Telemedicine in the practice setting. Infrastructure, not technology, limits practical application.
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Diffusion of Innovation↗
Biomedical subjects
Bryan P Bergeron
Publications and source records attributed to Bryan P Bergeron.
Enterprise digital assistants: the progression of wireless clinical computing.
By virtue of increasingly pervasive wireless connectivity, the proliferation of wireless handheld devices in clinical care is rapidly transforming the concept of the personal digital assistant (PDA) to the enterprise digital assistant (EDA). Wireless handheld devices are becoming extensions of the central hospital information system, in which it's understood that the health care enterprise, not the clinician carrying the information-dispensing device, owns the data. The practical implication for clinicians is that, despite the potential long-term benefits of seamless, just-in-time clinical data access, this paradigm shift portends decreased efficiency in the short term, as clinicians duplicate clinical data collection on private devices. Assuming eventual clinician acceptance, EDAs can form the basis of a national real-time clinical data acquisition system that ensures uniform prescribing, decision support, and diagnosis, and the means for tracking unusual disease presentation patterns that could be indicative of bioterrorism or natural disease outbreaks.
Computer Communication Networks↗
Virtual reality applications in clinical medicine.
Virtual reality, the use of computational methods to present users with a multimedia environment that simulates reality, is becoming a practical, affordable technology for the teaching and practice of clinical medicine. Although limited-fidelity virtual reality systems have been used in medical education for decades, modern, high-fidelity virtual reality systems have practical applications in areas ranging from psychiatry to surgical planning and telemedicine. Factors that limit widespread use of virtual reality in medicine include a lack of standards for the re-purposing and sharing of system components and the resultant low return on investment from custom systems. The standards issue is being addressed by economic incentives from organizations such as the U.S. military, which requires computer-based educational materials, including simulations, to be interoperable. Similarly, the low return on investment is becoming less of a factor in clinical scenarios in which virtual reality systems offer physicians and their patients experiences that are impossible or impractical to gain elsewhere.
Clinical Medicine↗
Wireless local area network security.
Wireless local area networks (WLANs) are increasingly popular in clinical settings because they facilitate the use of wireless PDAs, laptops, and other pervasive computing devices at the point of care. However, because of the relative immaturity of wireless network technology and evolving standards, WLANs, if improperly configured, can present significant security risks. Understanding the security limitations of the technology and available fixes can help minimize the risks of clinical data loss and maintain compliance with HIPAA guidelines.
Ambulatory Care Information Systems↗
Performance management in small practices.
Performance management, variably referred to as corporate, business, or enterprise performance management, has traditionally been viewed as a strategy to achieve an optimum mix of solvency, quality, safety, and patient satisfaction in large healthcare organizations. Now, however, with the readily available data from government and nonprofit organizations promoting quality health care and affordable business intelligence tools, small practices can adopt management strategies, tools, and techniques once limited to corporate executives. With a modest investment in self-assessment and affordable analysis tools, a small practice can benefit from a scaled-down version of the performance management initiatives in place at the leading health-care organizations.
Group Practice↗
Medical errors: computers are no panacea.
Increased patient loads, time pressures, and heightened public awareness of medical errors are forcing many physicians and clinical administrators to consider acquiring computerized physician order entry (CPOE) systems and clinical information systems. The recent revelation that CPOE systems can facilitate medical errors, however, is a call to physicians to remain vigilant despite the new technologies. By attending to specific data-capture and data-access errors associated with clinical information systems, physicians can minimize errors associated with clinical information systems and maximize the potential benefits to their patients.
Computer Security↗