A doctor's prescription for hospital info system; Children's builds integrated system atop standards, best of breed packaged products - Dr David M. Margulies is VP of Information Systems at Children's Hospital, Boston

Software Magazine, April, 1990 by John Desmond

The text database at Children's uses the Topic retrieval engine from Verity, Mountain View, Calif. "Verity is a key piece for one mode of browse," said Margulies. By allowing users to weight the relevance of desired terms of classes of terms, Topic is said to achieve up to 95% retrieval accuracy.

ENTERPRISE COMPUTING LAB, TOO

In addition to its work in integrated HIS, Children's is a laboratory for the organizational impact of enterprise-wide computing. Margulies said, "Enterprise computing requires adherence on an institutional scale to certain architectural rules, and the selection of applications more suitable for network-based integration.

"In some instances, however, a certain department may want to pick an application which is ill-suited for integration on an enterprise scale. That's when the war begins. It requires sacrificing for a greater good, a support that humans provide poorly," he said. "There is a continuous management tension."

MORE VOICE, IMAGING USE AHEAD

Future directions at Children's include pursuing wider use of voice and imaging, for example, attaching voice objects to X-rays. "The gap between the image and the image plus the interpretation of the radiology specialist is substantial. So we're working on attaching the voice to the image directly," Dr. Margulies said.

Dr. John Kirkpatrick, the radiologist-in-chief at Children's, said, "The beauty of this system is that down the road, we can have ultrasonography, nuclear medicine, magnetic resonance imaging and angiography imaging digitized. There's no reason why we should't be able to pull up all those images."

Children's experience in MIS shows that the absence of a complete solution is not a reason to avoid the pursuit. "The best is the enemy of the better," Margulies said. A barrier in the transmission of images, for instance, is the fact that many image-authoring devices cannot produce digital output, and there is no authoring language to place a bit-mapped image in a compound document. "But by mid-1991, that should be available," Margulies said.

The virtual database may also be a useful model for commercial MIS. "Our model is being emulated by hospitals around the country," Margulies said. "One cannot fully replicate the advantages of a single, homogeneous data environment when one is using 20 different environments. But we've come a long way in creating a virtual database."

And with information systems Vice President Margulies at the helm, Children's will travel a lot further.