Institute of Medicine, Computer-Based Patient Record, Washington, D. C. National Academy Press, 1991 C.J. McDonald et al.,The benefits of automated medical record systems for ambulatory care, "in Proceedings of the Computer Applications in Medical Care Conference, New York: IEEE Computer Society, Pp. 157-171 October 1986 W.W. Stead et al., Practicing nephrology with a computerized medical record, Kidney Int, vol. 24, Pp 446-454 Q. E. Whiting-OKeefe et al., "A computerized summary medical record system can produce more information than the standard medical record, "in Proceedings of MedInfo 86, Washington, D. C, 1986 High-Performance Computing and Communications, (HPCC D.A. Bromley, The Federal High-Performance Computing Program, Washington, D. C. Executive Office of the President, Office of Science and Technology Policy, 1989 Tational High-Performance Computer Technology Act, "Congressional Record, U.S. Senate 101st Congress, First Session 5/18/89, Washington, D.C. Smart/Optical Cards Handbook of Optical Memory Systems. Bi-monthly updating service. Boston: Medical Records Institute. Proceedings of the 13th Annual International Conference IEEE/EMBS, Track 21: Session 5, Medical Informatics V: Optical and Smart Cards, Orlando, Fla, Pp. 1387-1392, October 1991. 1989 Smart Card Industry Directory, Palo Alto, Calif. Palo Alto Management Inc., 1989 117.2 Hospital Information Systems Matthew e. baretich What does an electrical engineer need to know to be part of a team designing and implementing a hospital information system? For the most part, the necessary skills are those required to design and implement any comprehensive information system in a complex organization. Hospitals do, however, have unique characte istics that must be taken into account. These characteristics are described in the following pages. The Clinical environment Hospitals are, indeed, complex organizations. They perform a vital function(patient care) but are subject to trict regulation and operate under severe financial constraints. Quality of patient care is the highest value, but a competitive marketplace demands efficient operation. Hospital information systems range from nonexistent Hospitals are highly professionalized. Each professional group has a particular area of expertise and a unique perspective regarding the healthcare delivery system. Hospital administrators are much like administrators of ther organizations. Recent graduates essentially have standard Master of Business Administration) degrees with some extent of healthcare specialization. However, many administrators in positions of authority from schools than with business schools Hospitals also have large clinical staffs which include nurses and technologists(who are hospital employees) and medical doctors(who are usually not hospital employees). Clinicians are educated in the biological and medical sciences, and their preparation generally includes a large component of practical experience in the pital as well as theoretical study in the classroom. As hospital employees, nurses and technologists(respi- ratory, laboratory, etc )are part of the administrative structure of the hospital Medical doctors(physicians and geons),on the other hand, are part of a separate medical staff structure that is largely independent of the hospitals administrative structure. However, medical doctors control the admission and discharge of the hospitals patients, and many hospital activities are the result of medical orders for patient services e 2000 by CRC Press LLC© 2000 by CRC Press LLC Institute of Medicine, Computer-Based Patient Record, Washington, D.C.: National Academy Press, 1991. C.J. McDonald et al., “The benefits of automated medical record systems for ambulatory care,” in Proceedings of the Computer Applications in Medical Care Conference, New York: IEEE Computer Society, pp. 157–171, October 1986. W.W. Stead et al., “Practicing nephrology with a computerized medical record,” Kidney Int., vol. 24, pp. 446–454, 1983. Q.E. Whiting-O’Keefe et al., “A computerized summary medical record system can produce more information than the standard medical record,” in Proceedings of MedInfo ’86, Washington, D.C., 1986. High-Performance Computing and Communications, (HPCC) D.A. Bromley, “The Federal High-Performance Computing Program,” Washington, D.C.: Executive Office of the President, Office of Science and Technology Policy, 1989. “National High-Performance Computer Technology Act,” Congressional Record, U.S. Senate 101st Congress, First Session 5/18/89, Washington, D.C. Smart/Optical Cards Handbook of Optical Memory Systems. Bi-monthly updating service. Boston: Medical Records Institute. Proceedings of the 13th Annual International Conference IEEE/EMBS, Track 21: Session 5, Medical Informatics V: Optical and Smart Cards, Orlando, Fla., pp. 1387–1392, October 1991. 1989 Smart Card Industry Directory, Palo Alto, Calif.: Palo Alto Management Inc., 1989. 117.2 Hospital Information Systems Matthew F. Baretich What does an electrical engineer need to know to be part of a team designing and implementing a hospital information system? For the most part, the necessary skills are those required to design and implement any comprehensive information system in a complex organization. Hospitals do, however, have unique character￾istics that must be taken into account. These characteristics are described in the following pages. The Clinical Environment Hospitals are, indeed, complex organizations. They perform a vital function (patient care) but are subject to strict regulation and operate under severe financial constraints. Quality of patient care is the highest value, but a competitive marketplace demands efficient operation. Hospital information systems range from nonexistent to antique to state-of-the-art. Hospitals are highly professionalized. Each professional group has a particular area of expertise and a unique perspective regarding the healthcare delivery system. Hospital administrators are much like administrators of other organizations. Recent graduates essentially have standard MBA (Master of Business Administration) degrees with some extent of healthcare specialization. However, many administrators in positions of authority received MHA (Master of Hospital Administration) degrees from programs more closely affiliated with medical schools than with business schools. Hospitals also have large clinical staffs which include nurses and technologists (who are hospital employees) and medical doctors (who are usually not hospital employees). Clinicians are educated in the biological and medical sciences, and their preparation generally includes a large component of practical experience in the hospital as well as theoretical study in the classroom. As hospital employees, nurses and technologists (respi￾ratory, laboratory, etc.) are part of the administrative structure of the hospital. Medical doctors (physicians and surgeons), on the other hand, are part of a separate medical staff structure that is largely independent of the hospital’s administrative structure. However, medical doctors control the admission and discharge of the hospital’s patients, and many hospital activities are the result of medical orders for patient services