Medical Blog

4 - Discussion

The study described in this work was conducted in four departments of the hospital Broussais do not have to Currently equipment mini-computer. This situation is representative of the situation of most services of the Assistance Publique de Paris. It is likely that different responses were obtained in services that already have such equipment and a computerized management functions of the unit care. Some needs, priority may be considered as secondary once the computerization made, or the reverse. The low response rate of certain categories of staff (nurses and lesser degree secretarial staff) may be an important cause of bias. Despite these caveats, a number of results seem clear from the analysis. All categories of staff expressed the need to computerize some functions see as priorities. It is the daily management of medical records and transactions between prescribers and caregivers, units care and medical facilities.

The prior art search for a patient already hospitalized or seen in consultation in hospital, the daily management of the case taking into account the requirements at the bedside and integration automatically results in the file and editing the mail are the priorities common to all personal. Conversely, all groups agree not judge the priority of a part called functions medical and administrative management (bed management and the technical support groups of patients by diagnoses, accounting) and other functions such as decision support management protocols. Regarding the items together differently in the four groups, we find there the reflection of activity Main occupational category: the permanent physicians are more interested in the first synthetic medical record (editing reports, publications, medical statistics), while nursing or dietary requirements are not part of their priorities. For physicians not permanent, what are the elements that can help achieve the observation that retain their interest (Opening the file from the records or previous medical history), and the updating of outcome of reviews and editing reports. Among nurses, the priorities are well management duties of appointment or statement of results of additional tests and the development of specific tools for particular nursing. Finally, the secretaries are more sensitive tools for editing records, scheduling appointments or management local archives. Note also that the establishment of information by civil registration system

IT is a necessity for everyone (for the system itself, for that matter), and, secondly, the appearance statistics (particularly administrative) side is not quite among the caregivers. Also note opposition between doctors and non doctors, expressed in two areas, the nursing and dietary requirements on the one hand, and the medical statistics and research protocols other.
In services oriented around a small number of diagnoses, it seems legitimate to consider the development and the establishment of specialized computer records, developed around these main pathologies. These records are of interest result in data structure that facilitates the work of registration medical observations, which can form a support clinical or epidemiological research. However, we do not find medical statistics or protocols in the first computing needs expressed by physicians surveyed. Conversely, a large variety of different diagnoses, frequency, respectively quite low, as is the case in Medicine and Surgery 6 or 2, are rather an indication of a common file minimum, unskilled, but directly accessible by the various services required to take charge of a same patient.

Orders of magnitude varied among laboratories, suggest top priorities SIH network development for laboratories to high flows of transactions. In fact, it is necessary wish a homogeneous functional development of the network, avoiding, when prescribing examinations Further, the establishment of different procedures for each laboratory and which might increase the overall complexity of the information system.

Conclusion

After this investigation, it appears that users want the overall development of a tool computer daily, which can identify three main features:
• a function ID server, for managing the civil status of patients and seek passage history of a patient in the facility and history of hospitalizations;
• management prescriptions, mostly requests for further investigations and especially automatic return of results;
• access to specialized tools and desktop publishing assistance reporting. The significant differences in terms of needs expressed by the various categories of personal justification thinking particularly careful in choosing a strategy that will satisfy everyone. An effort awareness of all personnel in the techniques of medical and administrative management is required if one wishes that these techniques are welcomed.
In all cases it is desirable to extend this type of analysis to other categories of personal sector health services that already have significant computer and other hospitals to obtain a vision of a more just and comprehensive computerization needs care units.