Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.
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http://dx.doi.org/10.1007/s10916-009-9375-5 | DOI Listing |
Healthc Manage Forum
January 2025
University of Toronto, Toronto, Ontario, Canada.
Healthcare is a surprisingly large contributor to climate change, responsible for a significant quantity of global Greenhouse Gas (GHG) emissions. Global commitments to achieve "net zero" health systems, including by the federal government in Canada, suggest a growing need to understand and mobilize capacity for GHG emissions estimation across Canada's health sector. Our analysis highlights efforts by public sector healthcare organizations in Canada to estimate an increasingly broad scope of GHG emissions, building on longstanding efforts to report or reduce energy-related emissions from facilities.
View Article and Find Full Text PDFAddict Sci Clin Pract
January 2025
Health Services Research & Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way, Mail Stop S-152, Seattle, WA, 98108, USA.
Background: Unhealthy alcohol use is an independent, modifiable risk factor for HIV, but limited research addresses alcohol use and HIV prevention synergistically. Groups that experience chronic stigma, discrimination, and/or other marginalization, such as sexual and gender minoritized groups, may have enhanced HIV risk related to unhealthy alcohol use. We described awareness of and experiences with pre-exposure prophylaxis (PrEP) among a community sample of Veterans reporting unhealthy alcohol use (relative to those without), overall and across self-reported sexual orientation and gender identity.
View Article and Find Full Text PDFBMC Health Serv Res
January 2025
VA Center for Health Equity Research and Promotion, Pittsburgh, PA, USA.
Background: Because cirrhosis is often unrecognized, we aimed to develop a stepwise screening algorithm for cirrhosis in the Veterans Health Administration (VHA) and assess this approach's feasibility and acceptability.
Methods: VHA hepatology clinicians ("champions") were invited to participate in a pilot program from June 2020 to October 2022. The VHA Corporate Data Warehouse was queried to identify Veterans with possible undiagnosed cirrhosis using Fibrosis-4 (FIB-4) ≥ 3.
BMC Health Serv Res
January 2025
Laboratory of Innovation for Healthcare (Linc), Postgraduate Program in Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
Background: Inadequate medication knowledge and medication nonadherence by patients are considered an issue in healthcare, as they can lead to negative outcomes, such as therapeutic failures and hospitalization. Even though drug dispensing, which has pharmacist counseling as a core element, is a service traditionally performed by pharmacists, there is still no evidence about the influence of this service on these health outcomes.
Objective: To evaluate the influence of drug dispensing on patients' medication knowledge and medication adherence.
Syst Rev
January 2025
Division of Epidemiology & Biostatistics, School of Public Health, University of Cape Town, Cape Town, South Africa.
Introduction: Human mobility is associated with an increased risk of HIV acquisition and disengagement from HIV care, leading to poorer health outcomes among highly mobile individuals compared to less mobile individuals. Mobile individuals, broadly defined as those who temporally, seasonally, or permanently move from one place to another for voluntary or involuntary reasons, face many challenges in accessing HIV care services. These challenges include logistical difficulties, interruptions in HIV care continuity, and limited access to services across different locations, which together hinder timely testing, treatment initiation, and viral suppression.
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