Judith V. Douglas - Böcker

The computerization activi­ ties described in these pages began in 1977 at the Department of Veterans Affairs (VA), but we devoted most of our focus and efforts to building and then implementing the extensive hospital information system known as the Decentralized Hospital Computer System (DHCP) throughout VA.

This book focuses on current federal sector efforts to shape healthcare, i.e., to improve performance while containing costs. The solutions offered include redesigning processes and, where appropriate, the use of enabling technologies to do so. Since historically, innovations in the federal sector have often migrated to and profoundly changed practices in the private sector, many of the initiatives described involve some degree of partnering between the public and private sector. Others represent work in the federal sector that address the same problems confronted in the private sector and offer valuable and transferable solutions and approaches. The major strength of this book is its use of concrete examples that show how process redesign and the integration of enabling technologies have led to performance improvement and cost reduction in the largest healthcare system in the world. The contributors--all acknowledged experts in their fields--draw upon their knowledge of the healthcare industry and their expertise in working within and with the federal sector health system.They focus on exciting changes and improvements, and they elaborate on strategies for the future that will reshape federal sector healthcare. The book does not intend to give "correct answers," but to demonstrate mature thinking in shaping healthcare in general. In the years ahead, engineering healthcare to meet the demands of newly knowledgeable consumers will be critical. In addition to giving insights into what the federal sector leadership is doing to address the challenges of population health, each chapter will highlight the perspective of employers, payers, and deliverers of health services.

Cancer Informatics chronicles the development of the National Cancer Institute's new Cancer Informatics Infrastructure (CII) - an information management system infrastructure designed to faciliate clinical trials, provide for reliable, secure information exchange, and improve patient care. The book details the challenges involved in creating and managing such a knowledge base, including technologies, standards, and current, state-of-the-art applications.The ultimate goal of CII is to function as an enabler of clinical trials, expediting the clinical trials lifecycle, faciliating faster and safer drug development and more appropriate treatment choices for cancer patients. Contributors address the role the CII must play in converting the growing knowledge of genes, proteins, and pathways into appropriate preventative, diagnostic, and therapeutic measures. Presented in four sections, the first provides an overview of the processes involved in moving the infrastructure for cancer from theory into practice. Sections two through four offer the latest work done in the areas of technology, cancer-specific and national standards, and applications to faciliate clinical trials.

This book highlights innovative healthcare information technologies as they perform information integration throughout various health care settings. Contributors, representative of these settings, provide case studies citing active examples of technology systems at work, addressing critical success factors, documenting success in terms of improved quality and/or reduced cost. Each example will address the full range of issues associated with technological innovation in health care, from policy and clinical considerations, to business and operational issues.

Performance Improvement through Information Management highlights performance improvement and business strategies throughout various health care settings, focusing on business drivers and management mechanisms, explaining when, how, and why information technology solutions are of value.

As a result of severe wounds received in World War II, I have spent many months in military hospitals, including 20 months in an Army hospital immediately after the war. I continue to use the Military Health System, as do many of my colleagues in Congress, because I firmly believe the quality of health care delivered in military and veterans hospitals is second to none. The largest system of its type in the world, the U.S. military healthcare system is undergoing changes as dramatic as those experienced by the entire country. During Desert Storm, we saw new technologies, such as telemedicine, at work in the field. Since then, military medicine has contin­ ued to imprave and develop innovations that often focus on healthcare issues of concern to society as a whole. We already have seen technology transfer at work. Things we use in our everyday lives, from sunscreen to the Internet, have come to us directly from innovations developed by federal researchers. The private sector, working with the public agencies, has creatively adapted federal research. For example, the hemopump is used successfully by heart surgeons world­ wide to save heart patients. This device, developed by Richard Wampler, was based on satellite technology information that was declassified in the early 1980s. The chapters in this book focus on current federal sector efforts to shape health care and technology transfer. Many of the initiatives described involve some degree of partnering between the public and private sectors.

In recognition of the evolving electronic health information environment and of interdisciplinary health care teams, the book is designed to be of interest to members of other health care professions (quality officers, administrators, etc.) as well as health information technology professionals (in health care facilities and in industry).

Cancer Informatics chronicles the development of the National Cancer Institute's new Cancer Informatics Infrastructure (CII) - an information management system infrastructure designed to faciliate clinical trials, provide for reliable, secure information exchange, and improve patient care.

Performance Improvement through Information Management highlights performance improvement and business strategies throughout various health care settings, focusing on business drivers and management mechanisms, explaining when, how, and why information technology solutions are of value.