Databases for Health Care

I. Definition of the Technology.- A. Databases and Their Objectives.- B. Terminology in the Area of Data Bases.- 1. Components of databases.- 2. File management systems versus database management systems.- 3. Related Systems.- C. Scientific Basis for Database Technology.- 1. The schema.- 2. The data model.- 3. Types of database models.- D. Database Operation.- 1. Entering data into the database.- 2. Data storage.- 3. Data organization for retrieval.- 4. Data presentation.- 5. Database administration.- II. Use of Databases in Health Care.- A. Health Care Settings and the Relevancy of Database Technology.- 1. Private solo practice.- 2. Group practice.- 3. Specialty practice.- 4. Hospitals.- 5. Clinical research.- 6. Non-patient databases.- B. Current Health Care Applications of Databases.- 1. Reimbursement databases.- 2. Disease-specific shared databases.- 3. Databases used in HMO’s.- 4. Surveillance databases.- 5. Specialty clinical databases.- 6. General clinical databases.- 7. Databases in research.- C. The Future Use of Databases in Health Care.- 1. Cost-effectiveness issues.- 2. Initiatives and innovation due to technology push.- 3. The human element.- 4. Sharing of information.- 5. Privacy in Databases.- 6. Missing data.- 7. Problems of current interest.- D. The Effect of Databases on Health Care Costs, Quality, and Access.- III. State of the Art of Database Technology in Health Care.- A. Systems in Research or Development Status.- B. Industrial Status.- 1. Medical database systems.- 2. General database systems that are applicable to health care.- C. Current Directions of Development.- IV. Appendix: Examples of Current Databases in Health Care.- A. Public Health: CCPDS at the Fred Hutchinson Cancer Center in Seattle.- B. Randomized Controlled Clinical Trials: ECOG and RTOG at the Harvard Univ. Dept. of Public Health.- C. Clinical Research: TOD and ARAMIS at Stanford University.- D. HMO Support: COSTAR and the Harvard Community Health Service.- E. Hospital Systems: POMCS at Coral Gables Variety Childrens.- V. References.