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PubMed2002

A standard XML Schema for computerised anaesthetic records.

We believe that one of the most influential developments for the practice of anaesthesia in this decade will be the introduction of a national (or possibly international) standard XML Schema for computerised anaesthetic records, and that such development should be actively promoted by appropriate professional groups. We discuss the implications of such a schema, and make suggestions regarding its requirements. We also report on one approach to the development of an XML Schema for anaesthetic records (provisionally named SnowSchema in honour of Dr John Snow), and compare the current version with the suggested requirements.

Anesthesia↗
PubMed1992

[A computerized anesthesia record system: four years' experience].

A computerized anesthesia record system is in routine use for cardiovascular procedures in our operating rooms. This system is implemented on an NEC PC-9801 personal computer and automatically collects hemodynamic variables from a polygraph as well as from intraoperative laboratory reports via RS-232C ports. Events such as intubation can be entered manually using a standard keyboard. Since the introduction of the system in 1987, the system has been used in 90 percent of the total cases performed and 2941 electronic data files were recorded in a four-year period. Excluding some short procedures for which the system was not used, failure to store records on disks resulted from system errors due to power-line troubles in the operating rooms as well as users' omission to command the system. User-acceptance of event entry was poor. In 74 percent of the cases, not a single event was entered. Advantage of an automated anesthesia record system over a hand-written record is being recognized. Wide-spread use of such a system will require ergonomic design of the system and man-machine interfaces suitable for use in an operating room.

Anesthesiology↗
PubMed1992

How can a standard software package for data management in anesthesia be achieved?

Collecting data for administrative, statistical, medical, and organizational purposes is becoming increasingly important in anesthesia. In 1986 the Swiss Society for Anesthesiology decided to create a program that would be compatible for different computers and would expedite data collection. The system developed was called Information System for Operations (ISOP), which was written in the database and programming system Massachusetts General Hospital Utility Multi Programming System (MUMPS). It was installed in eight hospitals and met the initial requirements, but the individual requirements of the hospitals were greatly underestimated. MUMPS has an impressive data storage capability and handling when used in a personal computer (PC) network. The user-interface, however, is inferior to other PC packages, partly because windowing and mouse support were not implemented when the ANSI standard was set. Improved statistical programs, a module for on-line data acquisition, and intensive care unit (ICU) use will be additional modules to the program.

Anesthesia Department, Hospital↗
PubMed1992

[PC-assisted planning and documentation of the surgical schedule].

A computer program for personal computers was developed to support and control the schedule in the operation theatre. With this program a great amount of operational and medical data will be recorded (e.g. the duration of operation and anesthesia, the number of operating rooms occupied, the personnel involved, the diagnosis and surgical therapy). The screen shows up-to-date information about the ongoing events. All data can be easily evaluated for different criteria. In a four years period the program presented has proved valuable for daily routine planning and documentation in a great operation unit.

Database Management Systems↗
PubMed1994

[A UNIX-based electronic data processing system for routine use in a trauma surgery department].

A computer program for a UNIX workstation has been developed to support routine activities in a surgical department. A relational database contains reports on operations, medical letters and further data imported from independent computer subsystems outside the department. Data are accessible at 15 terminals and PCs through a simple and intuitive user interface with a mouse. The patient record is organized in a hypertext fashion and permits direct access to the various types of documents in a consistent manner. The implementation is currently used to manage information on 40,000 patients and has proved valuable in daily routine over a 2-year period.

Computer Systems↗
PubMed1996

[Computer-assisted documentation of mandibular fractures].

For the registration, documentation and evaluation of patient data in cranio-maxillo-facial (cmf) trauma surgery a Windows-based application front end for relational data base systems (RDBS) has been developed. A simple-to-learn, easily reconfigurable user interface can be adjusted to the dynamically changing needs of individual departments. A graphical user interface (GUI) eases the entry of complex information like fracture positions, the location of implanted osteosynthesis material, etc. The new program also simplifies the daily routine documentation tasks. Being linked to a Hospital Information System (HIS) it makes use of the patients' individual base data stored there. Statistical data for various studies can be extracted from the database. The program has been successfully tested on a collective of 1.178 cmf trauma patients. Predefined analyses can be generated now by the simple click of a button for various case selections. New users learn to operate the program in a very short time.

Computer Graphics↗
PubMed1998

[Teleconference and telesurgery].

Interchange of information has become possible independent of the user's place or time by modern telemedical services and opens up new dimensions for diagnostic and therapeutic procedures. For teleconferences and teleconsultations in surgery, the intraoperative high-quality transmission of live images is essential without disturbing the sterility and operation routine. The clinical specifications require special systems for broadband, stereoscopic online image transmission both intra- and inter-institutionally. Moreover, a telemedical concept integrates the communication equipment suitable for the different diagnostic and functional facilities of a clinic, a digital multimedia patient record and modules for cooperative working. These implementations are a prerequisite for extensive telesurgical interventions using navigational tools, guided instruments or autonomous roboter systems. The realization of such a comprehensive telesurgical concept (OP 2000) is presented.

Computer Communication Networks↗
PubMed1993

[Computer-assisted surgery documentation in clinical routine practice].

In surgery, computer support is still of minor importance. It is the aim of this publication to outline the concept of a computer-assisted documentation system for surgical procedures, to describe the realization of the concept and to discuss the results of the evaluation. Planning of the system started in 1988 with an analysis of existing computer support at our clinic, definition of the parameters to be documented and determination of the classifications to be used, followed by a design for the system's use and a decision on hardware and software. The system is run on an IBM-compatible personal computer with three terminals, and the software used is MEDOS. The surgical procedures are documented with a four-level hierarchical classification related to the VESKA code and the internal university codes. After extensive training of the doctors, routine use commenced in 1991. Up to now 9837 operations have been documented by 35 surgeons. The system produces all necessary statistics and supports scientific studies and inquiries from individual doctors. A prospective evaluation of 300 consecutive operations demonstrated good compliance of the doctors and high data quality. To achieve optimal benefit from the use of computers it is recommended that departmental communication and documentation systems be gradually built up in surgical departments.

Attitude of Health Personnel↗
PubMed1990

Recognition accuracy with a voice-recognition system designed for anesthesia record keeping.

We tested on three occasions, with anesthetists as subjects, the accuracy of two voice-recognition systems designed for anesthetic record keeping. Initially, a prototype system was tested (10 subjects); several years later the resulting commercial system was tested in a quiet environment (11 subjects) and in noisy operating rooms (10 subjects). For each test an anesthetist first trained the system to recognize his or her voice by reading aloud a list of common anesthetic terms. To determine recognition accuracy, the percentage of words recognized correctly by the computer, each subject repeated the vocabulary words ten times. Although accuracy was similar during the three tests, it was slightly higher with the laboratory test (mean percent of words recognized correctly, 96.5%; range of accuracy for individual anesthetists, 91.6 to 98.8%) than with the prototype test (95.9%; range, 89.1 to 99.6%). Accuracy was lowest with the operating room test (95.3%; range, 87.8 to 98.4%). Twenty-four words caused particular difficulty during the laboratory test and were eliminated from the vocabulary of the subsequent operating room test. Omitting these 24 words from the laboratory vocabulary list allowed a more nearly direct comparison with the results from the operating room list; recognition accuracy improved in the former to 97.5% (range, 92.1 to 98.9%). Two anesthetists--one each from the laboratory and operating room tests--performed poorly, and eliminating their scores changed the respective overall scores to 98.2% (range, 96.7 to 98.9%) and 96.5% (range, 94.3 to 98.4%). Thus, the corrected difference between the laboratory accuracy and the operating room accuracy was 1.7%.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia↗