Practice and communications systems: Part 2. Selecting computer hardware.
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During the past year, the number of biological databases that can be queried via Internet has dramatically increased. This increase has resulted from the introduction of networking tools, such as Gopher and WAIS, that make it easy for research workers to index databases and make them available for on-line browsing. Biocomputing in the nineties will see the advent of more client/server options for the solution of problems in bioinformatics.
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Physicians burdened with increasing paper work may find relief in computer-based patient records (CPR). CPRs may aid clinicians in the areas of billing, documentation, reporting, and data retrieval. Value-added features like decision support and event monitoring facilitate patient outcome, decrease health care costs and allow improved administration. The authors discuss obstacles in the use of computers in patient care with a focus on security, confidentiality, and Y2K.
Clinical information systems are the computer and information systems used by health care personnel to facilitate patient care. These systems have evolved from financial systems to true patient care systems with variable levels of functionality. Early systems provided laboratory and radiology results, and modern systems now provide copies of the radiology images and decision support for therapeutic orders. The rapidly changing technological infrastructure has created barriers to implementation of the electronic medical record, while coding schemes continue to be refined to enable data access and aggregate data analysis. Further refinement of clinical information systems is required before the potential value of these systems is realized in the clinical management of patients.
Electronic billing systems make dermatology practices more efficient and productive. The decision to purchase and install such a system, however, involves a significant amount of time and is often accompanied by many mistakes. This article presents errors commonly made in the evaluation and purchase process and offers solutions. The success of dermatologists in the future will be partly determined by their effectiveness at managing information.
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In this time of increased temporomandibular disorder (TMD) therapy, it has become necessary for the clinician to proportionately increase his/her office documentation. The legal profession has strongly advised the dental profession that the best deterrent to litigation is maximum documentation. This has increased the paperwork of any office dealing with TMD patients on a regular basis. This paper presents the author's experiences and evaluation of one software company that claims to improve office efficiency and speed at the same time. The Patient Communications Systems, Inc. (PCS) is presented after more than four years of clinical experience in the author's practice. There are three forms that comprise the TMD package: (1) health questionnaire; (2) clinical evaluation; and (3) radiographic exam, diagnosis, and treatment plan. Each form is presented along with some of the narratives that can be generated. Some constructive suggestions have been made to help the overall flow of information that is relative to the author's office. This correspondence system has proven to be very time efficient, and has improved the level of correspondence in this referral practice multifold.
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By the middle of 1993, > 30,000 protein sequences has been listed. For 1000 of these, the three-dimensional (tertiary) structure has been experimentally solved. Another 7000 can be modelled by homology. For the remaining 21,000 sequences, secondary structure prediction provides a rough estimate of structural features. Predictions in three states range between 35% (random) and 88% (homology modelling) overall accuracy. Using information about evolutionary conservation as contained in multiple sequence alignments, the secondary structure of 4700 protein sequences was predicted by the automatic e-mail server PHD. For proteins with at least one known homologue, the method has an expected overall three-state accuracy of 71.4% for proteins with at least one known homologue (evaluated on 126 unique protein chains).
A new utility program, MSU, is described that simplifies the use of electronic mail servers for sequence analysis. Service descriptions are defined in external control files which can be changed without affecting the main program. This approach makes MSU a highly flexible tool that allows easy modification, extension and customization of service descriptions to suit users' personal requirements.