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PubMed1994

Gnome--an Internet-based sequence analysis tool.

Gnome (GenomeNet Open Mail-service Environment) is a sequence analysis tool that enables an end-user to make use of several Internet- (mainly e-mail) based services with an easy-to-use graphical user interface. Users can conduct homology and motif searches, and database-entry retrieval against the latest databases by emitting search requests to and receiving their results form a search-server by e-mail. The search results are viewed and managed efficiently with this system. The Macintosh and X (Motif) versions of the Gnome client and the UNIX version of the Gnome server are available to academic users free of charge.

Computer Communication Networks↗
PubMed1986

A microcomputer program for hydropathic analysis of proteins with I/O through word processing and graphics software.

A BASIC program has been devised for the hydropathic analysis of protein sequences according to the method of Kyte and Doolittle (1982). The program uses sequence data from input files that are created with a word processor and produces two types of output file: one contains a bar graph of the hydropathic profile in a format that can be easily edited; the other is a tabulation of hydropathic indices along a protein's sequence that can be used as input by the program for the production of a bar graph or as input into other graphics and analysis software. An MS-DOS microcomputer, operating under IBM BASICA or GWBASIC and a dot matrix printer with block graphics capabilities are the only hardware requirements for graphic display of hydropathy profiles. The program is capable of unattended analysis from a list of up to 15 input files.

Amino Acid Sequence↗
PubMed1994

Information management in primary medical care in South Australia.

The objectives of this study were to describe how GPs in South Australia manage and use office and clinical information, as well as their plans for the future. The study was set in a primary medical care centre in South Australia, and used a cross-sectional study with a mail questionnaire. Utilization of and satisfaction with office and clinical information management systems, with a focus on the use of patient summaries were outcome measures. A random sample was obtained from a register of GPs in South Australia that had been stratified into geographic regions based on socioeconomic indicators. Sixty-eight per cent of GPs approached responded (n = 315). There was no significant difference in response rate from each region. The use of computer applications was comparable to that in the general population. Half the GPs used index cards and 5% used computer-based records. Users of RACGP problem-oriented A4 folders were most (92%) and index card users least (65%) satisfied. The use of patient summaries could be improved. GPs planned to change to computer-based billing, more comprehensive paper-based records and computer-based patient records. Perceived reasons for and obstacles to change were documented. Factors that influenced the use of different forms of office and clinical information management were type and place of practice, staff employed, gender, a diploma in obstetrics, age, year of graduation, type of record used and satisfaction with it, vocational registration, FRACGP and FMP training. Given the pattern of utilization, generally low satisfaction and planned changes, there is an unmet need for useful office and clinical information management systems in general practice.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Do general practice computer systems assist in medical audit?

This study was designed to assess the capabilities of current general practice computer software to perform medical audit. A total of 43 general practice clinical software suppliers were asked to complete a questionnaire consisting of general questions concerning their systems' responses to 85 audit questions that a practice might wish to ask in the areas of quality of care and contractual compliance. It was assumed that all systems had full patient data. Fourteen installations representing 14 systems that had been randomly selected from the responders were visited to validate the suppliers' responses. Thirty-two (74%) suppliers responded to the questionnaire and they represented 7696 installations. One supplier marketed two distinct systems giving 33 systems for analysis. The majority (52%) of responding suppliers had between 0 and 50 installations. Many shortfalls in auditing capability were demonstrated, e.g. 24% of systems were unable to audit the clinical content of a patient review, 48% were unable to audit the numbers of acute and repeat prescriptions, 51% were unable to audit emergency admissions, 70% were unable to audit the length of time a drug had been prescribed for and 85% were unable to audit the continuity of patient care. Limitations in the ability to perform even basic medical audits were demonstrated among current general practice computer systems. These have implications for the development of medical audit. Seven (21%) of the systems had no facilities for statistical analysis including percentages and 8 (24%) had no graphical abilities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Computerised data collection: practicability and quality in selected general practices.

The objective of the study as to assess the consistency with which a set of pre-defined data about three fictitious patients was entered into a sample group of practice computer systems, and to measure the time required for routine data capture of this kind. The study design was a prospective, piloted, postal survey, in which respondents were requested to enter a variety of general sample data onto their systems, to time the process, and record details of any difficulties. The subjects were 76 (39%) responding general practices in England and Ulster, from a random sample of members of a GP computer specialist group. These results (which in view of the highly motivated characteristics of the responding sample are likely to represent best practice) showed that differing conventions were applied in entering patient data, even among practices using the same type of computer system. Potentially significant errors and distortions were found in the data as recorded in the systems, such as the 29% of immunisation sequences which were slightly inaccurately entered. The main problems with the data entry comprised simple operator errors, inconsistency in the use of terms entered, and difficulties in recording negative data (only 20% of practices could enter patient 'not incontinent'). Practices varied widely in the way they allocated data recording responsibilities to staff, with only 6% of practices involving all staff in data entry.(ABSTRACT TRUNCATED AT 250 WORDS)

Bias↗
PubMed2000

Recruiting patients to randomized trials in primary care: principles and case study.

BACKGROUND: There are many factors affecting recruitment to trials in primary care, and trials are often jeopardized due to the inability to enter sufficient patient numbers. It is generally agreed that the interest in and commitment of GPs to the project are important, and their forgetfulness and time pressures are major factors which mitigate against maximal recruitment. OBJECTIVES: The aim of this study is to focus on maximizing recruitment of patients to a randomized controlled trial of exercise classes for back pain patients. METHODS: Two distinct methods of recruitment were used. One practice provided a computerized list of names and asked patients' permission, by letter, to be contacted by the researchers. The other 18 practices manually recorded referrals after the consultation by the GP. RESULTS: Referral rates were slower than expected. Many patients either did not fit the inclusion criteria or excluded themselves due to domestic commitments or work. During 24 months, 1588 patients were referred. A total of 187 patients (12%) met the criteria and could be included in the study. The practice which referred patients through a computerized listing contributed 44% of the patients successfully included in the study. CONCLUSIONS: Recruitment rates depended on the method and rate of GP referrals, the proportion of referrals meeting the entry criteria and the proportion of patients available to attend the exercise classes.

Attitude of Health Personnel↗
PubMed2001

Towards improvement of the accuracy and completeness of medication registration with the use of an electronic medical record (EMR).

BACKGROUND: Approximately 80% of GPs use a GP information system (GIS) and an electronic medical record (EMR) in their daily practice. To reap the full benefits of an EMR for patient care, post-graduate education and research, the data input must be well structured and accurately coded. OBJECTIVES: The quality and user-friendliness of the software positively influence the completeness and reliability of the data recorded in the GIS. To assess this in actual practice, this study examined whether or not an increase occurred in the accuracy and completeness of indication-related medication registration after the GIS's software package was upgraded. METHOD: GPs recorded data for the Registration Network Groningen (RNG) concerning four medication groups: insulin, trimethoprim, the contraceptive pill and beta-blocking agents. The completeness and accuracy of the registered data were assessed both before and after the change to the new software package. The completeness is evaluated on the basis of the indications missing for the prescribed medications. To assess accuracy, a check was made to determine whether the indications corresponded to those deemed relevant for that particular medication according to National Pharmaceutical Guidelines. RESULTS: The percentage of missing indications decreased notably, especially in the chronically prescribed medication groups. For insulin, the percentage decreased from 40.5 to 3% and for the contraceptive pill from 34.5 to 1%. For trimethoprim, the percentage decreased from 10 to 1%, and for beta-blocking agents from 22 to 1.5%. Of the indications present, the percentage of relevant indications showed a slight increase, with the largest increase observed for the contraceptive pill where the percentage rose from 86 to 96%. CONCLUSIONS: The completeness of recorded indications improved considerably after the change of software. This is due mostly to the efforts of the GPs, their practice assistants and the support of the RNG organization involved in the conversion procedure. Accuracy improved slightly, especially due to the software modifications which ensured that non-existent codes could not be entered. To summarize, with increased user-friendliness of the software, combined with the training of motivated GPs, the quality of recorded data improved.

Adrenergic Antagonists↗
PubMed1991

Elders' nonadherence: its assessment and medication reminding by voice mail.

This study investigates four questions related to the problem of medication nonadherence among elders. First, does memory failure play a significant role in nonadherence? Second, can memory-related nonadherence be predicted by simple tests of cognitive performance? Third, can the new portable bar code scanner technology be used to unobtrusively monitor nonadherence? Most importantly, can inexpensive telephone voice mail technology be used to improve medication adherence? The results show that: elders have substantial levels of forgetting; nonadherence decreases with higher cognitive test scores; portable bar code scanners are useful for monitoring adherence; and voice mail reduces tardiness and complete forgetting.

Aged↗
PubMed1988

New developments at BIONET.

BIONET has made considerable progress in developing communication links among molecular biologists and biochemists worldwide. We describe these efforts and also note the many new enhancements to the BIONET system itself.

Amino Acid Sequence↗
PubMed1997

A randomized trial of the impact of telephone and recorded delivery reminders on the response rate to research questionnaires.

BACKGROUND: A range of factors have been shown to affect the response rate to mailed questionnaires, but particular strategies to improve patients' response in trials conducted in general practice require further study. METHODS: Non-responders in a larger trial were randomized to receive a telephone or recorded delivery reminder on the third contact. The cost of administration of each method was estimated. RESULTS: Significantly more patients returned completed questionnaires when sent questionnaires by recorded delivery, although the cost per patient contacted was nearly three times more than for contact by telephone. CONCLUSION: Our study indicates that sending reminders by recorded delivery, although more expensive, is more effective than telephone reminders for recruiting patients to a study in general practice using research questionnaires.

Adult↗
PubMed1994

A taxonomy of shared care for chronic disease.

BACKGROUND: Shared care is promoted as a way of integrating primary and secondary services and achieving one of the targets set for the NHS in the 1990s. We aimed to compose a taxonomy of shared care schemes for chronic disease in order to inform the development of develop shared care. METHODS: A two-phase postal questionnaire survey of Scotland and North West Thames Region, England. In the first phase we identified the number of shared care schemes for chronic disease, which were followed up in the second phase. RESULTS: Shared care schemes were classified into six groups, or models, according to their method of data transfer. These are: (I) community clinics, where the specialist undertakes a clinic in general practice; (II) basic, where communication comprises the regular exchange of letters or standardized record sheets; (III) liaison, where the hospital team and general practitioner (GP) meet to discuss and agree the management of patients under shared care; (IV) shared care record cards, where the exchange of information is made through a booklet or 'cooperation card', commonly carried by the patient; (V) computer-assisted shared care, where a circuit of information is established between GP and hospital specialist based on data collected at each patient visit and mediated through computer-generated summaries; (VI) electronic mail, where hospital specialist and GP both have access to the same data on patients shared between them. CONCLUSION: Despite substantial variation in the operation of shared care, schemes can be broadly classified and constructed in six different ways. In establishing this taxonomy, a choice is offered to health care workers wishing to develop shared care.

Chronic Disease↗
PubMed1993

Exploring the medical applications of the internet: a guide for beginning users.

Various techniques for accessing informational resources of interest to physicians and other medical professionals currently are available on Internet, a global internetworking of computer systems. The basic strategies for sending electronic mail, transferring files, and logging on to distant computers, as well as newer and more user-friendly indexing and interface systems for accomplishing these tasks are discussed.

Computer Communication Networks↗
PubMed2004

The progressive roles of electronic medicine: benefits, concerns, and costs.

Electronic healthcare will significantly alter the way physicians practice medicine. Electronic medical records with specialized software programs can increase the quality of patient care, reduce unnecessary medical tests, and directly connect with pharmacies to transmit prescriptions. Electronic communication can allow physicians to respond to patients' clinical concerns and questions, and Internet access can provide physicians better access to literature. Nevertheless, there is significant physician hesitance toward adopting medical computerization: patient e-mail can potentially overload physicians with extra work, web sites can direct patients to poor medical information, the computerized interface can degrade the patient-physician relationship, and health regulations can create concern over electronic privacy issues. The finances of e-health appear promising, yet conflicting studies create uncertainty. However, if managed appropriately, the potential disadvantages of e-health can be minimized, and the benefits of e-health in clinical practices can be obtained.

Communication↗
PubMed1995

Using electronic mail for a small-group curriculum in ethical and social issues.

PURPOSE: To initiate an electronic mail (e-mail) program as a supplement to a medical humanities curriculum focusing on ethical and social issues. METHOD: In 1991-92 an e-mail track (called NET) was established for second-year students participating in Medicine in Contemporary Society, a four-year curriculum in medical humanities at the State University of New York at Stony Brook School of Medicine. In 1991-92 ten students volunteered to form a NET group; in 1992-93 22 students, forming two groups, were randomly selected from a volunteer pool of 76 students (from a class of 100). In both study years, the NET students analyzed and discussed electronically a series of cases posted sequentially through the academic year. Faculty tutors reviewed the students' responses, interacting with the groups and with individual students by e-mail. NET was evaluated in two ways: at the end of the course, the students completed e-mail questionnaires that included quantitative and qualitative assessments; and throughout the course, the tutors assessed the students' participation, quality of case analysis and discussion, and quality of writing. RESULTS: The students' assessments indicated that they considered NET to be more educational than the lectures, "live" group discussions, problem-based learning exercises, and formal papers in the medical humanities curriculum; that they made gains in computer literacy; and that NET enhanced their abilities to think about ethical and social issues. The tutors judged that the students had improved their written self-expression as the course progressed. CONCLUSION: NET adequately accomplished the goals set for it as an adjunct to the small-group sessions and other components of the medical humanities curriculum.

Attitude↗
PubMed2001

A look to the future: how emerging information technology will impact operations and practice.

The use of information technology tools in home care delivery is dramatically increasingly. This technology can streamline business and clinical processes by linking people with one another and to vital healthcare information at any time, any place. This article describes four emerging information technology trends that are currently influencing home care nursing and presents future implications.

Community Health Nursing↗