Automated Health Information System. . .

Health information system is often being used without a clear definition of its objectives, components and area of application. This paper reviews the types and major uses of systems designed for collecting, processing, analyzing and distributing information required for organizing and operating health services. Theoretical considerations based on information theory, systems theory and the prevailing planning ideology for the development of the data base of such systems as well as practical guidelines for the inclusion of specific data items into the data base, are being presented.

Enormous investment has gone into computerised hospital information systems worldwide. The estimated costs for each large hospital are about $50m (£33m), yet the overall benefits and costs of hospital information systems have rarely been assessed.When systems are evaluated, about three quarters are considered to have failed, and there is no evidence that they improve the productivity of health professionals.

To generate information that is useful to decision makers, evaluations of hospital information systems need to be multidimensional, covering many aspects beyond technical functionality. A major new information and communication technology initiative in South Africa gave us the opportunity to evaluate the introduction of computerisation into a new environment. We describe how the project and its evaluation were set up and examine where the project went wrong. The lessons learnt are applicable to the installation of all hospital information systems.

Telenursing. . .

Telenursing refers to the use of telecommunications and information technology for providing nursing services in health care whenever a large physical distance exists between patient and nurse, or between any number of nurses. As a field it is part of telehealth, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, telemonitoring, etc.

Telenursing is achieving a large rate of growth in many countries, due to several factors: the preoccupation in driving down the costs of health care, an increase in the number of aging and chronically ill population, and the increase in coverage of health care to distant, rural, small or sparsely populated regions. Among its many benefits, telenursing may help solve increasing shortages of nurses; to reduce distances and save travel time, and to keep patients out of hospital. A greater degree of job satisfaction has been registered among telenurses.

Nurses are a central part of the use of technologies in health care. As such, telenursing is not a new role for nurses. There is evidence of existence of the role of telenurses for more than 25 years. In fact, any nurse who has provided guidance, education, or lab results over the telephone has taken part in telenursing. However, telenursing can also include more sophisticated systems than the telephone, such as two-way audio and video systems, Internet, satellite, and other communication systems.        

Telenursing is fraught with legal, ethical and regulatory issues, as it happens with telehealth as a whole. In many countries, interstate and intercountry practice of telenursing is forbidden (the attending nurse must have a license both in her state/country of residence and in the state/country where the patient receiving telecare is located). Legal issues such as accountability and malpractice, etc. are also still largely unsolved and difficult to address. In addition, there are many considerations related to patient confidentiality and safety of clinical data.