Biomedical subjects

Rita D Zielstorff

Publications and source records attributed to Rita D Zielstorff.

3 recordsLinked to original sources

PubMedDate not supplied

Controlled vocabularies for consumer health.

There is often a disconnect between the language that consumers use to express health concerns and the language that is used by health care professionals. At the same time, health care consumerism and the availability of vast health-related resources on the Internet have resulted in millions of persons using the Internet for health-related matters daily. The mismatch in language, however, poses a barrier to access to relevant information. It also prevents full participation in shared health records, and sometimes interferes in communication between patients and their health care providers. Nurse informaticians, with their deep expertise in vocabulary development, could play an important role in solving this dilemma. Structured vocabularies comprised of lay terms, with definitions, variant spellings, and regional dialects, along with mappings to equivalent or related professional terms, could make health literature much more accessible to consumers, and provide the basis for bi-directional translation of health terms in a shared medical record. In addition, the presence of terms for which no representation currently exists in nursing terminologies could serve as a stimulus for developing new knowledge about patient phenomena not previously recognized.

Community Participation↗

PubMedDate not supplied

Does national regulatory mandate of provider order entry portend greater benefit than risk for health care delivery? The 2001 ACMI debate. The American College of Medical Informatics.

The 2001 debate of the American College of Medical Informatics focused on the proposition that national regulatory mandate of computer-based provider order entry (CPOE), to take effect by the end of 2005, portends greater benefit than risk for health care delivery. Both sides accepted that provider order entry offers potential benefit. Those supporting the proposition emphasized public safety, noting that payers have little economic incentive to pay for quality and that a mandate would force vendors to improve the usability and value of their systems. They argued that the mandate would align the economic incentives to finally allow CPOE to be widely adopted. Those opposing the proposition emphasized the risks resulting from a mandate, including the direct implementation costs, the logistic issues of implementation, and the cost of failed implementations. They also noted the potential for errors introduced by the systems themselves and the fact that the safety and utility of commercially available CPOE products have yet to be proved.

Delivery of Health Care↗

PubMedDate not supplied

Automating complex guidelines for chronic disease: lessons learned.

There is scant published experience with implementing complex, multistep computerized practice guidelines for the long-term management of chronic diseases. We have implemented a system for creating, maintaining, and navigating computer-based clinical algorithms integrated with our electronic medical record. This article describes our progress and reports on lessons learned that might guide future work in this field. We discuss issues and obstacles related to choosing and adapting a guideline for electronic implementation, representing and executing the guideline as a computerized algorithm, and integrating it into the clinical workflow of outpatient care. Although obstacles were encountered at each of these steps, the most difficult were related to workflow integration.

Algorithms↗