A municipalização vem transformando a lógica das relações entre usuários, serviços e gestores e, neste cenário as ações desenvolvidas pela Divisão de Avaliação, Controle e Auditoria (DACA) tornam-se cada vez mais relevantes. Os objetivos deste estudo foram: descrever a produção de internações hospitalares processadas e remuneradas, no período de 1996 a 2003, pela Secretaria Municipal de Saúde de Ribeirão Preto-SP (SMS-RP), nos aspectos físicos e financeiros; identificar os fatores explicativos para a variação desta produção segundo relato dos sujeitos que produzem e/ou utilizam as informações sobre internação hospitalar no município de estudo. As bases teóricas da investigação constituíram-se: das Normas Operacionais Básicas e Normas Operacionais da Assistência à Saúde com vistas à implementação do Sistema Único de Saúde; o financiamento, o sistema de informações e gestão das internações hospitalares na esfera local de saúde. Para desenvolvimento da pesquisa adotou-se uma abordagem descritiva utilizando dados quantiqualitativos. A população de estudo constituiu-se de todas as internações hospitalares processadas/pagas pela SMS-RP, através do Sistema de Informações Hospitalares do SUS (SIH-SUS), para os cinco hospitais (A,B,C,D e E) contratados/conveniados com o SUS, no período de 1996-2003, nas especialidades de clínica médica, cirurgia, obstetrícia e pediatria. As técnicas de coleta de dados foram a pesquisa documental em banco de dados oficiais da DACA e DATASUS referente às internações hospitalares e, a realização de entrevista semi estruturada e ilustrada por uma vinheta. Foram sujeitos do estudo 18 pessoas que no sistema local de saúde, produzem e/ou utilizam as informações pertinentes às internações hospitalares no município para fins de avaliação, auditoria, controle e tomada de decisão quanto à distribuição de Autorização de Internação Hospitalar (AIH) e alocação de recursos financeiros. No período de 1996-2003 foram pagas pela SMS-RP 160.612 internações, totalizando gastos da ordem de R$ 98.154.570,78. Houve, no período, um incremento de 56% no número de internações e de 156,3% nos recursos financeiros. Nos hospitais B e C, ambos filantrópicos, as internações cresceram 91,3% e 27,9%, respectivamente, concentrando cerca de 2/3 das internações do período. O hospital A (privado) mostrou redução de 85,9% no volume de internações, porém os valores médios de AIH são elevados, indicando que o hospital pode ter se especializado em procedimentos de alto custo. As internações na especialidade de clínica cirúrgica cresceram 72,4% e, na clínica médica, 60,7%. Na especialidade de obstetrícia o crescimento de internações foi de 31,6% e na pediatria de 31,4%. O valor médio de AIH apresentou variação entre os cinco hospitais, sendo que o menor valor foi de R$ 40,38 na pediatria e o maior, de R$ 6.963,82 na clínica cirúrgica. Os valores financeiros alocados tiveram um crescimento acentuado em relação a produção física. Os fatores explicativos apontados pelos entrevistados para a variação na produção de internações dizem v respeito à estrutura demográfica e envelhecimento da população; organização do sistema local de saúde; incorporação tecnológica, financiamento e atuação do gestor. Os resultados obtidos indicam a necessidade de organização e sistematização das atividades da DACA para instrumentalizar o gestor nos aspectos de fiscalização, controle, regulação e avaliação da produção de internações no âmbito do sistema local de saúde. / Bringing hospital admissions under municipal control has transformed the logic in the relationship among users, services and management and this frame, the actions deployed by the Evaluation, Control and Audit Division (DACA) become more and more relevant. The goals of the present study are: describing, taking into account financial and physical aspects, hospital admissions that took place from 1996 to 2003 record and paid by the Municipal Health Department of Ribeirão Preto and identifying the factors explaining variations in these admissions according to reports made by subjects producing and using informations about them at local level. The following elements constitute the theoretical bases of the present study: Basic Operational Norms and Heath Care Operational Norms having as goal the implementation of Unified Health Care System (SUS), funding, information system and hospital admission management within the municipality. In order to develop the research the descritive approach using dates the quantitative and qualitative. The population studied was composed of all hospital admissions recorded and paid by the Municipal Health Department, through the Hospital Information System of Unified Health Care System (SUS), to all five hospital (A,B,C,D e E) under contract to SUS in the period from 1996 to 2003 in the following specialities: general medic practice, surgery, obstetrics and pediatrics. The techniques of collecting data were to investigate into official documents and data banks belonging to DACA and DATASUS relating to hospital admissions and doing a semistructured interview illustrated by the aid of a sequence. The study had 18 subjects who in the local system produce and use informations about hospital admissions in the order to make them available, to control, audit, evaluation and decision making so that they can be used in the distribution of Hospital Admission Authorization and allocation of financial resources. In the period from 1996 to 2003, the Municipal Health Department paid 160.612 hospital admissions what led to expenses amounting to R$ 98.154.570,98. In the same period there was an increase of 56 % in the number of hospital admissions and 156,3% in the financial resources. In the hospitals B and C, both philanthropic institutions, admissions grew by 91,3% and by 27,9% respectively, representing 2/3 vii of the admissions in the period. Hospital A, private, showed an 85,9% reduction of admissions in the same period. However, the average levels of Hospital Admission Authorization were very high, indicating that the hospital may have focused rather on high-cost procedures. Admissions in the clinic surgery increased by 72,4% and the general medic practice by 60,7%. In obstetrics, the increase of admissions was 31,6% and the pediatrics of 31,4%. The average value of the Hospital Admission Authorization presented variations among the five hospitals and the highest cost was R$ 6.993,82 in clinic surgery and the lowest one was R$ 40,38 in pediatrics. It was also observed that the financial and physical production changed each year and among the five hospitals. The allocated financial values had a considerable increase as compared to physical production. The pointed explanatory factors for the interviewees for the variation in the production of hospital admission production concern the demographic structure and aging of the population; organization of the local system of health; technological incorporation, financing and the manager's performance. The obtained results indicate the organization need and systematize of the activities of DACA for instrumental the manager in the fiscalization aspects, control, regulation and evaluation of the production. hospital admissions in all aspects at local level of health.

Os modelos tridimensionais fornecem uma visão mais completa dos objetos analisados por considerarem a profundidade de cada um deles. Com o crescimento de modelos tridimensionais disponíveis atualmente na área de saúde, se faz necessária a implementação de mecanismos eficientes de busca, que ofereçam formas alternativas para localizar casos de pacientes com determinadas características. A disponibilização de um histórico de imagens similares em relação àquelas pertencentes ao exame do paciente pode auxiliar no diagnóstico oferecendo casos semelhantes. O presente projeto visou desenvolver técnicas para recuperação de imagens médicas tridimensionais com base em seu conteúdo, com foco no contexto médico, mais especificamente na área cardíaca. Pretendeu-se contribuir com a detecção de anomalias por meio da disponibilização de quadros clínicos similares por meio de um protótipo de sistema de consulta. Para alcançar o objetivo proposto foram realizadas as seguintes etapas: revisão bibliográfica, definição da base de dados, implementação de extratores e funções de similaridade, construção de um protótipo de sistema de recuperação, realização de testes com imagens médicas e análises dos resultados. Os resultados obtidos com os métodos desenvolvidos foram positivos, alcançando em alguns testes 90% de precisão no retorno da busca. Verificou-se que extratores que levaram em consideração a informação espacial das deformações obtiveram um resultado melhor do que os métodos que analisaram os modelos sob uma perspectiva global. Estes resultados confirmaram o potencial que a recuperação por conteúdo possui no contexto médico podendo auxiliar na composição de diagnósticos, além de contribuir com a área de Computação no sentido de ter desenvolvido técnicas para recuperação por conteúdo no domínio de modelos tridimensionais. / Three-dimensional models provide a more complete view about objects analyzed by considering their depth. Considering the growth of three-dimensional models currently available in Health area, it is necessary to implement ecient query mechanisms that oer alternative ways to locate cases of patients with certain characteristics. Providing a images historical similar to those belonging to the patient can aided the diagnosis oering similar clinical cases. This project aimed to develop techniques to recovery three-dimensional medical images based on their content and apply them in the medical context, specically in the Cardiology area. This project intended to contribute to the detection of anomalies making available similar clinical cases, throught a prototype of query system. To achieve the proposed objectives the following phases are planned: literature review, denition of the database that will be used, extractors and similarity functions implementation, cons-truction of a retrieval system prototype, conduction of tests with medical imaging and analysis of results. The results obtained with the methods developed were positive, in some tests were achieved 90% of accuracy in the search return. It was found that descrip-tors that took into account the spatial information of the deformations obtained a better result than the methods which analyzed the models from a global perspective. These results conrmed the potential of content based retrieval has in the medical context to assist in diagnosis composition as well as contributing to the Computing eld in the sense of had developed content based retrieval methods on three-dimensional models domain.

This diploma thesis is focused on information systems in the field of hospital and nursing-care bed management and contactless vital signals monitoring. The aim of this thesis is to provide the basic overview of information systems used in health care facilities, to introduce both the LINis and Vitalmonitor systems, to analyse the effectiveness of their implementation as well as to prepare their financing models. The introductory section defines the area of health information systems. It covers the whole system spectrum from the strategic to the less important ones. This definition determines the environment for the new systems. The analysis of the largest suppliers within the Czech Republic is also included in this section. The second part deals with the LINis system and Vitalmonitor system, their basic functionality, structure and integration. The most important is the third section which contains the analysis of the effects resulting from the standard information system extension. The Effects of the LINis system and Vitalmonitor system are assessed according to the level of patient care, staff performance, value added for different types of medical facilities and financing models.

A municipalização vem transformando a lógica das relações entre usuários, serviços e gestores e, neste cenário as ações desenvolvidas pela Divisão de Avaliação, Controle e Auditoria (DACA) tornam-se cada vez mais relevantes. Os objetivos deste estudo foram: descrever a produção de internações hospitalares processadas e remuneradas, no período de 1996 a 2003, pela Secretaria Municipal de Saúde de Ribeirão Preto-SP (SMS-RP), nos aspectos físicos e financeiros; identificar os fatores explicativos para a variação desta produção segundo relato dos sujeitos que produzem e/ou utilizam as informações sobre internação hospitalar no município de estudo. As bases teóricas da investigação constituíram-se: das Normas Operacionais Básicas e Normas Operacionais da Assistência à Saúde com vistas à implementação do Sistema Único de Saúde; o financiamento, o sistema de informações e gestão das internações hospitalares na esfera local de saúde. Para desenvolvimento da pesquisa adotou-se uma abordagem descritiva utilizando dados quantiqualitativos. A população de estudo constituiu-se de todas as internações hospitalares processadas/pagas pela SMS-RP, através do Sistema de Informações Hospitalares do SUS (SIH-SUS), para os cinco hospitais (A,B,C,D e E) contratados/conveniados com o SUS, no período de 1996-2003, nas especialidades de clínica médica, cirurgia, obstetrícia e pediatria. As técnicas de coleta de dados foram a pesquisa documental em banco de dados oficiais da DACA e DATASUS referente às internações hospitalares e, a realização de entrevista semi estruturada e ilustrada por uma vinheta. Foram sujeitos do estudo 18 pessoas que no sistema local de saúde, produzem e/ou utilizam as informações pertinentes às internações hospitalares no município para fins de avaliação, auditoria, controle e tomada de decisão quanto à distribuição de Autorização de Internação Hospitalar (AIH) e alocação de recursos financeiros. No período de 1996-2003 foram pagas pela SMS-RP 160.612 internações, totalizando gastos da ordem de R$ 98.154.570,78. Houve, no período, um incremento de 56% no número de internações e de 156,3% nos recursos financeiros. Nos hospitais B e C, ambos filantrópicos, as internações cresceram 91,3% e 27,9%, respectivamente, concentrando cerca de 2/3 das internações do período. O hospital A (privado) mostrou redução de 85,9% no volume de internações, porém os valores médios de AIH são elevados, indicando que o hospital pode ter se especializado em procedimentos de alto custo. As internações na especialidade de clínica cirúrgica cresceram 72,4% e, na clínica médica, 60,7%. Na especialidade de obstetrícia o crescimento de internações foi de 31,6% e na pediatria de 31,4%. O valor médio de AIH apresentou variação entre os cinco hospitais, sendo que o menor valor foi de R$ 40,38 na pediatria e o maior, de R$ 6.963,82 na clínica cirúrgica. Os valores financeiros alocados tiveram um crescimento acentuado em relação a produção física. Os fatores explicativos apontados pelos entrevistados para a variação na produção de internações dizem v respeito à estrutura demográfica e envelhecimento da população; organização do sistema local de saúde; incorporação tecnológica, financiamento e atuação do gestor. Os resultados obtidos indicam a necessidade de organização e sistematização das atividades da DACA para instrumentalizar o gestor nos aspectos de fiscalização, controle, regulação e avaliação da produção de internações no âmbito do sistema local de saúde. / Bringing hospital admissions under municipal control has transformed the logic in the relationship among users, services and management and this frame, the actions deployed by the Evaluation, Control and Audit Division (DACA) become more and more relevant. The goals of the present study are: describing, taking into account financial and physical aspects, hospital admissions that took place from 1996 to 2003 record and paid by the Municipal Health Department of Ribeirão Preto and identifying the factors explaining variations in these admissions according to reports made by subjects producing and using informations about them at local level. The following elements constitute the theoretical bases of the present study: Basic Operational Norms and Heath Care Operational Norms having as goal the implementation of Unified Health Care System (SUS), funding, information system and hospital admission management within the municipality. In order to develop the research the descritive approach using dates the quantitative and qualitative. The population studied was composed of all hospital admissions recorded and paid by the Municipal Health Department, through the Hospital Information System of Unified Health Care System (SUS), to all five hospital (A,B,C,D e E) under contract to SUS in the period from 1996 to 2003 in the following specialities: general medic practice, surgery, obstetrics and pediatrics. The techniques of collecting data were to investigate into official documents and data banks belonging to DACA and DATASUS relating to hospital admissions and doing a semistructured interview illustrated by the aid of a sequence. The study had 18 subjects who in the local system produce and use informations about hospital admissions in the order to make them available, to control, audit, evaluation and decision making so that they can be used in the distribution of Hospital Admission Authorization and allocation of financial resources. In the period from 1996 to 2003, the Municipal Health Department paid 160.612 hospital admissions what led to expenses amounting to R$ 98.154.570,98. In the same period there was an increase of 56 % in the number of hospital admissions and 156,3% in the financial resources. In the hospitals B and C, both philanthropic institutions, admissions grew by 91,3% and by 27,9% respectively, representing 2/3 vii of the admissions in the period. Hospital A, private, showed an 85,9% reduction of admissions in the same period. However, the average levels of Hospital Admission Authorization were very high, indicating that the hospital may have focused rather on high-cost procedures. Admissions in the clinic surgery increased by 72,4% and the general medic practice by 60,7%. In obstetrics, the increase of admissions was 31,6% and the pediatrics of 31,4%. The average value of the Hospital Admission Authorization presented variations among the five hospitals and the highest cost was R$ 6.993,82 in clinic surgery and the lowest one was R$ 40,38 in pediatrics. It was also observed that the financial and physical production changed each year and among the five hospitals. The allocated financial values had a considerable increase as compared to physical production. The pointed explanatory factors for the interviewees for the variation in the production of hospital admission production concern the demographic structure and aging of the population; organization of the local system of health; technological incorporation, financing and the manager's performance. The obtained results indicate the organization need and systematize of the activities of DACA for instrumental the manager in the fiscalization aspects, control, regulation and evaluation of the production. hospital admissions in all aspects at local level of health.

Os modelos tridimensionais fornecem uma visão mais completa dos objetos analisados por considerarem a profundidade de cada um deles. Com o crescimento de modelos tridimensionais disponíveis atualmente na área de saúde, se faz necessária a implementação de mecanismos eficientes de busca, que ofereçam formas alternativas para localizar casos de pacientes com determinadas características. A disponibilização de um histórico de imagens similares em relação àquelas pertencentes ao exame do paciente pode auxiliar no diagnóstico oferecendo casos semelhantes. O presente projeto visou desenvolver técnicas para recuperação de imagens médicas tridimensionais com base em seu conteúdo, com foco no contexto médico, mais especificamente na área cardíaca. Pretendeu-se contribuir com a detecção de anomalias por meio da disponibilização de quadros clínicos similares por meio de um protótipo de sistema de consulta. Para alcançar o objetivo proposto foram realizadas as seguintes etapas: revisão bibliográfica, definição da base de dados, implementação de extratores e funções de similaridade, construção de um protótipo de sistema de recuperação, realização de testes com imagens médicas e análises dos resultados. Os resultados obtidos com os métodos desenvolvidos foram positivos, alcançando em alguns testes 90% de precisão no retorno da busca. Verificou-se que extratores que levaram em consideração a informação espacial das deformações obtiveram um resultado melhor do que os métodos que analisaram os modelos sob uma perspectiva global. Estes resultados confirmaram o potencial que a recuperação por conteúdo possui no contexto médico podendo auxiliar na composição de diagnósticos, além de contribuir com a área de Computação no sentido de ter desenvolvido técnicas para recuperação por conteúdo no domínio de modelos tridimensionais. / Three-dimensional models provide a more complete view about objects analyzed by considering their depth. Considering the growth of three-dimensional models currently available in Health area, it is necessary to implement ecient query mechanisms that oer alternative ways to locate cases of patients with certain characteristics. Providing a images historical similar to those belonging to the patient can aided the diagnosis oering similar clinical cases. This project aimed to develop techniques to recovery three-dimensional medical images based on their content and apply them in the medical context, specically in the Cardiology area. This project intended to contribute to the detection of anomalies making available similar clinical cases, throught a prototype of query system. To achieve the proposed objectives the following phases are planned: literature review, denition of the database that will be used, extractors and similarity functions implementation, cons-truction of a retrieval system prototype, conduction of tests with medical imaging and analysis of results. The results obtained with the methods developed were positive, in some tests were achieved 90% of accuracy in the search return. It was found that descrip-tors that took into account the spatial information of the deformations obtained a better result than the methods which analyzed the models from a global perspective. These results conrmed the potential of content based retrieval has in the medical context to assist in diagnosis composition as well as contributing to the Computing eld in the sense of had developed content based retrieval methods on three-dimensional models domain.

Industrial experts agree that cloud computing can significantly improve business and public access to low cost computing power and storage. Despite the benefits of cloud computing, recent research surveys indicated that its adoption in U.S. hospitals is slower than expected. The purpose of this study was to understand what factors influence cloud adoption in U.S. hospitals. The theoretical foundation of the research was the diffusion of innovations and technology-organization-environment framework. The research question was to examine the predictability of cloud computing adoption for U.S. hospitals as a function of 6 influential factors: relative advantage, compatibility, complexity, organizational size, structure, and culture. The research methodology included a cross-sectional survey with an existing validated questionnaire. A stratified random sample of 118 information technology managers from qualified U.S. hospitals completed the questionnaire. The categorical regression analysis rendered F statistics and R2 values to test the predictive models. The research results revealed that all 6 influential factors had significant correlations with the public cloud adoption intent (adjusted R2 = .583) while only the 3 technological factors had significant correlations with the private cloud adoption intent (adjusted R2 = .785). The recommendation is to include environmental factors and increase sample size in the similar future research. The developed predictive models provided a clearer understanding among hospital IT executives and cloud service providers of cloud adoption drivers. The potential implications for positive social change can be the increase of efficiency and effectiveness in U.S. hospital operation once their speed of cloud adoption has increased.

As a consequence of the quick development of information technologies there has been a natural and gradual transition to the electronic data storage in nursing. The firstversions of the software application for such documentation have been developed in cooperation with professionals dealing with information technologies in the States of the European Union and it is the nurses who decide what the content of the nursing documentation will be. Therefore it is very important that the nurses {--} as the main users of this software {--} are actively involved in the creation process of the electronic nursing documentation. The advantage of introducing the electronic nursing documentation is filing of the important data about a client in the NIS where it is possible to retrieve the history anytime. In contrast to the traditional records, it is easier to read these records and it is not possible to cross any information out or lose it. Further, it saves nurses{\crq} time, it automatically records time and name of the medical worker who logged in the NIS and it meets the recommendations of the accreaditation standards. A qualitative research was used in the research part of this thesis. A semi-standardized interview with the head nurses and a structured interview with the senior staff nurses and ward sisters of the departments of internal medicine and of surginal wards of the selected hospitals were used to collect the data. Further, the method of content analysis was used to compare the electronic nursing documentation in the individua surveyed hospitals. The structured interview with the senior staff nurses and ward nurses was not done in the Hospital České Budějovice, a.s. because the programme of the electronic nursing documentation has not been started there. Case reports are created based on the gained interview results. The case reports comprise the research base on which categorized charts in which the research results are recorded are based. The research was conducted from January till June 2009. The surveyed group consists of head nurses, two senior staff nurses and two ward sisters of the departments of internal medicine and of surginal wards of the selected hospitals of the chosen regions of the Czech Republic. The research was conducted in the South Bohemian Region {--} the Hospital České Budějovice, a.s., the Pilsen Region {--} the Teaching Hospital Plzeň, the South Moravian Region {--} the Teaching Hospital Brno and the Vysočina Region {--} the Hospital Jihlava, p.o. Four research questions were defined at the beginning of our research in order to achieve our goal. The research questions 1: Does the electronic nursing documentation contain all phases of the nursing process (anamnesis, diagnosis, care plan and assessment)? The research questions 2: Is the nursing taxonomy a part of the electronic nursing documentation of each patient? How is the record of the nursing diagnosis created (crossing x filling in)? The research questions 3: Which nursing model has become the basis for the nursing anamnesis of the electronic nursing documentation? The research questions 4: Can the nurses take an active part in the preparation process of the electronic nursing documentation? All our research questions have been answered. We defined the following hypotheses based on the results of our research: H1: The electronic nursing documentation contains nursing anamnesis based on the Marjory Gordon{\crq}s conceptual model. H2: The nurses are offered to cooperate in the creation process of the electronic nursing documentation. H3: There is a taxonomy part in the nursing documentation. H4: The electronic nursing documentation covers all phases of the nursing process. We belive that the results of he

Hospital Information Systems (HIS) are considering a significant aspect for supporting health care professionals in their work. However, a large number of them are often poor to provide the needed information for accomplishing various work activities in the oriented environment. The aim of this research is to address users’-Administrators and Clinicians- perceptions in order to gain a deeper knowledge about problems they encounter with daily work performed through IS. Additionally, the scope is extended into formulating suggestions through the employment of Soft System Methodology (SSM) that could bring improvements. A qualitative interpretive method with an inductive analysis was followed. Data collection completed through focus group interview sessions and the adoption of SSM three activities in order to acquire the complexity of the problem situation.   Research findings revealed that despite IS Lisora serves as a tool for supporting users work operations, it causes significant problems in their daily operations since the information flow are not feasible. Thus, the research study suggests five feasible and desirable improvements that could improve the overall processes followed by the hospital’s users and bring improvements. In all, SSM was proved to be very efficient in identifying problems that exist. In this way proposed solutions to the problems were enlightened. The general hospital of Preveza shall benefit from the higher efficiency offered by the system, which in turn shall improve the quality of health-care services offered.

Introduction : L’amélioration de la pertinence des soins est une priorité nationale. À l’hôpital, elle peut s’appuyer sur la mesure d’indicateurs. L’objectif était de : (i) définir le cadre méthodologique et les enjeux liés au développement, à la validation et à la diffusion d’indicateurs ; (ii) construire une démarche de développement, validation et diffusion d’indicateurs de pertinence des prescriptions d’anticoagulants oraux (ACO) automatisés. Méthodes : La définition du cadre méthodologique et des enjeux a été réalisée à partir de synthèses de la littérature et de travaux exploratoires. La démarche appliquée aux indicateurs d’ACO reposait sur : (i) une revue de littérature pour définir des indicateurs à partir de recommandations européennes ; (ii) un consensus d’experts pour sélectionner des indicateurs utiles et opérationnels ; (iii) le développement prospectif de techniques de recherche de l’information pour construire les indicateurs ; (iv) une étude transversale pour évaluer les performances métrologiques des indicateurs. Résultats : Le cadre méthodologique et les enjeux ont été définis. La démarche appliquée aux indicateurs d’ACO a permis : (i) la définition de 19 indicateurs ; (ii) la sélection de 16 indicateurs utiles et opérationnels ; (iii) le développement de techniques pour construire les indicateurs via un entrepôt de données ; (iv) la proposition de méthodes pour évaluer les performances métrologiques des indicateurs en comparaison à un test de référence. Conclusion : Ces travaux apportent des outils pour développer, valider et diffuser des indicateurs. Les indicateurs les plus performants pourront être utilisés par des établissements de santé européens. / Introduction: Improvement of the appropriateness of care is a national priority. In hospitals, it can rely on the measurement of indicators. The objective was to: (i) define the methodological framework and challenges related to the development, validation and feedback of indicators; (ii) implement an approach for the development, validation and feedback of automated indicators of the appropriateness of oral anticoagulant (OA) prescriptions. Methods: Definition of the methodological framework and challenges has been performed through syntheses of literature data and exploratory works. The approach applied to indicators on OA prescriptions was based on: (i) a literature review to define indicators from European guidelines; (ii) a consensus of experts to select useful and operational indicators; (iii) the prospective development of data search techniques for retrieving information aimed at implementing indicators; (iv) a cross-sectional study to assess the ability of indicators to detect inappropriate OA prescriptions. Results: The methodological framework and challenges have been defined. The approach applied to indicators on OA prescriptions allowed: (i) defining 19 indicators; (ii) selecting 16 useful and operational indicators; (iii) developing techniques for implementing indicators from a data warehouse; (iv) developing methods for assessing the ability of tools to detect inappropriate OA prescriptions in comparison to a reference test. Conclusion: This work provides tools to develop, validate and convey indicators. The most performant indicators to detect inappropriate OA prescriptions may be used by European healthcare institutions.

This thesis deals with the information support of laboratory requisitions in medical facilities in the Czech Republic. Its aim is to analyze the usage status of electronic request systems and their integration into hospital systems in practice of Czech medical equipment. Further, on the basis of the survey, the thesis draws conclusions about the overall state and an assumed development of such systems. The analysis was conducted by means of questionnaire survey in a randomly chosen sample of health facilities in the CR. The study results can serve both to the actual respondents who participated in the study for comparison with the competition and to IS / ICT companies for the eventual development of application software systems to support the analyzed area. The work is divided into a theoretical and a practical part. The theoretical part is based on the available research, literature and electronic sources concerning information technology in health care. The practical part deals with the research study - a questionnaire survey, analysis, and interpretation of results.