A importância dos serviços de assistência odontológica prestada pela Faculdade de Odontologia da Universidade de São Paulo reflete nos dados obtidos do Anuário Estatístico da Universidade de São Paulo. Somente na disciplina de Cirurgia, foram realizados 1075 atendimentos cirúrgicos, no ano de 2000 saltando para 5686 em 2007. A cada paciente gera-se um prontuário que contém informações de cunho pessoal, da história médica, odontológicas, e de imagens que lhe atribui alto valor legal e de pesquisa. Com a alta procura pelos serviços oferecidos pela faculdade, o número de documentos gerados por paciente cresce proporcionalmente e constata-se que o arquivamento dos prontuários de toda a faculdade é frágil e sujeito à ocorrência de eventos que poderiam danificar o material. A morosidade na busca por dados dos pacientes, a perda de informações, e a dificuldade em realizar estudos epidemiológicos levaram à motivação para o desenvolvimento e avaliação de um prontuário virtual e seu respectivo Banco de Dados da disciplina de Cirurgia da Faculdade de Odontologia da Universidade de São Paulo. Um modelo de ficha para transcrição eletrônica, com os mesmos itens da ficha clínico-cirúrgica, foi elaborado e utilizado para a transcrição das informações dos pacientes atendidos no ambulatório de Cirurgia, no curso noturno, no ano de 2008. Um protótipo de prontuário virtual foi desenvolvido e os dados coletados de 417 pacientes foram inseridos e armazenados localmente num Banco de Dados desenvolvido para WEB, visando uma nova forma de acesso à informação. A partir dos testes de uso retrospectivo e prospectivo, concluímos que o protótipo do prontuário virtual representa uma importante ferramenta baseada em tecnologias de informação, de uso epidemiológico, de pesquisa e de avaliação dos requisitos necessários para o desenvolvimento de um prontuário virtual com mais robustez e flexibilidade. / The importance of the dental aid services offered by the School of Dentistry of the University of São Paulo reflects on the data from the Statistical Yearbook of the University of São Paulo. In the discipline of Oral Surgery by itself, 1075 surgical appointments were done in 2000, which has increased greatly to 5686 in 2007. To every new patient admitted by the service, a record file is created and contains personal information, health and dental history, and images, thus setting a high legal and research value on the patient record file for the institution. With the high demand for these dental services, the number of documents by patient proportionally augments and it can be seen in the entire institution fragility of the files archiving and risk of events occurrence that could damage the material. The slowness of retrieving patient data, lack of information, and difficulties motivate the development and evaluation of an electronic health record and its respective database in the discipline of Oral Surgery of the School of Dentistry of the University of São Paulo. A sheet form for electronic transcription, with the same content of the surgical-clinical questionnaire form, was elaborated to transcript the health information of the patients admitted at the Oral Surgery Service, in the nocturnal graduation course during 2008. A prototype of an electronic health record was created and the collected data were processed and stored in a web-based local database, aiming to an innovative access mode to information. By the tests of retrospective and prospective use of the electronic health record, we concluded the prototype of the electronic health record represents an important tool based in technologies of information, useful to epidemiology, research and evaluation of required features to development of an electronic health record more robust and flexible.

This Master thesis focuses on the concept of Records Management (RM) and Electronic Records Management (ERM) and how the adoption of an Electronic Document Records Management System (EDRMS) affects a business setting. The research focuses on the factors of perceived efficiency and on the costs that exist in a company. More specifically, this Master thesis is a qualitative exploratory case study which's aim is to examine and present the experiences and the attitudes of 4 individuals who are working in companies that possess an EDRMS. In order to acquire this deeper understanding, the data collection methods that were used were the in person semi structured interviews and the observation. During the research was examined how the perceived efficiency and the costs in a company are affected by a proper RM/ERM program. The analysis of the collected data shown that the specific individuals in the specific firms are benefited by the EDRMS and that their work is improved.

The purpose of this study was to examine whether or not DCS social workers would obtain client's educational records if they had electronic access to these records. If a social worker could access client school records quickly and easily and then enter the information into the case management computer system, the school history would travel with the client to their new environment. This information would insure that the foster child with special education needs was placed in the proper classroom, giving the child a better chance to succeed.

Implementation of electronic health records by the Health Information Technology for Economic and Clinical Health has led to the implementation of electronic dental records (EDRs) and digital radiography in dental offices. The purpose of this study was to determine the state of the implementation and usage of EDRs and digital radiographs by the private general and pediatric dental practices in Mississippi as well as reasons why the dental practices are not moving forward with the advanced technology. A survey was emailed to 712 dental practices: 116 responded (16% response rate), and 104 consented to participate (89.66%). Results indicated dental practices in Mississippi using EDRs was 46.07%, EDRs with paper records was 42.70%, and only paper records was 11.24%. Results indicated dental practices using digital radiography was 76.40%, conventional radiography was 13.48%, and both was 10.11%. Common reasons for not advancing were cost, insufficient training, computer/software issues, and “too old.”

In this thesis we present a numerical and analytical study of modelling extremes in chaotic dynamical systems. We study a range of examples with different dependency structures, and different clustering characteristics. We compare our analysis to the extreme statistics observed for financial returns data, and hence consider the modelling potential of using chaotic systems for understanding financial returns. As part of the study we use the block maxima approach and the peak over threshold method to compute the distribution parameters that arise in the corresponding extreme value distributions. We compare these computations to the theoretical answers, and moreover we obtain error bounds on the rate of convergence of these schemes. In particular we investigate the optimal block size when applying the block maxima method. Since the time series of observations on a dynamical system have dependency we must therefore go beyond the classic approach of studying extremes for independent identically distributed random variables. This is the main purpose of our study. As part of this thesis, we also study clustering in financial returns, and again investigate the potential of using dynamical systems models. Moreover we can also compare numerical quantification of clustering with theoretical approaches. As further work, we measure the dependency structures in our models using a rescaled range analysis. We also make preliminary investigations into record statistics for dynamical systems models, and relate our findings to record statistics in financial data, and to other models (such as random walk models).

No description available.

The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of being useful in retrieving and storing a patient’s lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline telecommunication network. The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical appraisal of the collated data resulted in the development of the proposed framework (MyTel) — a flexible telemedicine framework for the continuous upkeep of patients’ lifetime health records. Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage of patients’ demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the proposed framework more flexible and interoperable. The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health ICT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/final framework. The proposed framework may assist in achieving continual access to a patient’s lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient’s health history whenever required, even during the computer system’s downtime and the unavailability of the landline telecommunication network.

No description available.

Η πραγματικότητα είναι ότι στη σημερινή εποχή τα Δημόσια Νοσοκομεία αντιμετωπίζουν σοβαρά προβλήματα διαχείρισης και εκσυγχρονισμού των παρεχόμενων υπηρεσιών υγείας με κύριο αποτέλεσμα την αναποτελεσματικότητα της λειτουργίας τους και δυστυχώς το χαμηλό βαθμό ικανοποίησης των πολιτών. Ο πολίτης που καταφεύγει σε ένα Δημόσιο Νοσοκομείο ζητώντας την απαραίτητη υγειονομική φροντίδα και περίθαλψη δηλώνει σιωπηρά την εμπιστοσύνη του στις υπηρεσίες παροχής υγείας, καθώς και την αποδοχή του στο σύστημα της Δημόσιας Διοίκησης. Το σύστημα όμως δημιουργεί παραλείψεις, καθυστερήσεις, χαοτική γραφειοκρατία και υπέρογκες χρηματικές και μη-επιβαρύνσεις που έχουν σαν αποτέλεσμα τη χαμηλή απόδοση παραγωγής υπηρεσιών υγείας και την άναρχη λειτουργία του ιδιωτικού τομέα. Στην παρούσα διπλωματική εργασία θα μελετήσουμε τις αιτίες των προβλημάτων αυτών καθώς και τον Ιατρικό Φάκελο μέσα από τη σκοπιά της Πληροφορικής και λιγότερο της Οικονομίας. Όπως γνωρίζουμε τα τελευταία χρόνια η ανάπτυξη της τεχνολογίας έχει επιβάλλει μια διαφορετική παρουσίαση και οργάνωση της πληροφορίας. Ολοένα και περισσότερα εργαλεία δημιουργούνται ώστε να εξυπηρετήσουν τις ανάγκες για διαχείριση και διάθεση πληροφοριών. Οι εξελίξεις, τα συμπεράσματα καθώς και οι προβληματισμοί που αφορούν τον ηλεκτρονικό φάκελο υγείας αποτελούν και τον επίλογο της παρούσης διπλωματικής εργασίας. / The reality is that in today's era public hospitals are facing serious problems of management and modernization of health services with primary outcome inefficiency of operation and unfortunately the low degree of satisfaction. The citizen who resorts to a Public Hospital seeking necessary health care and care implicitly declares its confidence in the health services and the acceptance of the system of public administration. But the system creates omissions, delays, chaotic bureaucracy and excessive monetary and non-charges have resulted in a low yield health services and the uncontrolled operation of the private sector. In this particular paper we will study the causes of these problems and the medical records through the perspective of IT and less of the economy. As we know in recent years the development of technology has imposed a different presentation and organization of information. More and more tools are created to serve the needs for management and disposal information. These developments, findings and concerns relating to electronic health records is also the epilogue of this paper.

published_or_final_version / Community Medicine / Master / Master of Public Health