Sinforsa - SIMRS

Alternatif Software INA-DRG

2009-08-26T20:25:00.001-07:00

http://ina-drg.blogspot.com/2009/08/alternatif-software-ina-drg.html

Alternatif Software INA-DRG

2009-08-26T20:25:00.000-07:00

http://ina-drg.blogspot.com/2009/08/alternatif-software-ina-drg.html

WALK IN INTERVIEW

2009-06-01T21:12:00.001-07:00

ARISTA MITRA LESTARI, PT (HONDA MANGGA DUA)

Company Description

WALK IN INTERVIEW

Arista Group adalah perusahaan yang bergerak di bidang penjualan automotif baik mobil dan motor. Saat ini Perusahaan merupakan salah satu group dealer motor Yamaha yang terbesar dengan daerah pemasaran di DKI Jakarta, Jawa Barat dan Lampung. Perusahaan juga mempunyai beberapa dealer resmi mobil Honda di daerah DKI Jakarta, Depok dan Medan.

Saat ini Perusahaan sedang berkembang pesat dan membutuhkan para profesional berkualitas yang mempunyai motivasi tinggi untuk bergabung bersama Perusahaan untuk menjawab tantangan sebagai berikut :

STAFF IT

(Programmer / Support)

STAFF IT (Programmer / Support)

Post Date: 01 Jun 09

Persyaratan :

Pria usia maksimal 30 tahun.
Pendidikan S1 - komputer (Teknik Informatika / Teknik komputer / Mngm Informatika)
Mengusai RDBMS ( Sybase, SQL Server); Aplikasi database server : MySQL, SQL2000, MS Access; tool programming PC; Aplikasi Web Base : Visual Basic, C-Sharp, Delphi, HTML, ASP, PHP, Javascript; Aplikasi reporting : Crystal Report (IT-Programmer)
Menguasai LAN/WAN Environment untuk Enterprise configuration : switching Layer2/3, routing, VoIP, Firewall, Security; Wireless Environment : Access point, Wireless Client, Point to Point (IT-Support)
Lebih disukai jika memiliki ijazah/sertifikasi keahlian/pelatihan dari ventor IT : Microsoft, Cisco, Novell, SCO, Linux dengan titik berat pada sisi Software/Aplikasi Development (IT-Programmer); Memiliki kemampuan dasar mengelola : query, backup, dan restore database : SQL, MySQL (IT-Support)
Menguasai Aplikasi-aplikasi penunjang pekerjaan : MS Office, MS Project, Vision; Aplikasi Desktop Operation System : Window98, ME 2000 Professional, XP dan Windows Server (IT-Programmer / IT- Support)
Memiliki kemampuan administrasi dan dapat membuat laporan hasil kerja dengan baik (IT-Programmer / IT- Support)
Pengalaman minimal 1 thn diposisi yang sama sebagai programmer atau technical support (IT-Programmer / IT- Support)
Bersedia ditugaskan diluar kota (IT-Support)
Memiliki motivasi kerja yang tinggi, sanggup bekerja keras, dapat bekerja secara individu ataupun team work, serta memiliki integritas yang tinggi.

Bagi yang memenuhi persyaratan : kami memberikan gaji, Kompensasi & benefit, pelatihan, jenjang karir, yang menarik bagi yang terpilih.

Datang & bawalah Surat Lamaran, Daftar Riwayat Hidup, Copy KTP, dan Pas Photo terbaru.

Hari : Kamis

Tanggal : 4 Juni 2009

Waktu : 08.30 – 11.00 WIB

Tempat : Gedung Yamaha ARISTA Kalimalang

Jl. Raya Kalimalang No. 19

Jakarta Timur 13440

CAREER OPPORTUNITIES

2009-06-01T21:09:00.000-07:00

SINERGI DAYA MITRA, PT

Company Description

CAREER OPPORTUNITIES

SDM, a brand name of PT Sinergi Daya Mitra, is a fast growing national company specializing in providing innovative solutions in Human Capital Management.

We urgently required Experienced and Potential Candidates for project-based (contract)assignments (extendable) for the following position:

Application Support (AS)

Post Date: 02 Jun 09

Requirements:

Male / Female
Minimum Bachelor Degree (S1) in computer science and management information system
Minimum 2 years of experience as Programmer/ Application Support
Having knowledge in Banking business process/ knowledge
Have good knowledge in MS SQL Server
Have good knowledge in oracle
Have good knowledge in java
Have knowledge in VB
Have knowledge in C++

Only short-listed candidates will be notified

If you meet above requirements, send your application letter and resume along with expected remuneration to karir@dayamitra.com with position code on the subject line. Or send to

PT SINERGI DAYA MITRA

Menara KADIN Indonesia 30^th Floor

Jl. H.R. Rasuna Said X-5 Kav.2-3

Jakarta 12950

Software INA-DRG Depkes dapat digunakan dalam jaringan LAN

2009-05-18T20:51:00.000-07:00

Software INA-DRG Depkes dapat digunakan dalam jaringan LAN

Software entry data INA-DRG Depkes dapat digunakan dalam lingkup jaringan LAN.
Selengkapnya klik link berikut:
http://ina-drg.blogspot.com/2009/05/software-ina-drg-depkes-dapat-digunakan.html

Exploring Security Fundamentals

2009-05-13T18:41:00.000-07:00

Exploring Security Fundamentals

A “secure network” is a moving target. As new vulnerabilities and new methods of attack are discovered, a relatively unsophisticated user can potentially launch a devastating attack against an unprotected network. This section begins by describing the challenges posed by the current security landscape. You will learn about the three primary goals of security:

confidentiality, integrity, and availability.

This section also explains traffic classification and security controls. You will learn how to respond to a security violation and consider the legal and ethical ramifications of network security.

Why Network Security Is a Necessity

Network attacks are evolving in their sophistication and in their ability to evade detection.

Also, attacks are becoming more targeted and have greater financial consequences for their victims.

Types of Threats

Connecting a network to an outside network (for example, the Internet) introduces the possibility that outside attackers will exploit the network, perhaps by stealing network data or by impacting the network’s performance (for example, by introducing viruses).

However, even if a network were disconnected from any external network, security threats (in fact, most of the probable security threats) would still exist.

Specifically, according to the Computer Security Institute (CSI) in San Francisco, California, approximately 60 to 80 percent of network misuse incidents originate from the inside network. Therefore, although network isolation is rarely feasible in today’s e-business environment, even physical isolation from other networks does not ensure network security.

Based on these factors, network administrators must consider both internal and external threats.

Internal Threats

Network security threats originating inside a network tend to be more serious than external threats. Here are some reasons for the severity of internal threats:

¦ Inside users already have knowledge of the network and its available resources.

¦ Inside users typically have some level of access granted to them because of the nature of their job.

¦ Traditional network security mechanisms such as Intrusion prevention Systems (IPS)and firewalls are ineffective against much of the network misuse originating internally.

External Threats

Because external attackers probably do not have intimate knowledge of a network, and because they do not already possess access credentials, their attacks tend to be more technical in nature. For example, an attacker could perform a ping sweep on a network to identify IP addresses that respond to the series of pings. Then, those IP addresses could be subjected to aport scan , in which open services on those hosts are discovered. The attacker could then try to exploit a known vulnerability to compromise one of the discovered services on a host. If the attacker gains control of the host, he could use that as a jumping-off point to attack other systems in the network.

Fortunately, network administrators can mitigate many of the threats posed by external attackers. In fact, the majority of this book is dedicated to explaining security mechanisms that can defeat most external threats.

National IT Consultant seeks Software Dev. Manager

2009-01-12T03:40:00.000-08:00

SOFTWARE DEVELOPMENT MANAGER

A Pioneer in medical healthcare software development company currently requires software development manager with the following requirements :

Detail knowledge of software development life cycle and methodologies is a must. Furthermore, knowledge of software configuration management and product lifecycle management will be a definite advantage.

Previous hands-on experience in developing client and server side components for 3-tier client/server or web based application, network/socket programming, Java (Enterprise Edition), BEA WebLogic, JSP, HTML is a must.

Knowledgeable in Power Builder.

Proven track record in developing mission critical - enterprise grade, preferably ERP software application.

Having excellent management skill is must, driven, result oriented but also a good team-player.

Bachelor or master degree from a reputable university majoring in Computer Science/Engineering or business.

Mature, age between 30-40 years old with min. 5-10 years experience in managing software development projects.

Please send your CV to hrd@bvk.co.id. Strict confidentiality is maintained.

Common Errors in Patient Education

2008-12-30T17:46:00.001-08:00

One of the most important aspects of the nurse’s role is to educate patients. To do that effectively, there are a couple of points that nurses (as well as other health care professionals) should be aware of.

One is that health care illiteracy affects over one half of all Americans. Regardless of their ability to read and write, or their level of education, Americans don’t understand the health care system and how it works. They don’t even understand enough most of the time to know that they don’t understand.

The other point is that as a result of this problem, the Institute for Health Care Advancement (IHA)points out that costs are continuing to rise to the point of, “as much as $236 billion in unnecessary health care expenses annually due to the inability of patients to understand what medical providers are communicating to them.”

The IHA has complied a guide for health care professionals and consumers to help eliminate some of these problems. This list is composed of the 10 Most Common Errors Medical Professionals Make When Communicating with Their Patients.

Some of the points in this document include:

Prescription drug instructions are often written at a 10th or 11th grade reading level. Most of the population reads at a 5th grade level.
Communicating with patients using medical or other technical jargon such as “otitis media” or “myocardial infarction” instead of using laypersons’ terms such as “ear ache” or heart attack.”
Telling patients to go read about their condition, treatments or medications on the Internet when this information might be too complex, might disagree with the physician’s course of treatment, or the patient may not have access or know how to search the Internet.
Handing out reading material which is printed in too small a font to be easily read, especially by seniors who represent the largest portion of the population.
Not using simple graphics or other visual aids to enhance the patient’s understanding.
Not recognizing that the patient is nodding or saying “yes” as more of a means to be polite and not necessarily because s/he understands what is being said.

Providers should always ask patients to repeat back to them in their own words what they interpret to be the information or instructions given to them. Tis is the best way for the provider to be sure the patient understands correctly and then to make clarifications as needed.

Not demonstrating cultural awareness and how cultural differences may affect the patient’s ability to comply and to succeed with a treatment or other regimen.

Speaking too quickly and not allowing the patient time to formulate or ask questions.
Not providing the information and instructions in the patient’s first language.
Not taking time to adequately explain the meaning of terms on prescription drug labels. For example, “Take With Food,” is written at a 1st or 2nd grade level, but what does it really mean? Studies have shown that some patients have interpreted this as meaning stuffing the pill into a piece of solid food and swallowing it without taking any liquid. This could have varying degrees of problems depending upon the drug and even the size of the pill.

Other problems patients typically have difficulty with include how and when to make follow up appointments, where to go for tests, and even which medications should be refilled and continued versus a course of antibiotics.

Even the most highly educated patients may not understand medical information. Nurses, as the primary health educators, need to understand how to educate patients as well as how to evaluate the patient’s understanding before they leave.

Resources:
IHA (http://iha4health.org)
Helen Osborne M.Ed.,OTR/L, Health Literacy Consulting (http://healthliteracy.com)
By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the author/owner of TheNursingSite.com

Issues in health information

2008-12-28T23:05:00.000-08:00

Improving the use of information for health care decision-making: what is needed
World Health Organization / World Health Organization (WHO) (2005)

This paper, published by the World Health Organization, describes how health information systems work and considers how countries can reform them. It argues that some types of data are oversupplied whilst in other areas there are large unmet needs of information. Although many countries now have relatively good data on levels of (and trends in) child mortality, health services coverage, and health determinants, information on adult mortality and cause of death is not generally available. Other areas where better information is needed include: morbidity; coverage and costs of interventions; and equity. The use of information to inform decision- making is also weak at all levels of the healthcare system.
The paper calls for investment in sustainable national and sub-national health information systems and argues that countries will benefit greatly if such systems are based upon a national plan with a policy framework; core indicators; and data-collection, analysis and dissemination strategies. It also calls for national bodies to guide and oversee the implementation of the plan,
with full participation of stakeholders, users, and technical experts. International investors in health information should buy in to and support the country strategies. Collaborative efforts at the international level, such as the recently launched Health Metrics Network, are also important.

Available online at: http://www.who.int/healthmetrics/library/issue_1_05apr.doc

Why Health Care Information Systems Succeed or Fail

2008-12-28T22:59:00.000-08:00

Heeks, R.; Mundy, D.; Salazar, A. / Institute for Development Policy and Management (IDPM), Manchester (1999)
This document offers an understanding and model of why health care information systems succeed or fail, and with general guidance on how to avoid HCIS failure.

Some health care information systems (HCIS) do succeed, but the majority are likely to fail in some way. To explain why this happens, and how failure rates may be reduced, this paper describes the 'ITPOSMO' model of conception-reality gaps. This argues that the greater the change gap between current realities and the design conceptions (i.e. requirements and assumptions) of a new health care information system, the greater the risk of failure. Three archetypal large design-reality gaps affect the HCIS domain and are associated with an increased risk of failure:
• Rationality-reality gaps: that arise from the formal, rational way in which many HCIS are conceived, which mismatches the behavioural realities of some health care organisations

• Private-public sector gaps: that arise from application in public sector contexts of HCIS developed for the private sector.
• Country gaps: that arise from application in one country of HCIS developed in a different country.
Some generic conclusions can be drawn about successful approaches to HCIS development. Examples include the need for more reality-oriented techniques and applications, and greater use of participative approaches to HCIS. More specifically, techniques can be identified for each of the seven ITPOSMO dimensions that will help close the gap between conception and reality. This can include the freezing of one or more dimensions of change. Such techniques will help improve the contribution that information systems can make in health care organisations. [author]

Available online at: http://www.sed.manchester.ac.uk/idpmpublications/wp/igov/igov_wp09.shtml

Using a simple health care information system for health sector reform and health system management

2008-12-28T22:54:00.000-08:00

A guide to using the InHCC health management information system

Shankle, C.G.; Shiroma, M.G.; Gonzalez, J.G. / International Health Care Consultants (InHCC) (2002)

This paper, published by International Health Care Consultants (InHCC), presents a simple health management information system (HMIS) for collecting data to be used in the management of health sector reform policy. The system is intended to be easy to use and inexpensive. It focuses on the collection of information that measures six key dimensions of health system performance: access, effectiveness, efficiency, equity, quality, and sustainability. The paper argues that the information collected can be used not only to guide national policies, but also to direct the day-to-day management of the individual clinic or health centre and provide quality of care to the client.
The paper’s chapters cover: the purpose, definitions and framework for the InHCC system; a description of the system itself; dealing with client, household, and medical system information; and programming the system’s software. The system proposed involves rural clients using a low-cost computer system connected to the internet, and storing data in a centralised "data warehouse". Specialised computer applications for data processing can then be used to provide useful information for decision makers from the local level up to national and international level without the need for further processing.

Available online at: http://www.shetu.com/InHCc-Documentation.pdf

Virtual Private Networks

2008-12-28T17:43:00.000-08:00

Background

Virtual private networks (VPNs) are a fairly quixotic subject; there is no single defining product, nor even much of a consensus among VPN vendors as to what comprises a VPN. Consequently, everyone knows what a VPN is, but establishing a single definition can be remarkably difficult. Some definitions are sufficiently broad as to enable one to claim that Frame Relay qualifies as a VPN when, in fact, it is an overlay network. Although an overlay network secures transmissions through a public network, it does so passively via logical separation of the data streams.

VPNs provide a more active form of security by either encrypting or encapsulating data for transmission through an unsecured network. These two types of security—encryption and encapsulation—form the foundation of virtual private networking. However, both encryption and encapsulation are generic terms that describe a function that can be performed by a myriad of specific technologies. To add to the confusion, these two sets of technologies can be combined in different implementation topologies. Thus, VPNs can vary widely from vendor to vendor.

This chapter provides an overview of building VPNs using the Layer 2 Tunneling Protocol (L2TP), and it explores the possible implementation topologies.

Layer 2 Tunneling Protocol

The Internet Engineering Task Force (IETF) was faced with competing proposals from Microsoft and Cisco Systems for a protocol specification that would secure the transmission of IP datagrams through uncontrolled and untrusted network domains. Microsoft's proposal was an attempt to standardize the Point-to-Point Tunneling Protocol (PPTP), which it had championed. Cisco, too, had a protocol designed to perform a similar function. The IETF combined the best elements of each proposal and specified the open standard L2TP.

The simplest description of L2TP's functionality is that it carries the Point-to-Point Protocol (PPP) through networks that aren't point-to-point. PPP has become the most popular communications protocol for remote access using circuit-switched transmission facilities such as POTS lines or ISDN to create a temporary point-to-point connection between the calling device and its destination.

L2TP simulates a point-to-point connection by encapsulating PPP datagrams for transportation through routed networks or internetworks. Upon arrival at their intended destination, the encapsulation is removed, and the PPP datagrams are restored to their original format. Thus, a point-to-point communications session can be supported through disparate networks. This technique is known as tunneling.

Operational Mechanics

In a traditional remote access scenario, a remote user (or client) accesses a network by directly connecting a network access server (NAS). Generally, the NAS provides several distinct functions: It terminates the point-to-point communications session of the remote user, validates the identity of that user, and then serves that user with access to the network. Although most remote access technologies bundle these functions into a single device, L2TP separates them into two physically separate devices: the L2TP Access Server (LAS) and the L2TP Network Server (LNS).

As its names imply, the L2TP Access Server supports authentication, and ingress. Upon successful authentication, the remote user's session is forwarded to the LNS, which lets that user into the network. Their separation enables greater flexibility for implementation than other remote access technologies.

Implementation Topologies

L2TP can be implemented in two distinct topologies:

•Client-aware tunneling

•Client-transparent tunneling

The distinction between these two topologies is whether the client machine that is using L2TP to access a remote network is aware that its connection is being tunneled.

Client-Aware Tunneling

The first implementation topology is known as client-aware tunneling. This name is derived from the remote client initiating (hence, being "aware" of) the tunnel. In this scenario, the client establishes a logical connection within a physical connection to the LAS. The client remains aware of the tunneled connection all the way through to the LNS, and it can even determine which of its traffic goes through the tunnel.

Client-Transparent Tunneling

Client-transparent tunneling features L2TP access concentrators (LACs) distributed geographically close to the remote users. Such geographic dispersion is intended to reduce the long-distance telephone charges that would otherwise be incurred by remote users dialing into a centrally located LAC.

The remote users need not support L2TP directly; they merely establish a point-to-point communication session with the LAC using PPP. Ostensibly, the user will be encapsulating IP datagrams in PPP frames. The LAC exchanges PPP messages with the remote user and establishes an L2TP tunnel with the LNS through which the remote user's PPP messages are passed.

The LNS is the remote user's gateway to its home network. It is the terminus of the tunnel; it strips off all L2TP encapsulation and serves up network access for the remote user.

Adding More Security

As useful as L2TP is, it is important to recognize that it is not a panacea. It enables flexibility in delivering remote access, but it does not afford a high degree of security for data in transit. This is due in large part to the relatively nonsecure nature of PPP. In fairness, PPP was designed explicitly for point-to-point communications, so securing the connection should not have been a high priority.

An additional cause for concern stems from the fact that L2TP's tunnels are not cryptographic. Their data payloads are transmitted in the clear, wrapped only by L2TP and PPP framing. However, additional security may be afforded by implementing the IPSec protocols in conjunction with L2TP. The IPSec protocols support strong authentication technologies as well as encryption.

Summary

VPNs offer a compelling vision of connectivity through foreign networks at greatly reduced operating costs. However, the reduced costs are accompanied by increased risk. L2TP offers an open standard approach for supporting a remote access VPN. When augmented by IPSec protocols, L2TP enables the realization of the promise of a VPN: an open standard technology for securing remote access in a virtually private network.

Review Questions

Q—What is a VPN?

A—A VPN is a generic term that describes any combination of technologies that can be used to secure a connection through an otherwise unsecured or untrusted network.

Q—Explain the difference between L2TP's LAC and LSN.

A—The LAC provides authentication and access concentration for remote users. After a remote user is authenticated, that user's communications session is then forwarded to the LSN, which provides access to that user's home network.

Q—What additional functionality does IPSec offer an L2TP implementation?

A—L2TP's native security mechanisms build on the assumption that the nature of a
point-to-point connection satisfies most of a remote user's security requirements. IPSec complements L2TP by offering a more robust set of technologies for authenticating remote users and for securing data in transit through foreign networks by encrypting data.

Q—What is a tunnel?

A—A tunnel is a logical structure that encapsulates the frame and data of one protocol inside the Payload or Data field of another protocol. Thus, the encapsulated data frame may transit through networks that it would otherwise not be capable of traversing.

EMR Standards

2008-11-13T19:52:00.000-08:00

EMR Standards

Though there are few standards for modern day EMR systems as a whole, there are many standards relating to specific aspects of EHRs and EMRs. These include:

ASTM International Continuity of Care Record - a patient health summary standard based upon XML, the CCR can be created, read and interpreted by various EHR or EMR systems, allowing easy interoperability between otherwise disparate enities.^[21]
ANSI X12 (EDI) - A set of transaction protocols used for transmitting virtually any aspect of patient data. Has become popular in the United States for transmitting billing information, because several of the transactions became required by the Health Insurance Portability and Accountability Act (HIPAA) for transmitting data to Medicare.
CEN - CONTSYS (EN 13940), a system of concepts to support continuity of care.
CEN - EHRcom (EN 13606), the European standard for the communication of information from EHR systems.
CEN - HISA (EN 12967), a services standard for inter-system communication in a clinical information environment.
DICOM - a heavily used standard for representing and communicating radiology images and reporting
HL7 - HL7 messages are used for interchange between hospital and physician record systems and between EMR systems and practice management systems; HL7 Clinical Document Architecture (CDA) documents are used to communicate documents such as physician notes and other material.
ISO - ISO TC 215 has defined the EHR, and also produced a technical specification ISO 18308 describing the requirements for EHR Architectures.
openEHR - next generation public specifications and implementations for EHR systems and communication, based on a complete separation of software and clinical models.

Various factors involving the timing, the right players, market history, utility, and governance play a key role in the overall enrichment of the standard and certification development. The standardization and certification even though seem to bring uniformity in the EMR development, do not guarantee their acceptability and sustainability in the long run. ^[22] In 2005 the US Federal Government awarded a contract to CCHIT - Certification Commission for Healthcare Information Technology to develop certification criteria for EMR. Starting in early 2007 vendors began to utilize these certification criteria for their EMR systems.

Electronic medical record

2008-11-12T19:34:00.000-08:00

Definition

The term has sometimes included other (HIT, or Health Information Technology) systems which keep track of medical information, such as the practice management system which supports the electronic medical record.

Issues

As of 2006, adoption of EMRs and other health information technology, such as computer physician order entry (CPOE), has been minimal in the United States, in spite of studies (such as Development of a Module for Point-of-care Charge Capture and Submission Using an Anesthesia Information Management System by David L. Reich, Ronald A. Kahn and David Wax, et al PMID 16810010) showing revenue gains after implementation. Fewer than 10% of American hospitals have implemented health information technology,^[2] while a mere 16% of primary care physicians use EHRs.^[3] The vast majority of healthcare transactions in the United States still take place on paper, a system that has remained unchanged since the 1950s. The healthcare industry spends only 2% of gross revenues on HIT, which is meager compared to other information intensive industries such as finance, which spend upwards of 10%.^[4] The following issues are behind the slow rate of adoption:

Interoperability

In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged. ^[5]

In the United States, the development of standards for EMR interoperability is at the forefront of the national health care agenda.[3] EMRs, while an important factor in interoperability, are not a critical first step to sharing data between practicing physicians, pharmacies and hospitals. Many physicians currently have computerized practice management systems that can be used in conjunction with health information exchange (HIE), allowing for first steps in sharing share patient information(lab results, public health reporting) which are necessary for timely, patient-centered and portable care. There are currently multiple competing vendors of EHR systems, each selling a software suite that in many cases is not compatible with those of their competitors. Only counting the outpatient vendors, there are more than 25 major brands currently on the market. In 2004, President Bush created the Office of the National Coordinator for Health Information Technology (ONC), originally headed by David Brailer, in order to address interoperability issues and to establish a National Health Information Network (NHIN). Under the ONC, Regional Health Information Organizations (RHIOs) have been established in many states in order to promote the sharing of health information. Congress is currently working on legislation to increase funding to these and similar programs.

The Center for Information Technology Leadership described four different categories (“levels”) of data structuring at which health care data exchange can take place. ^[6] While it can be achieved at any level, each has different technical requirements and offers different potential for benefits realization.

The four levels are^[7]:

Level	Data Type	Example
1	Non-electronic data	Paper, mail, and phone call.
2	Machine transportable data	Fax, email, and unindexed documents.
3	Machine organizable data (structured messages, unstructured content)	HL7 messages and indexed (labeled) documents, images, and objects.
4	Machine interpretable data (structured messages, standardized content)	Automated transfer from an external lab of coded results into a provider’s EHR. Data can be transmitted (or accessed without transmission) by HIT systems without need for further semantic interpretation or translation.

Older record incorporation

To attain the wide accessibility, efficiency, patient safety and cost savings promised by EMR, older paper medical records ideally should be incorporated into the patient's record. The digital scanning >

Privacy

A major concern is adequate confidentiality of the individual records being managed electronically. According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access.^[8] Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws.^[9] In the European Union (EU), several Directives of the European Parliament and of the Council protect the processing and free movement of personal data, including for purposes of health care.^[10] The organizations and individuals charged with the management of this information are required to ensure adequate protection is provided and that access to the information is only by authorized parties. The growth of EHR creates new issues, since electronic data may be physically much more difficult to secure, as lapses in data security are increasingly being reported.^[11] Information security practices have been established for computer networks, but technologies like wireless computer networks offer new challenges as well.

Social and organizational barriers

According to the Agency for Healthcare Research and Quality's National Resource Center for Health Information Technology, EMR implementations follow the 80/20 rule; that is, 80% of the work of implementation must be spent on issues of change management, while only 20% is spent on technical issues related to the technology itself. Such organizational and social issues include restructuring workflows, dealing with physicians' resistance to change (or, alternatively, software engineers' evolving research in deep modeling of the physician's knowledge and workflow domains), as well as IT personnels' resistance to design and implementation flexibility needed in the complex healthcare environment, and creating a collaborative environment that fosters communication between physicians and information technology project managers. Exemplifying this need are several highly publicized HIT implementation failures, such as one at Cedars Sinai Medical Center in Los Angeles, in which physicians revolted and forced the administration to scrap a $34 million CPOE system ^[12] as well as others compiled at a collection of cases of health IT difficulties by medical informatics specialists.^[13] There are, however, several successful examples of EMR implementations in large hospitals, usually hospital systems that have had years of experience developing custom EMRs, for example the Veterans Administration hospital system, Kaiser Permanente's HealthConnect and the VistA EMR.

Technology limitations

Limitations in software, hardware and networking technologies has made EMR difficult to affordably implement in small, budget conscious, multiple location healthcare organizations. Until recently most EMR systems were developed using older programming languages such as Visual Basic and C++; however with many systems now being developed using Microsoft .NET Framework and Java technology EMRs can be securely implemented across multiple locations with greater performance and interoperability.^[14] Prior to the recent introduction of IEEE 802.11 g and n wireless technology access to large files such as MRI and X-Ray images was slow. With these new wireless technologies data can be securely transferred at speeds of up to 108 Mbit/s, across extended distances and in older buildings built with brick or concrete walls. Tablet PC technology has significantly improved over the recent years, Li-Ion/polymer batteries for battery life of up to 8 hours, biometric security, low-voltage processors and lighter weight solutions. For the new generation of Tablet PC, there are now EMRs that are fully handwriting capable^[15]

Preservation

Under data protection legislation and the law generally responsibility for patient records (irrespective of the form they are kept in) is always on the creator and custodian of the record, usually a health care practice or facility. The physical medical records are the property of the medical provider (or facility) that prepares them. This includes films and tracings from diagnostic imaging procedures such as X-ray, CT, PET, MRI, ultrasound, etc. The patient, however, according to HIPAA, owns the information contained within the record and has a right to view the originals, and to obtain copies under law.^[16] Additionally, those responsible for the management of the EMR are responsible to see the hardware, software and media used to manage the information remain usable and not degraded. This requires backup of the data and protection being provided to copies. It will also require the planned periodic migration of information to address concerns of media degradation from use.^[17]

Legal status

Medical records, such as physician orders, exam and test reports are legal documents, which must be kept in unaltered form and authenticated by the creator.

Digital signatures Most national and international standards accept electronic signatures.^[18] According to the American Bar Association, "A signature authenticates a writing by identifying the signer with the signed document. When the signer makes a mark in a distinctive manner, the writing becomes attributable to the signer."^[19] With proper security software, electronic authentication is more difficult to falsify than the handwritten doctor's signature. However, as the recent rise in identity theft demonstrates, no security method can totally prevent fraud, so auditing information security will continue to be prudent when using EMR.
Digital records such as EHR create difficulties ensuring that the content, context and structure are preserved when the records do not have a physical existence. As of 2006, national and state archives authorities are still developing open, non-proprietary technical standards for electronic records management (ERM).^[20]

from : wikipedia

Manajemen Proyek - Project Management

2008-10-12T21:05:00.000-07:00

Satu hal yang perlu diperhatikan dalam rangka membangun suatu sistem informasi rumah sakit yang handal adalah adanya dukungan dokumentasi melalui langkah atau proses manajemen proyek (Project Management). Jika anda mempertimbangkan sistim manajemen bisnis yang baru, anda mungkin akan perhatian terhadap waktu yang akan dihabiskan untuk mengimplementasikannya. Banyak sekali cerita cerita horor tentang implementasi yang melebihi anggaran dan tidak memenuhi kebutuhan bisnis mereka.
Metodologi implementasi yang menggunakan metode manajemen proyek yang keras, sehingga anda dapat melihat kemajuan dari proyek anda dalam setiap langkah. Dengan manajemen proyek yang tepat, akan senantiasa memberikan informasi terkini yang lengkap, risiko, anggaran yang telah terpakai, dan kritikal dari sistem metrik lainnya dari implementasi anda yang berlangsung terus-menerus. Dengan demikian dapat mempromosikan kesuksesannya melalui :

Transparency – Aktivitas dan jadwal sehingga anda dapat memantau apa yang terjadi dalam implementasi proyek.
Information – Komunikasi, laporan, dan pertemuan pertemuan reguler
Cooperation – Pengawasan dan pendelegasian tanggung-jawab
Setting and meeting requirements – Persetujuan, dokumentasi dan spesifikasi pelanggan

Manajemen proyek meliputi semua tahap, aktivitas dan tugas yang diperlukan melalui siklus implementasi. Tugas-tugas yang kami implementasikan kepada anda meliputi :

Planning - Penjadwalan dan prioritas bekerja dengan menggambarkan perencanaan termasuk estimasi dan alokasi dan sumber penghasilan.
Risk Management – Analisa dan monitoring resiko untuk mengurangi imbasnya dari keadaan yang tak terduga sebaliknya .
Issue Management – Manajemen yang tepatguna dan pengawasan dari setiap masalah proyek.
Status Reporting – Koordinasi komunikasi diantara anda, tim proyek, dan para supplier sebagai pihak ketiga.
Project Administration - Administrasi proyek yang menggunakan tools proyek manajemen.
Project Change Management - Evaluasi, penjadwalan dan pengaturan untuk setiap perubahan order yang muncul.

Unified Modeling Language

2008-10-10T22:14:00.000-07:00

One important step in development of hospital information system is to model the system with appropriate tool. The right tool is Unified Modeling Language (UML). Here is a short definition of UML :

Unified Modeling Language (UML) is a standardized general-purpose modeling language in the field of software engineering. UML includes a set of graphical notation techniques to create abstract models of specific systems, referred to as UML model.

There are many UML products, one of them can be downloaded from here: http://www.visual-paradigm.com/download/

Computer Simulation of Hospital Patient Scheduling Systems

2008-09-28T19:37:00.000-07:00

Gordon H. Robinson, Paul Wing, and Louis E. Davis

Abstract

A method of analyzing alternative systems of scheduling hospital admissions by means of a computer simulation is described. The simulation is divided into three programs, dealing sequentially with requests for admission, scheduling, and evaluation of costs of three basic scheduling systems and using the output of each phase of the simulation as input to the following phase. The feasibility of using the scheduling program in a real-time automated patient-scheduling system is discussed, with indications of adaptations required and additional functions that could be handled by the system.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M)

CARE2X | Open Source Healthcare System

2008-08-31T20:23:00.000-07:00

Care2x integrates data, functions and workflows in a healthcare environment. It is currently composed of four major components. Each of these components can also function individually.

HIS - Hospital/Healthservice Information System

PM - Practice (GP) management

CDS - Central Data Server

HXP - Health Xchange Protocol

The mission : to develop the most useful and practical integrated healthcare information system which is open for others to develop further.

The "Team" The development team has currently more than 100 members with different skills and backgrounds. They come from more than 20 nations. [ Credits list ][ Credits list with pictures ]
The Infrastructure The project development is supported by a solid infrastructure comprising several components which play important specific roles. See here.	History The project was started back in 2002 by a nurse with the public release of the first beta version. Detailed history can be read here.

Official release

This is the maintenance release of the 2nd Generation Deployment version 2.2. The release was made by Kaloyan Raev from Bulgaria. The most noticeable things it features are:

New graphical installer (based on MirrorMed's installer)

MySQL 5 support

Main menu visibility according to the user's permissions

Improved Arabian and Italian translations

Improved Turkish ICD10

There are many other improvements and fixes that can be found in the full change log:.

To download 2nd Generation 2.2 click here.

PHARMACY INFORMATION SYSTEMS

2008-07-07T06:30:00.000-07:00

Pharmacy information systems (PIS) are complex computer systems that have been designed to meet the needs of a pharmacy department. Through the use of such systems, pharmacists can supervise and have inputs on how medication is used in a hospital.

Some of the activities which Pharmacy Information Systems have been employed in pharmacy departments include:

Clinical Screening: The Pharmacy Information System can assist in patient care by the monitoring of drug interactions, drug allergies and other possible medication-related complications.

When a prescription order is entered, the system can check to see if there are any interactions between two or more drugs taken by the patient simultaneously or with any typical food, any known allergies to the drug, and if the appropriate dosage has been given based on the patient’s age, weight and other physiologic factors. Alerts and flags come up when the system picks up any of these.

Prescription Management: The Pharmacy Information System can also be use to mange prescription for inpatients and/or outpatients. When prescription orders are received, the orders are matched to available pharmaceutical products and then dispensed accordingly depending on whether the patient is an inpatient or outpatient.
It is possible to track all prescriptions passed through the system from who prescribed the drug, when it was prescribed to when it was dispensed.
It is also possible to print out prescription labels and instructions on how medication should be taken based on the prescription.
Inventory Management: Pharmacies require a continuous inventory culture in order to ensure that drugs do not go out of stock. This is made even more difficult when there are multiple dispensing points. When don manually it is very difficult to maintain an accurate inventory.
Pharmacy Information Systems aid inventory management by maintaining an internal inventory of all pharmaceutical products, providing alerts when the quantity of an item is below a set quantity and providing an electronic ordering system that recommends the ordering of the affected item and with the appropriate quantity from approved suppliers.
Patient Drug Profiles: These are patient profiles managed by the Pharmacy Information System and contain details of their current and past medications, known allergies and physiological parameters. These profiles are used for used for clinical screening anytime a prescription is ordered for the patient.
Report Generation: Most Pharmacy Information Systems can generate reports which range from determining medication usage patterns in the hospital to the cost of drugs purchased and /or dispensed.
Interactivity with other systems: It is important that Pharmacy Information Systems should be able to interact with other available systems such as the clinical information systems to receive prescription orders and financial information system for billing and charging.

NURSING INFORMATION SYSTEM

2008-07-07T06:28:00.000-07:00

Nursing information systems (NIS) are computer systems that manage clinical data from a variety of healthcare environments, and made available in a timely and orderly fashion to aid nurses in improving patient care.

To achieve this, most Nursing Information Systems are designed using a database and at least one nursing classification language such as North American Nursing Diagnosis (NANDA), Nursing Intervention Classification (NIC) and Nursing Diagnosis Extension and Classification (NDEC).

Some of the features that are provided by Nursing Information Systems include:

Patient Charting: A patient’s vital signs, admission and nursing assessments, care plan and nursing notes can be entered into the system either as structured or free text. These are the stored in a central repository and retrieved when needed.
Staff Schedules: Nurse can self schedule their shifts using scheduling rules provided in shift modules. The shifts can later be confirmed or changed by a scheduling coordinator or manager. Shift modules are designed to handle absences, overtime, staffing levels and cost-effective staffing.
Clinical Data Integration: Here clinical information from all the disciplines can be retrieved, viewed and analysed by nursing staff and then integrated into a patient’s care plan.
Decision Support: Decision support module can be added to Nursing Information Systems, and they provide prompts and reminders, along with guides to disease linkages between signs/symptoms, etiologies/related factors and patient populations. Online access to medical resources can also be made available.

There are benefits to be enjoyed by implementing Nursing Information Systems and they include:

Improved workload functionality: Staffing levels and appropriate skill mix per shift can be more easily determined by the shift modules. This leads to less time spent in designing and amending rosters.
Better care planning: Time spent on care planning is reduced, while the quality of what is recorded is improved. This makes for more complete care plans and more complete assessments and evaluations.
Better drug administration: Electronically prescribed drugs are more legible, thus making it less likely that drugs would be wrongly administered to patients.

Despite the benefits Nursing Information Systems have to offer, they are not widely used in healthcare and where they have been installed, they have not been readily accepted. This could probably due to lack of adequate training and failure of educate the end-user what the reasons are for its introduction. Moreover, very little research has been done to determine the cost benefits or cost effectives of such information systems.

CLINICAL INFORMATION SYSTEM

2008-07-07T06:23:00.000-07:00

A Clinical Information System (CIS) is a computer based system that is designed for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process.

Clinical Information Systems may be limited in extent to a single area (e.g. laboratory systems, ECG management systems) or they may be more widespread and include virtually all aspects of clinical information (e.g. electronic medical records).

Clinical Information Systems provide a clinical data repository that stores clinical data such as the patient’s history of illness and the interactions with care providers. The repository encodes information capable of helping physicians decide about the patient’s condition, treatment options, and wellness activities as well as the status of decisions, actions undertaken and other relevant information that could help in performing those actions.

Some of the areas addressed by Clinical Information Systems are:

Clinical Decision Support: This provides users with the tools to acquire, manipulate, apply and display appropriate information to aid in the making of correct, timely and evidence-based clinical decisions.
Electronic Medical Records (EMRs): this contains information about the patient, from their personal details, such as their name, age, address and sex to details of every aspect of care given by the hospital (from routine visits to major operations)

.
Training and Research: Patient information can be made available to physicians for the purpose of training and research. Data mining of the information stored in databases could provide insights into disease states and how best to manage them.

For years, research has been done to show the value of Clinical Information Systems, and these have highlighted not just the benefits but also the barriers that might be faced by hospitals who implement such systems.

Some of the benefits are:

Easy Access to Patient Data: Clinical Information Systems can provide convenient access to medical records at all points of care. This is especially beneficial at ambulatory points, hence enhancing continuity of care. Internet-based access improves the ability to remotely access such data.
Structured Information: The clinical information captured in Clinical Information Systems is well organised, thus making I easier to maintain and quicker to search through for relevant information. The information is also legible, making it less likely that mistakes would be made due to illegible writing.
Improved Drug Prescription and Patient Safety: Clinical Information Systems improve drug dosing and this leads to the reduction of adverse drug interactions while promoting more appropriate pharmaceutical utilisation.

Despite the benefits being offered by Clinical Information Systems, they are not without the barriers that prevent them from being rolled out in every hospital. These include some of the following:

Initial cost of acquisition: the high cost of basic infrastructure of clinical information technology can be a stumbling block to many healthcare organisations.
Privacy and Security: There are still huge concerns in the healthcare industry about the privacy of patient data on computer systems and how to keep such information secure. The HIPAA and Data Protection Act passed by respective governments in the US and the UK were introduced to address some of these concerns.
Clinician Resistance: Clinicians usually have 10-20 minutes to see their patients and if their interactions with a CIS during these sessions proves to be counterintuitive by taking up more time than is necessary, there is bound to resistance to it use.
Integration of Legacy Systems: This poses a stiff challenge to many organisations.

source : biohealthmatics.com

HOSPITAL INFORMATION SYSTEMS

2008-07-07T06:19:00.000-07:00

A hospital information systems (HIS) is a computer system that is designed to manage all the hospital’s medical and administrative information in order to enable health professional perform their jobs effectively and efficiently.

Hospital information systems were first developed in the 1960s and have been an essential part in hospital information management and administration. Early systems consisted of large central computers connected to by dumb terminals, which are now being replaced by networked microcomputers. The systems were used to manage patient finance and hospital inventory.

Hospital information systems now focus on the integration of all clinical, financial and administrative applications and thus could also be called an integrated hospital information processing systems (IHIPS).

Components of a hospital information system consist of two or more of the following:

A look at the list above shows how complex a hospital information system can be. Advancement in computer technology and the development of information exchange standards such HL7 and DICOM, make the task administering and integrating such systems a little more easier.

No hospital information system can be regarded as a success unless it has the full participation of its users. Thus human and social factors would have to be considered in its design, more often than not, they can be easily addressed by providing adequate training and education about the system.

source : www.biohealthmatics.com

Recovery Data Secara Gratis & Mudah

2008-06-23T19:55:00.000-07:00

Sekarang banyak sekali bermunculan software recovery bahkan sebagian gratis, sampai kadang bingung ingin menggunakan aplikasi yang mana. Satu hal yang menggembirakan, bahwa banyak aplikasi recovery yang bersifat portable. Kita tinggal copy paste saja filenya dan bisa langsung jalan dari removable media seperti flashdisk, jadi tidak perlu proses instalasi khusus, sehingga bisa kita letakkan di flashdisk untuk persiapan bila suatu saat anda kehilangan data.

Di bawah ini akan diulas 3 dari sekian banyak software yang bersifat portable dan gratis.

Recover Files

Merupakan software recovery yang dapat digunakan untuk mengembalikan data yang sudah terhapus, baik dari recylce bin, network drive, compact flash card, portable drive, dari Window DOS, maupun Windows Explorer ketika menghapus dengan menekan tombol shift.

Sepertinya mustahil bukan? Memang benar jika anda belum mengetahui rahasianya. Saat kita memerintah Windows menghapus sebuah file, pada prinsipnya Windows tidak 'menghapus' file tersebut, tetapi menunggu sampai Windows perlu menulis kembali space hard drive yang sebelumnya ditempati oleh file tadi.

Recover Files melakukan scan secara seksama file-file yang masih 'tertinggal' pada hard drive dan/atau file-file yang masih punya cukup data tersisa untuk diselamatkan.

Oleh karena itu, keberhasilan recovery semakin besar jika anda semakin cepat me-recover file yang terhapus; juga semakin kecil ukuran file semakin besar kemungkinan diselamatkan. Recover Files sangat berguna ketika anda akan mengembalikan data yang baru saja terhapus.

Recover Files memiliki keunggulan ukuran kecil (553 KB), proses cepat, tampilan sederhana dan mudah dipahami serta praktis karena hanya single exe saja.

Aplikasi ini bisa berjalan di Windows 95, 98, Me, NT, 2000, XP, 2003, Vista, dan mendukung format partisi NTFS dan FAT.
Software ini dapat didonload klik di sini atau di sini.

Recuva-File Recovery

Recuva (diucapkan "recover") merupakan freeware windows utility untuk merestore files yang sudah terhapus dari komputer, termasuk dari recycle bin, memory card atau MP3 player. Dapat juga diakibatkan karena komputer crash, virsu dan sebagainya.

Seperti Recover Files, aplikasi ini juga hanya single exe, tinggal copy paste saja, ukurannya relatif kecil (776 KB), proses juga cepat. Untuk tampilan tidak selengkap Recover Files.
Software ini dapat didonload dengan klik di sini atau di sini.

DataRecovery

DataRecovery merupakan freeware yang dibuat oleh programmer TOKIWA (dari Jepang) untuk recovery aplikasi yang telah terhapus, misalnya dari recycle bin. Aplikasi ini hanya single exe, dengan ukuran sekitar 199 KB dan tampilan sederhana, tapi proses scan sangat cepat.

Sistem operasi yang didukung adalah Windows 9x, Me, NT4, 2000, XP dan Vista.

Fasilitas utama yang disediakan adalah:
- Mendukung FAT12, FAT16, FAT32, NTFS
- Undelete NTFS compressed files
- Undelete EFS encrypted files
- Fasilitas wipe out files, untuk menghapus file supaya tidak bisa direcovery lagi
- Pencarian sebagian string/ text dalam file
Software ini dapat didonload dengan klik di sini atau di sini.

Kemandirian dalam Software Development :: Mampukah?

2008-06-17T20:06:00.000-07:00

Seperti layaknya sebuah sistem pada umumnya, sistem informasi di rumah sakit juga memiliki kesamaan dalam beberapa hal. Dalam hal ini point yang sangat penting adalah bahwa sistem informasi rumah sakit akan selalu berubah mengikuti perkembangan. Ada hal-hal atau permasalahan yang dulunya belum muncul kemudian pada saatnya nanti menjadi masalah yang keberadaannya akan mempengaruhi kinerja sistem. Sebagai contoh, mungkin pada awalnya sistem yang sangat vital adalah billing system, di mana pada prinsipnya adalah merupakan dokumentasi transaksi perawatan dan pengobatan dari pasien. Adalah tidak begitu sulit untuk merekapitulasi semua tindakan perawatan dan pengobatan yang dilakukan terhadap pasien dan tidak memandang atau memperhatikan clinical pathway, atau yang selama ini sudah berjalan yaitu fee for service. Kemudian tentunya akan menjadi masalah terutama bagi penanggung biaya pihak ketiga, yaitu asuransi kesehatan, karena menurut pandangan mereka bisa jadi dengan konsep perawatan yang tertata dengan baik (seperti clinical pathway) akan dapat menurunkan jumlah biaya perawatan pasien.

Seandainya suatu rumah sakit sudah menerapkan software komputer (billing) dengan konsep pembiayaan fee for service, tentunya juga akan mengalami banyak kendala dan permasalahan untuk melakukan perubahan seperti yang diinginkan oleh pihak asuransi misalnya, karena bisa jadi software yang sudah ada harus dirombak total untuk dapat berjalan sesuai dengan yang dikehendaki. Masalah yang timbul diantaranya adalah siapa yang akan mengubah software tersebut, berapa biaya yang diperlukan, dan perlu waktu berapa lama untuk menyelesaikan.

Dari sini lah muncul gagasan agar setiap rumah sakit dapat mengembangkan software secara mandiri. Kemandirian ini tentunya perlu didukung adanya fasilitas-fasilitas yang memadai baik infrastruktur hardware dan software development tool dan yang tak kalah penting tentunya sumber daya manusia yang memadai. Diharapkan dengan adanya kemandirian ini, rumah sakit dapat dengan tidak susah payah untuk selalu mengikuti perubahan baik internal maupun eksternal.

Beberapa hal yang perlu diperhatikan dalam mewujudkan kemandirian ini adalah:

Kebutuhan hardware (komputer dan jaringan) yang perlu perencanaan yang baik karena selalu mengalami perubahan.
Kebutuhan software dasar (terutama sistem operasi dan RAD Tool) guna mengembangkan aplikasi sistem informasi rumah sakit itu sendiri. Harus ada pilihan apakah akan menggunakan lisensi atau open source semacam Linux.
Adanya sumberdaya manusia yang cakap dan profesional yang minimal terdiri dari network and harware specialist, system and database analyst, serta programmer
Adanya sarana untuk mengembangkan kemampuan sumber daya manusia dalam bidang TI misalnya dengan pelatihan
Perencanaan anggaran dan biaya yang baik.

Kalau kita perhatikan, memang sangat tidak mudah untuk mewujudkan hal seperti di atas. Namun apakah kita ingin berada di satu posisi untuk selamanya?

Bux.to

2008-06-16T23:02:00.001-07:00

Before you create an account at bux.to you must create an account at Alertpay.com

Welcome to Bux.to

At Bux.to, you get paid to click on ads and visit websites. The process is easy! You simply click a link and view a website for 30 seconds to earn money. You can earn even more by referring friends. You'll get paid $0.01 for each website you personally view and $0.01 for each website your referrals view. Payment requests can be made every day and are processed through AlertPay. The minimum payout is $10.00.

Earnings Example
» You click 10 ads per day = $0.10
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» Your monthly earnings = $63.00