent but interrelated elements or components comprising a whole with each element related to other elements.

  • A collection or a group of independent but interrelated components or elements organized to accomplish a specific function or set of functions. The organized components comprise a unified whole.
  • Any component that has no relationship with any other component of the system, cannot be a part of that system.
    The components of a system interface in order to facilitate the ‘flow’ of information, matter or energy.
  • A collection of component ideas, processes or objects which has an input and an output.

Videos:

  1. System thinking: Introduction (2:11)
  2. What is Systems Thinking? (2:20)
  3. Systems thinking is a way of appreciating complex social problems (1:59)
  4. A  day in the life of Sydney Children’s Hospital (8:59)
  5. Complex adaptive systems (1:01)
  6. Complex Adaptive System Theory by a nurse manager (4:47)
  7. A Day in the Life of a  Beth Israel Hospital in Boston (hospital is a system) (10:59)

See Also:

  1. Systems Theory

 

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January 21st, 2012 at 7:01 am

Health Informatics

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Health informatics is the intersection of information science, computer science, and health care. It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, dissemination and use of information in health and biomedicine.

Health informatics is the study and application of methods to improve the management of data, information and knwoledge relevant to patient care and community health.

Health informatics tools include not only computers but also clinical guidelines, health care terminologies, and information and communication systems.

Sub-domains of or health care informatics include: clinical informatics, nursing informatics, imaging informatics, consumer health informatics, public health informatics, dental informatics, clinical research informatics, bioinformatics, veterinary informatics, and pharmacy informatics.

Videos:

  1. What is Healthcare Informatics? by Stephan Kudayba (6:04)
  2. What is Health Informatics? by Dr. David Zitner (3:44)
  3. How one hospital is using health informatics to provide health care (4:40)
  4. Texas Children’s Hospital-Healthcare Information Systems (4:43)
  5. Health Informatics as defined by Edward Shortliffe (8:56)
  6. Informatics and Health Informatics by Don Detmer (3:17)

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January 21st, 2012 at 6:08 am

Informatics

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Informatics is the study of information, or more specifically, it is the term used to refer to the application of computer technology to the management of information. Informatics is primarily concerned with the structure, creation, management, storage, retrieval, dissemination and transfer of information. Informatics also includes studying the application of information in organizations, on its usage and the interaction between people, organizations and information systems.

Videos:

  1. What is Informatics? (2:05)
  2. University of Iowa View on Informatics (5:04)
  3. What is Informatics? by Edward Shortiffe (2:08)
  4. Informatics and Health Informatics by Don Detmer (3:17)

 

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January 21st, 2012 at 5:50 am

Supply Chain Management Software

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A Supply Chain Management Software (SCMS), is a specialized electronic information System for requisitioning, procurement, receipt, handling, distribution, and charge capture of supply and asset inventory control.

Key Features of Supply Chain Management Software:

  • Order Management
    SCMS can dramatically accelerate the execution of the entire order-to-delivery cycle by helping hospitals to more productively generate and track sales orders.
  • Dynamic Scheduling of Deliveries
    SCMS enables the dynamic scheduling of supplier deliveries to more effectively meet demand.
  • Purchasing and Procurement
    SCMS can fully automate and streamline all activities and tasks associated with  sourcing, purchasing, and payables.
  • Inventory Management
    SCMS can improve the way organizations track and manage their supplies of raw materials and components needed for providing health services.
  • Forecasting and Planning
    With a supply chain software, hospitals can more accurately anticipate demand, and plan their procurement accordingly. As a result, they can avoid unnecessary purchases of supplies, eliminate service over-runs, and prevent the need to store excess supplies in stores.
  • EDI for Supply Chain Management
    SCMS throguh Electronic Data Interchange allows organization link to its trading partners to electronically send transactions such as purchase orders, price/catalogs and invoices electronically.
  • RFID and Barcoding
    SCMS integrates RFID and Barcoding technologies in their operations.
  • User-Defined Cost Centers
    SCMS allows users to define cost centers as per facilities policies.
  • Accountablity and Tracking
    SCMS allows to track movement, and receipt of supplies and equipment and helps answers for the “who, what, when, and where” associated with the receipt, movement and consumption of each supply item.
  • Accurate Capture of Data and Cost Information
    Scanning technology used by SCMS facilitates ease of data capture while ensuring accuracy and point-of-care charge capture.
  • Surgical Instrument Management
    SCM helps hospitals gain greater visibility and control of surgical instruments, enabling hospitals to reduce costs through optimized instrument inventory levels, improved instrument utilization rates and increased productivity of staff assembling surgical trays. This will help hospital bottom line and enhance customer satisfaction by reducing the number of delayed or cancelled surgeries.
  • Efficient ordering
    Allows for more efficient ordering of supplies based on a more accurate overall picture of available inventories
  • Waiting time
    Helps to reduce wait time for supplies
  • Mobility
    SCMS allows for using a variety of delivery mediums (Desktop, PDAs, Web-based, and hard copy).
  • Return Management
    SCMS can simplify and accelerate the inspection and handling of defective, near expiry or expired supplies.
  • Contract Management
    SCMS helps organizations manage the creation of supplies purchasing contracts.
  • Management Reporting & Notification
    SCMS allows for vendor and contract compliance reporting; ad-hoc reporting; automated notifications. Reporting includes receiving reports, consumption reports, cost center reporting, and damage/return item reporting

Videos:

Human Resource Management Software

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A Human Resources Management System (HRMS) is an information system that combines a number of human resources management functions, including benefits administration, payroll, recruiting, training, performance analysis and review, and/or exit interview.

HRMS merges human resource management with information technology to simplify, streamline and automate the administrative processes (tasks) implemented by the Human Resources Management department. It enables the organization to reduce the workload of HR department and enhance the effectiveness and efficiency of operations by standardizing HR processes.

It can be used by small, medium and large organizations. With HRMS, all data pertaining to HRM is consolidated in one system (database).

Key Functions of HRMS

  1. Time Management. Effectively gathers and appraises employee time and work data. It allows easy tracking of employee’s information so that it can be assessed on a more scientific level whether an employee is performing to their full potential or not.
  2. Payroll. Most common function of HRMS. Automates the entire payroll process by gathering and updating employee payroll data on a regular basis. It also gathers information such as employee attendance, calculating various deductions and taxes on salaries, generating automatic periodic paychecks and handling employee tax reports.
  3. Benefits Management. Allows the human resource department to keep track of which benefits are being availed by which employee and how each employee is utilizing from the benefits provided. Benefits include health insurance, housing, retirement, …
  4. Recruitment and Hiring. HRMS helps in the process of recruitment. Automates and streamlines applications online and communication.
  5. Training. Administer and track employee training and development efforts;
  6. Performance Appraisal. Support organization’s efforts to assess and evaluate the performance of its employees.
  7. Leave Request. Automate the management of leave requests;
  8. Communication.  Automate the communication of supervisor approval for employee requests.
  9. Exit Interview. Automate and streamline the process of collecting valuable data to assess the overall quality of work-life; identifying employee issues that require resolution.
  10. Succession Management
  11. Termination Management
  12. Reminders and Alerts
  13. Disciplinary Management
  14. Reporting
  15. Orientation and New Employee Placement

Videos:

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December 18th, 2011 at 4:43 pm

National Drug Code (NDC)

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The NDC is a universal number that identifies a drug.

A National Drug Code (NDC) number is a unique number assigned to a product that identifies the manufacturer, drug, packaging size, and type. It appears on all drug labels

The National Drug Code (NDC) is a universal product code used as an identifier for every unique commercially available drug product for human use in the USA.

Developed by the Food and Drug Administration (FDA) in 1969.

FDA used the Drug Listing Act of 1972 to create a current list of all drugs manufactured, prepared, propagated, compounded, or processed by a drug establishment registered under the Federal Food, Drug, and Cosmetic Act.

The NDC system was originally established by Medicare as an essential part of an outpatient drug reimbursement program and as a method to identify drugs during commercial distribution.

NDC is used for

  • NDC is used for institutional billing.
  • The NDC is used to identify the manufacturer and the medicine
  • NDC  is used as identifier for drugs intended for human use.
  • The NDC is used to report prescribed drugs and biologics to enhance claim reporting .

NDC is used by

  • NDC numbers are used throughout the drug supply chain. Users extend from
    pharmaceutical firms,
    distribution system,
    medical community,
    insurance industry, and
    government

NDC can help to reduce or prevent medication errors, by assisting in the safe dispensing of medications. Outpatient pharmacists may use the NDC system to avoid confusion with look-alike/sound-alike drugs.

NDC help in the computerization of medication-related processes in health settings:

  • Supply chain
  • Ordering
  • Identifying
  • Decision support
  • Effectiveness evaluation

NDC Code is :

  • Up to 11 digits in length
  • Separated by hyphens (-) into three segments
  • Complete NDC is formatted 5-4-2, for a total of 11 digits:  12345-1234-12
  • The NDC is found on the drug container (that is vial, bottle, tube).
  • The first five digits identify the manufacturer of the drug and are assigned by the Food and Drug Administration. The remaining digits are assigned by the manufacturer and identify the specific product and package size.

NDC Code is comprised of 3-segments :

  1. The first segment is the “labeler” code.
    The first five digits identify the manufacturer of the drug and are assigned by the Food and Drug Administration.
    4-5 characters.
  2. The second segment is the “product” code.
    It identifies the strength, dosage form and formulation.
    3-4 characters.
  3. The third segment is the “package” code.
    identifies package size.
    1-2 characters

Links

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December 13th, 2011 at 8:57 am

Time and Attendance Software

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Time and attendance software is a computerized information system used by organizations to effectively and efficiently manage employees work time.  It collects employee time data and enters the information into a database. The collected data is reviewed and approved by a supervisor so it can be used for payroll processing and custom reports.

KEY FUNCTIONS (FEATURES)
The System:

  • Accurately captures and monitors real-time employee data;
  • Enforces work rules and regulations;
  • Eliminates buddy-punching;
  • Provides payroll with accurate information (interfacing vs. integrating); Transfers the hours worked, overtime, department, holidays, sick time, and vacation time;
  • Enables employees to view job-related time and employee information, including: schedules, time cards, accrued or used benefits, and exception history.
  • Collects exceptions defined within the payroll rule assigned to each employee;
  • Enables supervisors to view exceptions by employee in a calendar format;
  • Provide comprehensive employee statistics, from badge listings to overtime calculations;
  • Schedules can handle organization’s full range of conditions;
  • Schedules conform to relevant government requirements

BENEFITS to the ORGANIZATION

  • Accurate Tracking. A time and attendance system automates the process of tracking employees as they check in and out for work leading to accurate time data for each employee and fewer payroll processing errors (effectiveness).
  • Increased Efficiency. Time and attendance systems enable managers to monitor employee hours in real-time, track hours, unauthorized overtime, and create detailed reports about individual employees. Benefits include better schedule and workforce management and less human error in the payroll cycle.
  • Cost Control. Time and attendance systems can reduce payroll costs significantly. Better labor tracking can eliminate thousands in over payments and significantly lessen the work load of the payroll department.
  • Employees Satisfaction. Employees are satisfied that they are being paid accurately.
  • Audit Trail. Time records available when companies are audited, providing a detailed trail of employee exceptions and supervisor approvals.
  • Regulatory compliance. An effective time and attendance management software is a powerful tool in ensuring that the organization is complying with regulations pertaining to human resources management.

Videos:

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November 24th, 2011 at 6:27 am

Healthcare Common Procedure Coding System

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The Healthcare Common Procedure Coding System (HCPCS) is a set of health care procedure codes. Commonly pronounced Hick-Picks.

The Healthcare Common Procedure Coding System (HCPCS) was established in 1978 to provide a standardized coding system for describing the specific items and services provided in the delivery of health care.

  • HCPCS is the standard HIPAA code set for reporting supplies, orthotic and prosthetic devices, and durable medical equipment. In combination with the Current Procedure Terminology (CPT) codes, it is also used to report physician and other health care services.
  • HCPCS is one of the formats in which drugs and biologics may be coded for reimbursement and other reporting for non-retail pharmacy settings. (NDC is an alternative. The HIPAA regulations do not at present designate a single standard for this purpose.)
  • Health insurance plans process billions of claims every year. HCPCS codes were developed to help ensure that claims could be processed in a consistent and simplified way. HCPCS codes are divided into three subsystems: level I, level II and level III, each designated for a specific purpose.
  1. HCPCS Codes – Level ILevel I HCPCS codes are made up of CPT-4 codes (a numeric coding system devised by the American Medical Association). Health care professionals use this notation to identify services and procedures, for which they bill insurance programs. Level I HCPCS codes consist of 5 numeric digits.
  2. HCPCS Codes – Level II (Alpha-numeric codes)
    Level II HCPCS codes identify products, supplies, materials and services which are not included in the CPT-4 code, such as ambulance services, prosthetics, medical equipment and supplies when used outside a medical office. Level II HCPCS codes are also called alpha-numeric codes because they consist of one letter followed by 4 numeric digits.
  3. HCPCS – Level III (Local Codes)
    Level III HCPCS codes are developed by Medicaid State Agencies, Medicare contractors and private insurers for use in specific programs and jusrisdictions. HCPCS Level III codes are also called local codes. These codes allow insurers to electronically process claims for new services for which a level I or level II code has not yet been established.

Videos:

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November 22nd, 2011 at 4:27 am

Interoperability : Defined

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November 8th, 2011 at 1:29 am

Diagnosis Related Groups (DRGs)

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Diagnosis Related Groups (DRGs): A classification system that groups patients according to principal diagnosis, presence of a surgical procedure, age, presence or absence of significant comorbidities or complications, and other relevant criteria.

Diagnosis-related group (DRG) is a U.S. system to group and classify hospital cases into different groups (more than 500) on the basis of diagnosis/diagnoses, procedures, age, sex, discharge status, and the presence of complications or comorbidities.

A DRG is based upon the principal ICD-9-CM diagnosis code, ICD-9-CM surgical procedure code, age of patient, and expected length of stay in the hospital that will be reimbursed, independently of the charges that the hospital may have incurred

Cases within each category are similar clinically and are expected to use the same level of hospital resources

This system was developed for Medicare use as part of the prospective payment system.

DRGs have been used in the US since 1983 to determine how much Medicare pays participating hospitals. A DRG is a payment category that is used to classify patients, especially Medicare patients, for the purpose of reimbursing hospitals for each case in a given category with a fixed fee regardless of the actual costs incurred.

List of 2010 Diagnosis Related Groups (DRG’s)
List of 2006 Diagnosis Related Groups (DRG’s)

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November 4th, 2011 at 3:45 am

Smart Slippers

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April 21st, 2011 at 8:50 am

Personal Health Records Explained

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April 19th, 2011 at 6:07 am

Personal Health Record (PHR)

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What is a PHR?
An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

A personal health record or PHR is typically a health record (a collection of important information) that is initiated and maintained by an individual. It is different than patient  health record, which includes  information about one’s health compiled and maintained by healthcare providers. An ideal PHR would provide a complete and accurate summary of the health history of an individual by gathering data from many sources and making this information accessible online to anyone who has the authorization to view the information.

The information contained in a PHR will come from different healthcare providers (doctor, dentist, physio-therapists, …), but it is maintained and managed by the individual

PHR allows patients to store and access their health information electronically. PHR helps an individual plan and document any care or treatment he/she is receiving. PHRs have the potential to give individuals more control over their health information — collecting, using, and sharing it as they see fit.

Uses and Benefits of PHR:

  • Collect and store patient information;
  • Collect and store information from a patient’s health care provider;
  • Convert clinical information into more easily understood language;
  • Describe to patients ways to improve their health based on their information;
  • Make it possible for patients to take action on their information;
  • Track appointments, vaccinations, and other services;
  • Improve the quality of care you they receive;
  • Provide timely information when receiving emergency care and ensure access to vital health information;
  • Reduce costs by eliminating duplicate tests

In general, PHRs contain the following types of health information:

  • allergies and adverse drug reactions
  • chronic diseases
  • family history
  • illnesses and hospitalizations
  • imaging reports (e.g. x-ray)
  • immunization records
  • laboratory test results
  • medications and dosing including over the counter medications and herbal remedies
  • surgeries and other procedures
  • vaccinations
  • and Observations of Daily Living (ODLs)

Examples:

Videos

 

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April 19th, 2011 at 4:44 am

Epidemiological Studies

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Case Report (case series)
A case report is a descriptive study of a single individual (case report) or small group (case series) in which the possibility of an association between an observed effect and a specific exposure is based on detailed clinical evaluations and histories of the individual(s). They are most likely to be useful when the disease is rare and when it is caused exclusively or almost exclusively by a single kind of exposure. Case reports (or case series) may be first to provide clues in identifying a new disease or adverse health effect from an exposure.

Case Control Studies
Case-control is a type of epidemiological study design. In a case-control study, individuals with a disease are matched with people who do not have the disease (the ‘controls’). Further data are then collected on those individuals and the groups are compared to find out if other characteristics  are also different between the two groups. Case-control design is typically used for retrospective studies, but can also be applied to prospective studies as well.

Cohort Study
A cohort study is a  study design used in epidemiology. It first identifies individuals on the basis of their exposure to a disease causing factor, such as exposure to a toxic chemical or other factor that may be implicated in a disease. It begins by taking a group of people who are free from the disease of interest. The epidemiologist then follows the individuals over a period of time and observes new occurrences of the disease. It is called a cohort because a cohort of individuals refers to a group of individuals who are similar with respect to exposure to a certain disease causing factor.

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April 12th, 2011 at 4:17 am

Server

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In information systems, a server is any combination of hardware or software designed to provide services to clients. When used alone, the term typically refers to a computer which may be running a server operating system, but is also used to refer to any software or dedicated hardware capable of providing services.

  • A computer that delivers information and software to other computers linked by a network.
  • A computer designated for supplying information in many forms, so that other computers can use it. Common servers are Web servers, proxy servers , mail servers, and file servers.
  • A computer, or a software package, that provides a specific kind of service to client software running on other computers. The term can refer to a particular piece of software, such as a WWW server, or to the machine on which the software is running.

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April 6th, 2011 at 10:11 am

mHealth

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  • mHealth is short for “mobile health.”
  • mHealth is term used to refer to provision of health care supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones and PDAs, for health services and information.
  • mHealth is not one single technology. mHealth is an ecosystem and takes advantage of a lot of existing, mature technology — hardware, software, local wireless communications and telecommunications infrastructure.
  • The mHealth field has emerged as a sub-segment of health informatics.
  • mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vital signs, and direct provision of care.

Videos

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April 5th, 2011 at 6:37 am

Poverty .. Definition

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Poverty refers to the condition of having little or no money and few or no material possessions. Poverty is the state of being poor or indigent and not affording basic human needs such as clean water, nutrition, health care, education, clothing and shelter.

Poverty is a key social determinant of health.

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April 5th, 2011 at 3:16 am

Blade Server

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A blade server is a compact computer server (a tightly compressed computer processing unit). The blades are designed to work with the rack, as they do not have their own power, cooling or protective covers.

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April 5th, 2011 at 3:07 am

Authentication

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Authentication is the procedure of determining whether someone is, in fact, who he/she declares to be. Authentication is generally required to access secure data or enter a secure area.

  • In information systems, user Authentication refers to the process of determining user’s identity as well as determining what a user is authorized to access {Who and What}.
  • Authentication typically involves the use of a user name and password; certificate, PIN, digital signature and other information that can be used to validate the identity over a network.
  • User authentication ensures that the right information gets to the right person.
  • Example: Hospital admission clerk accesses the information system using her username and password, which allows her access to the admission module of the system, but not other parts of the system.

وبالعربية الإستيقان أو التوثق من الشخصية وهي عملية التوثق من شخصية المستخدم الذي يسعى للوصول إلى بيانات ومعلومات محمية. وتحدد عملية التوثق الشخصية ومستوى الإطلاع (النفاذية) والصلاحيات المسموح بها لهذا الشخص

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April 5th, 2011 at 2:59 am