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Related Concept Videos

Integrated Healthcare System01:20

Integrated Healthcare System

An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
Methods of Documentation II: POMR01:26

Methods of Documentation II: POMR

The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Formats for Nursing Documentation01:28

Formats for Nursing Documentation

Nursing documentation encompasses various formats designed to capture precise patient data, facilitate communication among healthcare team members, and ensure comprehensive and accurate patient records. Let's explore each of these formats in detail:
Nursing Assessment Form:
• A nursing assessment form is a foundational document that captures detailed patient data from physical assessments and nursing histories.
• It includes patient demographics, medical history, current medications, vital...
Documentation in Long-Term and Home Healthcare Setting01:29

Documentation in Long-Term and Home Healthcare Setting

Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Nursing Clinical Information System01:27

Nursing Clinical Information System

Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:

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Related Experiment Video

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Generation of Comprehensive Thoracic Oncology Database - Tool for Translational Research
11:18

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Published on: January 22, 2011

[A multidisciplinary mModule for oncological documentation within a hospital information system].

U Kunze1, T Ganslandt, P Preusser

  • 1Klinik und Poliklinik für Allgemeine Chirurgie, Universitätsklinikum Münster.

Zentralblatt Fur Chirurgie
|March 11, 2004
PubMed
Summary

Oncological patient documentation in Germany is often paper-based and inadequate. A new digital system integrated into hospital information systems (HIS) improves data accuracy and workflow efficiency for cancer care.

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Area of Science:

  • Oncology
  • Health Informatics
  • Medical Documentation

Background:

  • Current oncological patient follow-up in Germany is frequently paper-based, limited in scope, and lacks multidisciplinary integration.
  • This leads to redundant data, errors, and increased workload.

Purpose of the Study:

  • To design and implement a digital oncological documentation system integrated within hospital information systems (HIS).
  • To improve the completeness, accuracy, and efficiency of cancer patient follow-up documentation.

Main Methods:

  • Developed a modular digital oncological documentation system.
  • Integrated the system into existing hospital information systems (HIS) at Muenster University Hospital.
  • Ensured flexibility and adaptability for seamless workflow integration.

Main Results:

  • The system integrates tumor documentation, quality assurance, and process optimization within HIS.
  • Facilitates cross-departmental data access, entry, and presentation.
  • Demonstrated feasibility of seamless integration into routine clinical workflows.

Conclusions:

  • Digital oncological documentation systems integrated into HIS can overcome limitations of traditional methods.
  • Such systems enhance data quality and streamline processes in cancer care.
  • Flexibility of the underlying HIS is crucial for successful implementation.