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R A Korpman

Publications and source records attributed to R A Korpman.

At least 37 records · Page 2Linked to original sources
PubMed1987

A prescription for better pharmacy computerization.

The net effect of these features in an integrated system is that the pharmacist spends time more productively managing patient drug therapy, not the computer system. The patient's location and demographics, once entered, are immediately available in a clinically useful form. Information about medications, the patient's responses to them and all other clinical parameters is available in the pharmacy without leaving the pharmacy application, making the pharmacist more effective and efficient. Physicians' orders are qualified by the system as they are entered, minimizing the number of nonproductive encounters between the pharmacist and the physician. Medication orders arrive at the pharmacy in a more timely manner and with fewer problems. The pharmacy can, in turn, be more responsive, helping the patient receive medication that is timely, accurate and clinically appropriate. These benefits arise primarily as a by-product of the pharmacy being integrated into an information system environment in which data is easily and directly accessed and shared. The more closely the pharmacy and its information requirements are examined, the more important the integration component appears. Many of the above benefits are not achievable with a dedicated stand-alone pharmacy computer system; some are achievable with an interface to a stand-alone nursing-station based HIS. In the pharmacy, is to increase and flourish in its role as an important and integral part of the healthcare delivery team, then access by the pharmacist to all patient information, and access by other providers to information contributed by the pharmacy is a necessary requisite. Improvement inpatient care can be the only result of such enhanced interchange.

Hospital Information Systems↗
PubMed1987

Hospitals, nursing, and medicine: the years ahead.

Integrated approaches to the delivery of patient care have the potential to do several things to alleviate potential problems resulting from the five changes discussed earlier. They bring physicians into a more active role with the largest group of employees in the hospital (nurses); giving them the opportunity to acquire a better appreciation of the objectives, goals, and constraints of other providers and of the institution as a whole. When nurses and other employees begin to appreciate the constraints placed on physicians by federal regulations and competition, mutual understandings are fostered. They lay a more solid foundation for good professional relationships between hospitals and IPAs and between hospital-based physicians and independent practitioners. They encourage the focus of all providers on quality patient care (at a price the community is willing to afford). They discourage the overlap of expensive services between providers and encourage planned growth for the community. They encourage collaborative practice at the bedside, at committee and board meetings, and throughout the community that can lead to the development of a new model of "health" care as opposed to "disease" care. Finally, they promote human understanding that encourages providers to recognize the appropriate professional (considering all the variables) for each role. Without such efforts, it appears that patient care quality will be the most likely aspect of health care to suffer in the future--a result against which all health care professionals should stridently guard.

Delivery of Health Care↗
PubMed1987

Using the computer to optimize human performance in health care delivery. The pathologist as medical information specialist.

The demands for information retrieval, processing, and synthesis placed on all providers of health care have increased dramatically in the last several decades. Although systems have been developed to capture charge-related data in support of cost reimbursement, there has been a conspicuous lack of attention paid to information tools to directly enhance the delivery of patient care. The termination of cost reimbursement, together with an increasing recognition of the problems inherent in current manual record-keeping systems, is creating a significant new focus on medical information. This change in focus requires a shift in systems orientation away from financial and departmentally centered systems and toward patient-centered approaches. There is thus increasing recognition of the need for a physician-level medical information specialist to serve as an institution's chief information officer, assuming responsibility for the collection, manipulation, and availability of all patient care-related data. By virtue of training, typical experience, hospital presence, and a noncompetitive position with the hospital's medical staff, the pathologist is uniquely suited for this position. To effectively perform this role, a variety of new specialized data management tools are becoming available. Integrated information systems, patient care management by exception, decision support tools, and, in the future, "artificial intelligence" assists can all be expected to become staples of pathology practice, especially impacting those pathologists who choose to be responsive to the new practice milieu of medical information science.

Artificial Intelligence↗
PubMed1986

Bedside terminals support quality patient care.

In order to effectively evaluate hospital information systems today one must consider all aspects of the System, not simply the placement of terminals. A well designed system will be totally integrated via a single database, will support the concept of patient care management by exception, and will be bedside-based. Bedside-based data entry is a key aspect of a well designed system. The placement of terminals should support the work flow, not vice-versa. There are times when nurses and physicians will logically document at the nursing station, in the nurse's lounge, the physicians office, or a clinic; therefore, terminals should be located in these areas. However, the majority of care rendered is provided to the patient in a bed. Therefore, if computers are going to be support tools for clinical applications they must include data entry devices at the bedside. Results to date show this to have a uniformly positive effect on cost of care, quality of care and patient satisfaction.

Health Facilities↗
PubMed1986

On the thickness of the red cell membrane skeleton: quantitative electron microscopy of maximally narrowed isthmus regions of intact cells.

The thickness of the red cell membrane skeleton was deduced from measurements of the isthmus zones of intact cells that were maximally narrowed by one of two independent methods. The first method involved application of viscous drag to red cells entrapped between spider web fibers. The second method utilized cellular dehydration followed by spectrin denaturation at 49.5 degrees C. Measurements on thin sections showed that the isthmus is narrowed to approximately 120 nm by either method, suggesting that the membrane skeleton occupies a zone beneath the lipid bilayer that is up to 60 nm in thickness. The tertiary and quarternary structure of band 3, a major integral membrane protein that anchors the membrane skeleton to the lipid bilayers may be a critical determinant of the location of the membrane skeleton within the red cell.

Biomechanical Phenomena↗
PubMed1980

Computers, health care, and medical information science.

The clinical laboratory is examined as a microcosm of the entire health care delivery system. The introduction of computers into the clinical laboratory raises issues that are difficult to resolve by the methods of information science or medical science applied in isolation. The melding of these two disciplines, together with the contributions of other disciplines, has created a new field of study called medical information science. The emergence of this new discipline and some specific problem-solving approaches used in its application in the clinical laboratory are examined.

Clinical Laboratory Techniques↗
PubMed1980

Whither the WBC differential?--some alternatives.

Most efforts to automate the WBC differential have involved the use of devices to identify and enumerate WBC types, the underlying assumption being that the cell type percentages constitute the important end results. A different assumption exists. It is that the clinical usefulness of this procedure derives primarily from the fact that a trained morphologist has conducted a detailed examination of the slide. Based on this second assumption, a different approach to automation was investigated. This involved the use of a computer system to augment the morphologist in the slide examination process. This augmentation was accomplished by: 1. Determination of linked abnormalities on 117,000 WBC counts and presentation of linkages to the morphologist when a particular abnormality was identified on the hemogram or the slide. 2. Information feedback which compared each technologist with others in the laboratory performing similar tasks. 3. Varying the number of cells examined per slide, based on the apparent abnormality of the slide. The linkage patterns found, their clinical usefulness, and the impact on technologist performance and test quality are discussed.

Computers↗
PubMed1975

Heparin therapy during extracorporeal circulation. I. Problems inherent in existing heparin protocols.

Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during and the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.

Adolescent↗
PubMed1975

Heparin therapy during extracorporeal circulation. II. The use of a dose-response curve to individualize heparin and protamine dosage.

Because the administration of heparin and protamine according to a set protocol will fail to anticoagulate safely or neutralize appropriately a significant number of patients, a method of monitoring heparin therapy during cardiopulmonary bypass is presented. A dose response curve relating heparin dosage to its effect on the activated coagulation time (ACT) can be determined with sufficient accuracy for clinical purposes from three ACT's. Preparation of such a curve makes it possible to maintain anticoagulation in a safe range during bypass and minimizes the number of monitoring tests of coagulation required. At the conclusion of bypass, this curve can be used to predict the precise amount of protamine needed for neutralization. Freed from the confusing effects of hyperheparinemia or protamine excess, the physician can diagnose and treat postoperative bleeding problems much more readily.

Blood Coagulation Tests↗