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At least 235 records · Page 13Linked to original sources
PubMed2004

[Sympathetic listening or steamrolling? Quality in the health professional-patient relationship in light of new information technology].

In the services sector, the product of labor is not a commodity that can be traded easily. What is sold is a specialized service, basically through an exchange of information to meet the client's needs and expectations. What emerge are thus the social relations between individuals: professionals and clients/consumers. This article presents evidence that the introduction of information technology undermines the quality of the relationship between the health professional and the patient. The article begins by discussing concepts pertaining to quality in the health sector. The health professional-patient relationship is then discussed through a brief review of the health/disease concept and specifically the physician-patient relationship. Analysis of primary data shows some indication that technological, physical, and management changes in health care units are undermining the quality of health care: many technological changes, but few operational changes, and many machines, but few professionals to treat patients.

Delivery of Health Care↗
PubMed2002

Use of automated ambulatory-care encounter records for detection of acute illness clusters, including potential bioterrorism events.

The advent of domestic bioterrorism has emphasized the need for enhanced detection of clusters of acute illness. We describe a monitoring system operational in eastern Massachusetts, based on diagnoses obtained from electronic records of ambulatory-care encounters. Within 24 hours, ambulatory and telephone encounters recording patients with diagnoses of interest are identified and merged into major syndrome groups. Counts of new episodes of illness, rates calculated from health insurance records, and estimates of the probability of observing at least this number of new episodes are reported for syndrome surveillance. Census tracts with unusually large counts are identified by comparing observed with expected syndrome frequencies. During 1996-1999, weekly counts of new cases of lower respiratory syndrome were highly correlated with weekly hospital admissions. This system complements emergency room- and hospital-based surveillance by adding the capacity to rapidly identify clusters of illness, including potential bioterrorism events.

Acute Disease↗
PubMed2004

Radiology as a part of a comprehensive telemedicine and eHealth network in Northern Finland.

Oulu University Hospital is the northernmost tertiary hospital in Finland and its responsibility area is the largest in the country, covering nearly half of the Finnish territory, also including the arctic regions. Because of vast distances and a sparse population, Oulu has been a forerunner in developing telemedicine and eHealth services in the country. The development started in 1990 and has resulted in the establishment of teleradiology and televideoconferencing services, distance education and a multimedia medical record with remote access capabilities. Wireless technology has been a special focus area, as has the development of an efficient communication between primary care and secondary care. This review highlights some of the key success elements.

Arctic Regions↗
PubMed2005

Electronic medical handover: towards safer medical care.

As the working hours of junior doctors decrease, adequate handover of patients becomes more important to maintain continuity of care and avoid errors caused by information gaps. A minimum dataset for surgical handover should include the patient's name, location (ward and bed number), date of admission, diagnosis, procedure (with date), complications and progress, management plan, resuscitation plan, consultant availability (and instructions if not available), expected need for review, and name of doctor completing handover and date to confirm that information is current. An electronic handover system is a potential solution, but our survey shows that free-text entry into such systems may be inadequate; prompts or predefined fields for handover content are possible solutions.

Consumer Behavior↗
PubMed1994

Quality in obstetrics using a telematic system.

A telematic based system for antenatal care has been developed to be used in service integration between primary and secondary health care units. The system is based on low cost platforms and has a user friendly human computer interface. This system will provide better integration and coordination between the health care providers involved, improving the quality of the services. This experiment is being funded in the framework of the EC.Project-A 2007-EPIC. Quality indicators, agreed in the "European concensus conference of quality indicators for perinatal care", organized in conjunction with OBSQID project (AIM.2125) were integrated in the system. Data collection has started and the outcome will be used to validate the indicators on a transeuropean basis under the framework of the OBSQID Project.

Data Collection↗
PubMed1994

Integrated specialty and operational system for diabetes management in south west England.

The management and control of diabetes throughout South West England has been assisted by the use of a networked computerised information system which is totally integrated with hospital and community information systems. The objectives of the diabetes system are to produce an aid to diabetes management, which includes the creation of a district diabetes register accessed and maintained by clinicians based in both the hospital and in the community, whilst at the same time providing auditable information.

Delivery of Health Care, Integrated↗
PubMed1994

The OBSQID project. Obstetrical quality development through integrated use of telematics.

OBSQID is a one-year project with the ultimate objective of identifying and validating European quality development indicators in perinatal care which will make it possible to exchange data at regional, national and transnational levels through the use of telematic and computerized information systems. This will make it possible to monitor, evaluate and identify "best practices" in order to use this experience to improve the quality and outcome of perinatal care in the European region. The project is a collaboration between WHO/EURO, counterparts in perinatal and obstetrical care in the Member States, and the Advanced Informatics in Medicine programme of the Commission of the European Communities.

Europe↗
PubMed1994

Case-based telematic systems towards equity in health care. Introduction to the symposium.

The theme of this International Symposium, co-sponsored by EFMI (the European Federation for Medical Informatics) and WHO-Eur (the European Office of the World Health Organisation) is made of four components: (1) an ethical principle: equity in health care, that aims to social justice; (2) measurements of equity that should be case-based/population related; (3) communication of this information at a wide scale, using telematics, e.g. integrated computer systems at distance; (4) actions to improve health care and equity in its delivery by using resource management tools and developing quality of care. The combination of these four elements is recommended as a coherent scheme for future actions of public authorities in health care. They were therefore associated in the somewhat complex title of the symposium. A special attention is given to the present degree of availability of a large number of case based/population related data sources in Europe, as well as on the need to develop generic models in telematics, rather than too strict standards at the user level. These information systems can be made easily accessible to clinicians and epidemiologists as an aid to their decision making in the European region.

Computer Communication Networks↗
PubMed1995

Act management and clinical guidelines.

Clinical activity has always demanded close co-operation and co-ordination between clinicians and specialties. This applies especially in hospitals and in the future it will apply equally in primary and community care. Co-operation and co-ordination require two things: access to guidelines to control shared, distributed clinical activity, and common access to the patient record. Act management facilitates this by managing the process of care as it passes from one performer to another, enabling each to know at what point in the process (or cycle) they stand, what is expected of them, what is expected of others, and enabling them to access the information that they require. This paper describes act management with reference to guidelines and it is a contribution to the process, presently under way, that is intended to bring the leading examples of act management from the AIM NUCLEUS project and guideline support from the AIM DILEMMA project into close interworking in the same system.

Decision Support Techniques↗
PubMed1995

Quality assurance in clinical neurophysiology: the ESTEEM project example.

This paper describes the current status of the utilisation of clinical practice guidelines (protocols) in the ESTEEM project as one form of the clinical quality assurance procedures considered in the project. The performance of electrodiagnostic studies, in terms of which types of conclusions need to be inferred during the examination plan, is briefly described. The main focus of the paper is a description of an European multicentre clinical audit in the field of Clinical Neurophysiology, using a common data-entry protocol for prospective EMG case collection and assessment with the ultimate objective of building up a multicentre reference database of EMG cases.

Computer Communication Networks↗