Tez No	İndirme	Tez Künye	Durumu
5660	Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.	Tıpta bilgisayar kullanımı ve bir bilişim sistemi geliştirme uygulaması / Yazar:OYA KALIPSIZ Danışman: PROF. DR. ÖNER ESEN Yer Bilgisi: İstanbul Üniversitesi / Sosyal Bilimler Enstitüsü / Sayısal Yöntemler Ana Bilim Dalı Konu:Bilgisayar Mühendisliği Bilimleri-Bilgisayar ve Kontrol = Computer Engineering and Computer Science and Control Dizin:	Onaylandı Doktora Türkçe 1989 254 s.
Kısıtlar çerçevesinde beklentileri gerçekleştirebilecek blok akış diyagramı düzenlenmiştir (Şekil-5.1). Yazılım sistem tasarımının çıktı spesifikasyonları olarak; hasta taburcu özetleri (Ek tablo -4 a,b,c), tanı ve tedavi gruplarına (Ek tablo-5 ve 6), taburcu şekline (Ek tablo-7) göre hasta liste leri, belli bir dönemde yapılan ameliyat (ek tablo-8) ve yatı rılan hasta (ek tablo-9) listeleri ile aylık istatistik fişi (ek tablo -12) hazırlanmıştır. Girdi spesifikasyonları olarak da veri kaynakları ve formlar (ek tablo-2 a/e, 3) belirlenmiş tir. Ana dosya spesifikasyonları olarak da; hasta bilgileri (ek tablo-13), tânı-tedavi kodları, doktor bilgileri, çıkış kodu (ek tablo -14) ana dosyaları düzenlenmiştir. İşlemler ve veri akışı, Seki 1-5. 2 de gösterilmiştir. Sistem geliştirme gideri 250.000,- Tl, çalıştırma ve ba kım giderleri de 350.000,- TL t ah lin edilmiştir. Yeni sistemin 1989 yılı başından itibaren işletmeye ge çirilmesi programlanmıştır.iv Bir hastane bilişim sisteminin geliştirilmesi, genel kurallara uygun olarak; 1) İnceleme ve analiz, 2) Sistem tasa rımı, 3) Yeni sistemin kurulması ve işletilmesi aşamalarında gerçekleştirilmelidir ( Şekil -4.1/4.16). Hastane bilişim sistemleri çoğunlukla ayrıntılı bir analiz ve değerlendirme yapılmaksızın, günlük gereksinime göre eklemeler halinde geliştirilmiştir. Bu durum, çeşitli sorunla ra yol açmaktadır. Keza elde edilen yığın halindeki veriler, halen sağlık hizmetlerinin ölçüm ve değerlendirilmesinde kul lanılamamaktadır. Bu sorun ve aksaklıkları gidermek için, sağ lık hizmetlerinde de bilişim sistemi geliştirmeleri, kurallara uygun olarak yürütülmelidir. Hastane bilişim sisteminin geliştirilmesine bir örnek olarak, burada İ.Ü. Cerrahpaşa Tıp Fakültesi Hekimlikte Acil Vak'alar Anabilim Dalı Kliniği bilişim sisteminin geliştiril mesi üzerine tarafımızdan bir çalışma yapılmıştır. Bilişim sistemini geliştirme, yönteme uygun olarak: 1) İnceleme ve analiz, 2) Sistem tasarımı, 3) Yeni sistemin kurulması ve iş letilmesi aşamalarında gerçekleştirilmiştir. Sistemin kısıtları: 1) Satın alınmış IBM uyumlu Bond- well mikrobilgisayarın kullanılması, 2) Yazılımın, kliniğin bugünkü işlemlerini yürütmek yanında tanı -tedavi ve doktor kodlarına, kabul ve ameliyat tarihlerine, taburcu tipine göre karşılaş t imalı listeler ve aylık istatistikler elde edebilecek biçimde özel olarak düzenlenmesi, 3) Hasta kaydı kalemlerinde gereksiz ayrıntıya yer verilmemesi, 4) Tanı ve tedavi kodlanma sında Anabilim Dalı başkanının ICD-9CM uluslararası hastalık sınıfları katalogundan yaptığı seçimin esas alınması, 5) Gele cekte ihtiyaca göre yazılım üzerinde değişiklik ve eklemeler yapılabilmesi, 6) Poliklinik hasta kayıtlarının eklenmesi ha linde, sistem kapasitesinin geliştirilmesi olarak belirlenmiş tir.Kısıtlar çerçevesinde beklentileri gerçekleştirebilecek blok akış diyagramı düzenlenmiştir (Şekil-5.1). Yazılım sistem tasarımının çıktı spesifikasyonları olarak; hasta taburcu özetleri (Ek tablo -4 a,b,c), tanı ve tedavi gruplarına (Ek tablo-5 ve 6), taburcu şekline (Ek tablo-7) göre hasta liste leri, belli bir dönemde yapılan ameliyat (ek tablo-8) ve yatı rılan hasta (ek tablo-9) listeleri ile aylık istatistik fişi (ek tablo -12) hazırlanmıştır. Girdi spesifikasyonları olarak da veri kaynakları ve formlar (ek tablo-2 a/e, 3) belirlenmiş tir. Ana dosya spesifikasyonları olarak da; hasta bilgileri (ek tablo-13), tânı-tedavi kodları, doktor bilgileri, çıkış kodu (ek tablo -14) ana dosyaları düzenlenmiştir. İşlemler ve veri akışı, Seki 1-5. 2 de gösterilmiştir. Sistem geliştirme gideri 250.000,- Tl, çalıştırma ve ba kım giderleri de 350.000,- TL t ah lin edilmiştir. Yeni sistemin 1989 yılı başından itibaren işletmeye ge çirilmesi programlanmıştır.
vt SUMMARY The hospital can be described as a systems diagram, showing the relationships among various inputs and environmen tal factors as these factors influence the provision of ser vices to the community (See Figure: 1.1) Hospital systems in clude mechanical systems, human systems, and man -machine sys tems. Most hospital information systems fall into machine category, with computers and other data-processing equipment used by hospital personnel. Organized systems in hospitals sould be also as cybernetic systems with formal management controls built in as an integral part of the design (see: Figur: 1.3). Any management control system in a hospital is obviously informati on -dependent. In order for major hospital functions to be properly managed, informations is needed about each of the major system component. Although hospital admi nistrators are becoming increasingly sophisticated in the effective use of information, there are still many ineffective practices wich are common in the hospital industry. Another major problem in many hospital information systems is the failure to apply consistent definitions to information ele ments collected continuously over a period of time. Hospitals generally use standart computer technology, although some hardware is specialized or particularly suitable for the hospital environment. Today's hospital computer sys tems are oriented toward on-line services, routine batch operations and facilities remain. Computer networking may be used to improve performance and reduce costs. Hospital infor mation systems obtain software from s variety of sources. In- house programming resources are normally used to modify commercial software packages, rather than to write complete new packages. Programming lanugages in common use include FORTRAN, COBOL, BASIC, PASCAL, PL/1, and RPGII. MUMPS is extensively used in hospital environment. APL is used in some environments.viii The master patient index is a permanent listing of all patients treated in a facility. It provides identification and location information regarding medical or health records. The cencus is the daily count of patients in the facility. Preparing and distributing the cencus and related statistics mean collecting, validating, and summarizing the number of hospital admissions, the actual number of patients in hospital beds, and the number of discharges and transfers and presenting the data in a daily census report that is distributed to all hospital departments. Screening admissions for utilization review is a pro cedure set up to certify hospital admissions. The review pro cess checks to see that individual admissions meet a predeter mined set of medical criteria and is used to determine justi fication for hospital admission. Coding diagnostic and procedural data means assigning a number or alphanumerical code to each of the various elements of a medical record. It allows for an organized approach in the later retrieval of such diagnostic and procedural data as diagnosis, operation, procedure, reason for visit, pathologic specimens, injuries, obstetric conditions an procedures, symptoms, mental conditions, congenital anomalies, physical signs and ill -defined conditions-Medical record practitioners will be familiar with many coding systems including ICD-9CM, CPT-4 and SNOMED. Indexing uses the code numbers assigned to rompile all records classified under one code number. Managing and controlling record accessibilty is an ope ration used to identify and control the location of patient records. Given a departmental objective to retrieve patient records within five minutes of a valid request, medical record department personnel responsible to carry out the request must rely on a specific method of retention and retrieval.vt SUMMARY The hospital can be described as a systems diagram, showing the relationships among various inputs and environmen tal factors as these factors influence the provision of ser vices to the community (See Figure: 1.1) Hospital systems in clude mechanical systems, human systems, and man -machine sys tems. Most hospital information systems fall into machine category, with computers and other data-processing equipment used by hospital personnel. Organized systems in hospitals sould be also as cybernetic systems with formal management controls built in as an integral part of the design (see: Figur: 1.3). Any management control system in a hospital is obviously informati on -dependent. In order for major hospital functions to be properly managed, informations is needed about each of the major system component. Although hospital admi nistrators are becoming increasingly sophisticated in the effective use of information, there are still many ineffective practices wich are common in the hospital industry. Another major problem in many hospital information systems is the failure to apply consistent definitions to information ele ments collected continuously over a period of time. Hospitals generally use standart computer technology, although some hardware is specialized or particularly suitable for the hospital environment. Today's hospital computer sys tems are oriented toward on-line services, routine batch operations and facilities remain. Computer networking may be used to improve performance and reduce costs. Hospital infor mation systems obtain software from s variety of sources. In- house programming resources are normally used to modify commercial software packages, rather than to write complete new packages. Programming lanugages in common use include FORTRAN, COBOL, BASIC, PASCAL, PL/1, and RPGII. MUMPS is extensively used in hospital environment. APL is used in some environments.viii The master patient index is a permanent listing of all patients treated in a facility. It provides identification and location information regarding medical or health records. The cencus is the daily count of patients in the facility. Preparing and distributing the cencus and related statistics mean collecting, validating, and summarizing the number of hospital admissions, the actual number of patients in hospital beds, and the number of discharges and transfers and presenting the data in a daily census report that is distributed to all hospital departments. Screening admissions for utilization review is a pro cedure set up to certify hospital admissions. The review pro cess checks to see that individual admissions meet a predeter mined set of medical criteria and is used to determine justi fication for hospital admission. Coding diagnostic and procedural data means assigning a number or alphanumerical code to each of the various elements of a medical record. It allows for an organized approach in the later retrieval of such diagnostic and procedural data as diagnosis, operation, procedure, reason for visit, pathologic specimens, injuries, obstetric conditions an procedures, symptoms, mental conditions, congenital anomalies, physical signs and ill -defined conditions-Medical record practitioners will be familiar with many coding systems including ICD-9CM, CPT-4 and SNOMED. Indexing uses the code numbers assigned to rompile all records classified under one code number. Managing and controlling record accessibilty is an ope ration used to identify and control the location of patient records. Given a departmental objective to retrieve patient records within five minutes of a valid request, medical record department personnel responsible to carry out the request must rely on a specific method of retention and retrieval.vt SUMMARY The hospital can be described as a systems diagram, showing the relationships among various inputs and environmen tal factors as these factors influence the provision of ser vices to the community (See Figure: 1.1) Hospital systems in clude mechanical systems, human systems, and man -machine sys tems. Most hospital information systems fall into machine category, with computers and other data-processing equipment used by hospital personnel. Organized systems in hospitals sould be also as cybernetic systems with formal management controls built in as an integral part of the design (see: Figur: 1.3). Any management control system in a hospital is obviously informati on -dependent. In order for major hospital functions to be properly managed, informations is needed about each of the major system component. Although hospital admi nistrators are becoming increasingly sophisticated in the effective use of information, there are still many ineffective practices wich are common in the hospital industry. Another major problem in many hospital information systems is the failure to apply consistent definitions to information ele ments collected continuously over a period of time. Hospitals generally use standart computer technology, although some hardware is specialized or particularly suitable for the hospital environment. Today's hospital computer sys tems are oriented toward on-line services, routine batch operations and facilities remain. Computer networking may be used to improve performance and reduce costs. Hospital infor mation systems obtain software from s variety of sources. In- house programming resources are normally used to modify commercial software packages, rather than to write complete new packages. Programming lanugages in common use include FORTRAN, COBOL, BASIC, PASCAL, PL/1, and RPGII. MUMPS is extensively used in hospital environment. APL is used in some environments.