Computer communications in rural practice.
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Biomedical subjects
Publications and source records attributed to M L Braunstein.
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Dysmenorrhea, though rarely coded as a diagnosis in the records of family physicians, is a common problem in their female patients. Responses to a questionnaire indicated that at least 50 percent of women experience menstrual pain at one time with a minimum of 29 percent experiencing pain in any two-month period. The average duration of pain was greater than one day. A disability index was developed which revealed that half the women were Grade 3, or severely disabled. This study suggests that menstrual pain is a common problem in family practice and clearly ranks as a major cause of temporary disability in women patients.
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The human pedigree provides a highly organized representation of historical family morbidity. In order to allow for careful analysis of large numbers of pedigrees, we have developed an interactive computer system for their storage, retrieval and statistical review. The system is capable of integration with our computerized medical record through the use of a common classification (ICHPPC) for patient morbidity. This linkage of pedigrees to clinical data may allow a richer utilization of the clinical experience within Family Practice for the support of research into disease patterns within the family.
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An interactive on-line clinical information system is in operation within the residency of the Department of Family Practice at the Medical University of South Carolina in Charleston. This approach eliminates some of the traditional sources of error in collecting clinical information. Particular attention is given to flexibility of data presentation: data may be segregated by time, by disease entity, by age and sex of the patient, by physician, by year of residency, and by disease class. The responsiveness of this on-line technology allows the production of complete, up-to-date practice reports within 24 hours of a request.
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A computer-administered interview on life events (CAI-LEV) was developed for use by patients in the waiting room of the model family practice unit at the Medical University of South Carolina, Charleston, South Carolina. Computer printouts of CAI-LEV are immediately available for doctor/patient communication, so that CAI-LEV fits into ongoing patient flow and care. Throughout a three-month study, confidentiality of information was protected by the use of numbers for patient responses to questions in 16 areas covering a wide range of possible life events. The adept physician can utilize the printout to assess stress in the patient's current situation, to focus quickly on any particular area of concern, or to initiate a counseling session. Of some 250 completed interview, 93 have been reviewed by residents and faculty after in-depth utilization during patient care. Of these 93 physician-evaluated interviews, 40 percent yielded important new information, while in 22 percent of the cases, doctor/patient communication was improved.