Difference between revisions of "Diogene"

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In 1999, an effort was made to integrate the many clinical databases that have developed over the years in different departments in the hospital with "Diogene 2". The challenge was in the integration of different systems developed by different teams with different references and vocabulary (8). Therefore, a newly developed clinical vocabulary was created based on the international ICD classification which facilitated the communication and exchange of data (7).
 
In 1999, an effort was made to integrate the many clinical databases that have developed over the years in different departments in the hospital with "Diogene 2". The challenge was in the integration of different systems developed by different teams with different references and vocabulary (8). Therefore, a newly developed clinical vocabulary was created based on the international ICD classification which facilitated the communication and exchange of data (7).
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DOCLIN is a clinical information system that is integrated with DIOGENE. DOCLIN was created for the communication and the exchange of data between different medical departments at the University of Geneva that had independently created and operated databases. The 4 year-project began in 1997. (9)
  
 
Diogene now supports many applications including lab, radiology, and pharmacy (2).  It went from centralized to an open distributed architecture; therefore, reaching other public hospitals and general practitioners in Geneva.   
 
Diogene now supports many applications including lab, radiology, and pharmacy (2).  It went from centralized to an open distributed architecture; therefore, reaching other public hospitals and general practitioners in Geneva.   

Revision as of 02:22, 18 January 2010

Joan Breuer, Ph.D. 01/12/2010 19:41 The primary person that started this system is: Professeur Jean-Raoul Scherrer, MD. The following new information covers new, improved clinical applications of Diogene: Start here: http://www.ncbi.nlm.nih.gov/pubmed/10978919 Int J Med Inform. 2000 Sep;58-59:167-77.

Expanding DIOGENE with a clinical information system based on a new hospital-wide clinical findings dictionary. Bréant C, Borst F, Campi D, Griesser V, Son Le H, Junod JM.

Medical Informatics Division, University Hospital of Geneva, 1211 Geneva 14, Switzerland. claudine.breant@dim.hcuge.ch

The DIOGENE hospital information system has been expanded with a centralized and integrated patient clinical database recording structured patient data. The objective is to provide a standardized framework for the building of future clinical databases and for the integration of existing heterogeneous ones. The combined 'across time view' and 'across departments view' generated from the integrated clinical data will enable an evolutionary view of the patient state, both across time and across medical specialties. For this purpose and to permit the communication and exchange of data, a new controlled vocabulary for representing clinical data has been created. The construction of this vocabulary is based on the international ICD classification, already being used in DIOGENE for encoding patient diagnosis and procedures. A new extension of the ICD is proposed for medical information that goes beyond diagnosis and procedures encoding. The building of a common clinical findings dictionary, recording the definition of clinical entities, is based on this newly developed clinical vocabulary. This process is incremental, manual and substantial.

PMID: 10978919 [PubMed - indexed for MEDLINE]

End editing by JoanBreuer here

Diogene was developed in the 1970's (1) by Professeur Jean-Raoul Scherrer, MD at the University Hospital in Geneva, Switzerland (2). The need for this hospital information system arose as medical expenses had to be directly compared to the quality of healthcare provided (6).


The system had both a centralized patient database, and centralized group of operators who train and support users. The centralized patient database included mechanisms for data protection and recovery of a transaction-oriented system. It also included a separate network of remote printers that provided service throughout the entire institution; and a three-component structure that enhanced communication between administrative and medical applications (1). It retained its architectural unity until Diogene 2 was launched.

In 1993, Unimage, a radiology information system was created and implemented at the Cantonal University Hospital of Geneva as a part of the migration towards the Diogene 2 hospital information system. It was designed to fit the needs of the radiology department, and to operate in different services, (i.e. diagnostic radiology, nuclear medicine and therapy radiology) offering a simple two-way data communication with the PACS world; created for a distributed environment, as well as a graphical (X/Motif) user interface (4).

In June 1995, the need for modification and extension over the years led to the creation of a full-scale distributed/open hospital information system “Diogene 2” (5). Diogene 2 integrated knowledge by incorporating knowledge bases such as Medline providing relevant information for helping the physician to take adequate decisions; and medico-economical issues helping to understand resources consumption (6).

In 1999, an effort was made to integrate the many clinical databases that have developed over the years in different departments in the hospital with "Diogene 2". The challenge was in the integration of different systems developed by different teams with different references and vocabulary (8). Therefore, a newly developed clinical vocabulary was created based on the international ICD classification which facilitated the communication and exchange of data (7).

DOCLIN is a clinical information system that is integrated with DIOGENE. DOCLIN was created for the communication and the exchange of data between different medical departments at the University of Geneva that had independently created and operated databases. The 4 year-project began in 1997. (9)

Diogene now supports many applications including lab, radiology, and pharmacy (2). It went from centralized to an open distributed architecture; therefore, reaching other public hospitals and general practitioners in Geneva.

DIOGENE integrates four axes of knowledge: medico-economical context for better understanding and influencing resources consumption; the whole set of patient reports and documents(reports,encodedsummaries,clinicalfindings,images,labdata,etc.),patient-dependent knowledge,in a vision integrating time and space; external knowledge bases such as Medline (patient-independent knowledge. The integration of these patient-dependent and independent knowledge in a case-based reasoning format, aims to provide on the physician desktop all relevant information for helping him to take the most appropriate adequate decision.(6)


References

1. 1990: Scherrer J R; Baud R H; Hochstrasser D; Ratib O. An integrated hospital information system in Geneva. M.D. computing : computers in medical practice 1990;7(2):81-9.

2. Scherrer JR, Baud R, de Roulet D. Moving toward the future design of HIS: A view from the seventies to the end of the nineties, The Diogene paradigm. in Hospital Information Systems by Prokosch and Dudeck

3. Borst F, Griesser P, Bourdilloud R, Scherrer JR. Fifteen years of medical encoding in the Diogene HIS. Medinfo. 1995;8 Pt 1:43-6.

4. Do QH, Conti S, Muñoz J, Pillou E, Tacchino M, Ratib O, Trayser G. Unimage, a new RIS for the DIOGENE 2 environment at Geneva Cantonal University Hospital. Med Inform (Lond). 1993;18(2):143-8

5. Scherrer JR, Lovis C, Baud R, Borst F, Spahni S. Integrated computerized patient records: the DIOGENE 2 distributed architecture paradigm with special emphasis on its middleware design. Stud Health Technol Inform. 1998;56:15-31.

6. Borst F, Lovis C, Thurler G, Maricot P, Rossier P, Revillard C, Scherrer JR.Happy birthday DIOGENE: a hospital information system born 20 years ago. Stud Health Technol Inform. 1998;52 Pt 2:922-6.

7. Bréant C, Borst F, Campi D, Griesser V, Le HS. Expanding DIOGENE with a clinical information system based on a new hospital-wide clinical finding dictionary. Stud Health Technol Inform. 1999;68:7-11.

8. http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2232696&blobtype=pdf

9. Shachak A, Hadas-Dayagi M, Ziv A, Reis S. Primary Care Physicians' Use of an Electronic Medical Record System: A Cognitive Task Analysis. [1]

10. Li L, Chase HS, Patel CO, Friedman C, Weng C. Comparing ICD9-Encoded Diagnoses and NLP-Processed Discharge Summaries for Clinical Trials Pre-Screening: A Case Study. [2]