The realities of implementation of Clinical Context Object Workgroup (CCOW) standards for integration of vendor disparate clinical software in a large medical center.
ABSTRACT CCOW standards have been touted to currently be the best way to integrate disparate clinical applications by passing user identification and passwords as well as patient context between these applications at the desktop. However, nothing has been published in academic journals on the actual realities of implementation of CCOW. In this report, we describe the implementation of CCOW for our three main clinical applications and compare this with the simultaneous development and implementation of a portal session manager for the same purpose. We found the portal session manager much easier to develop and implement than CCOW. The resulting functionality was almost equivalent as judged by our clinical end users who compared both solutions. We now have the portal session manager functional across the institution and have stopped any further work on CCOW.
SourceAvailable from: Ioan Cucoranu[Show abstract] [Hide abstract]
ABSTRACT: Data protection and security are critical components of routine pathology practice because laboratories are legally required to securely store and transmit electronic patient data. With increasing connectivity of information systems, laboratory work-stations, and instruments themselves to the Internet, the demand to continuously protect and secure laboratory information can become a daunting task. This review addresses informatics security issues in the pathology laboratory related to passwords, biometric devices, data encryption, internet security, virtual private networks, firewalls, anti-viral software, and emergency security situations, as well as the potential impact that newer technologies such as mobile devices have on the privacy and security of electronic protected health information (ePHI). In the United States, the Health Insurance Portability and Accountability Act (HIPAA) govern the privacy and protection of medical information and health records. The HIPAA security standards final rule mandate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and security of ePHI. Importantly, security failures often lead to privacy breaches, invoking the HIPAA privacy rule as well. Therefore, this review also highlights key aspects of HIPAA and its impact on the pathology laboratory in the United States.03/2013; 4:4. DOI:10.4103/2153-3539.108542
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ABSTRACT: Data generated in the care of patients are widely used to support clinical research and quality improvement, which has hastened the development of self-service query tools. User interface design for such tools, execution of query activity, and underlying application architecture have not been widely reported, and existing tools reflect a wide heterogeneity of methods and technical frameworks. We describe the design, application architecture, and use of a self-service model for enterprise data delivery within Duke Medicine.Journal of Biomedical Informatics 12/2014; DOI:10.1016/j.jbi.2014.07.006 · 2.48 Impact Factor
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ABSTRACT: Inter-institutional cooperation among physicians becomes increasingly important. Yet, it is unrealistic to assume that cooperation can be supported via a homogeneous system that is pre-installed in every organization. Instead, physicians will typically have their own autonomous systems that support internal processes. Traditional activity-oriented workflow models do not resolve inter-institutional integration challenges. The goal of the proposed solution is to provide information exchange between strict autonomous healthcare institutions, bridging the gap between primary and secondary care, following traditional paper-based working practice. In large-scale inter-institutional scenarios, it is necessary to decouple cooperation functionality from the existing applications. This thesis presents the alpha-Flow approach for distributed process management, which enables ad hoc cooperation via active electronic documents without the need to integrate local systems. The rationale behind separating content, decision support, and coordination work will be explained. A distributed case file, the alpha-Doc, is used to coordinate cooperating parties. Using this case file does not require any pre-installed system components, so genuine ad hoc information interchange is enabled. The case file contains both the distributed process schema in form of a collective therapy plan as well as arbitrary content documents that are shared among the cooperating parties. To illustrate the approach an inter-institutional use case is provided by cooperative breast-cancer treatment.Department of Computer Science, Friedrich-Alexander Universität Erlangen-Nürnberg, 11/2012, Degree: PhD, Supervisor: Richard Lenz