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PubMed1992

[IOL and aniseikonia calculation combined with documentation of surgical data and IOL inventory].

The exact recording of operation data is a precondition for keeping the standards high in cataract surgery, but surgeons are reluctant to answer a questionnaire after a strenuous operation. We have designed a program easy to use in the Macintosh Hypercard System that covers all aspects of cataract surgery such as: (1) the operating record; (2) a data sheet for recording the various details of the operation; (3) recording of the data on hard disc; (4) managing the IOL stock list; (5) proposal of IOL models that are in stock with regard to IOL power (SRK2) and aniseiconia. This program enables the surgeon to record the operation data with effortless ease and it is well accepted. There is no dictation. The operating record and data sheet are printed immediately. The program is controlled by a "mouse". Selection of the suitable IOL model is facilitated by the link between the calculation of IOL power and the IOL stock list. In special cases the IOL power can be changed to obtain less aniseiconia.

Aniseikonia↗
PubMed1995

A surgical process management tool.

Inspired by a shortage of qualified nursing personnel at local facilities, a group of University of Toronto researchers has created a simulation based decision support tool that enables hospitals to determine the overall effect of making modifications to operating room schedules, as well as a number of other system parameters, including the number of inpatient beds and the amount of nursing time available on surgical wards.

Appointments and Schedules↗
PubMed1997

[Internal quality assurance--Munster experiences].

Medical data monitoring is an effective tool to insure high quality and efficient performance of health care providers. In the Department of Thoracic and Cardiovascular Surgery of the University of Muenster this is based on a comprehensive data management system. This system has been custom tailored to enable optimal monitoring of quality, performance and cost aspects based on access to all available data. Data acquisition is achieved online and allows for continuous data analysis. This data monitoring is the basis for objective quality control of medical performance as well as for the evaluation of the impact of politically induced economic restrictions on the quality of care.

Cardiovascular Surgical Procedures↗
PubMed1997

[Automated anesthesia record keeping system in in the United States].

We have implemented an automated anesthesia record keeping system (AARK) since 1992. The system stands in need of re-designing to function as a perioperative patient's information system. We discussed the issues with anesthesiologists who's institutes are implemented with AARK in the United States. We visited the following three institutes: St. Luke's Hospital (Kansas City, MO), University of Florida (Gainesville, FL), and Burbank Hospital (Fitchburg, MA). All of them are implemented with ARKIVE system. Dr. Edsall in Burbank Hospital stressed quality assurance (QA), and using ARKIVE's database for QA. University of Florida has a big anesthesia and engineering team to develop a new ergonomically sound AARK. Some of the members regarded ARKIVE as an "out of date" system. Dr. Tuohy in St. Luke's Hospital stressed cost/benefit of AARK. Taking their experience into account, we are designing a new perioperative patient's information system including AARK.

Anesthesia↗
PubMed2005

[Automated anesthesia record system].

Based on Client/Server architecture, a software of automated anesthesia record system running under Windows operation system and networks has been developed and programmed with Microsoft Visual C++ 6.0, Visual Basic 6.0 and SQL Server. The system can deal with patient's information throughout the anesthesia. It can collect and integrate the data from several kinds of medical equipment such as monitor, infusion pump and anesthesia machine automatically and real-time. After that, the system presents the anesthesia sheets automatically. The record system makes the anesthesia record more accurate and integral and can raise the anesthesiologist's working efficiency.

Anesthesia↗
PubMed2001

Influence of the method of data collection on the documentation of blood-pressure readings with an Anesthesia Information Management System (AIMS).

The influence of methods for record keeping on the documentation of vital signs was assessed for the Anesthesia Information Management System (AIMS) NarkoData. We compared manually entered blood-pressure readings with automatically collected data. These data were stored in a data-base and subsequently evaluated and analyzed. The data sets were split into two groups, "manual" and "automatic". We evaluated the effect of automatic data collection on the incidence of corrected data, data validity and data variation. Blood-pressure readings of 37,726 data sets were analyzed. We could assess that the method of documentation did influence the data quality. It could not be assessed whether the incorrectness of data during automatic data gathering was caused by artefacts or by the anesthesiologist.

Anesthesiology↗
PubMed1993

A clinical computer database entry form for an intraoperative anesthesiology-based transesophageal echocardiography monitoring service.

Transesophageal echocardiography (TEE) has been increasingly applied to supplement and, in instances, to supplant conventional intraoperative cardiac monitoring. Our body of experience (> 1600 intraoperative TEE procedures), combined with insights gleaned from an intramural quality assurance study, and clinical implications of certain recent advances in the field, led us to develop the following TEE computer database entry form. The form, completed intraoperatively, consists of a patient and surgical procedure demographics section, followed by fields based on the TEE examination. The scans encompass transverse plane basal short axis, long axis, and transgastric views of the heart and great vessels. The two-dimensional echocardiographic, saline-contrast, color flow and pulsed Doppler data represent both right and left ventricular performance, valvular function and specific lesions. This database entry form is intended to serve as a guide for performance of a nominally complete intraoperative study and facilitate maintenance of a TEE archive consistent with current advances.

Anesthesia Department, Hospital↗
PubMed1995

An expert system to teach troubleshooting of common problems associated with the automated anesthesia recordkeeper.

Automated anesthesia recordkeepers have been used to monitor patients during surgery in up to 90% of cases at The Ohio State University. The record-keeping devices are complex and can be difficult to troubleshoot. The 1st-CLASS Fusion Program, an expert system "shell-program," has been programmed to allow the resident or nurse anesthetist to solve the two most common types of problems associated with the recordkeeper: printer problems and patient monitor problems. Use of this program allows the resident or nurse anesthetist to troubleshoot the recordkeeper quickly and accurately and promotes in the user a sense of competence and control over the technology.

Anesthesia↗
PubMed1995

[Online recording of monitor data. The artifact problem].

Increasing numbers of monitors at the anaesthesiologist's workplace, providing more than 20 different parameters of the patient's condition, have already made it impossible to record all the values in a handwritten form. Consequently, this most common method of record-keeping must be incomplete and inaccurate. In recent years computerised data-acquisition systems have been introduced into clinical practice in order to produce more reliable records. But after a 7-year experience in the use of such a system in cardiac anaesthesia, we have recognised certain problems that remain to be solved before automated record-keeping will achieve wider acceptance. The first is the handling problem, which was discussed in a previous paper. The second major problem is the appearance of artifacts, caused mainly by mechanical manipulations during the operation. In this paper, 300 courses of anaesthesia that were recorded online during different cardiac surgery procedures were examined and the incidence as well as the kind of artifacts occurring were evaluated. Algorithms were developed for each haemodynamic parameter to suppress these artifacts automatically by a subsequent analysing process; the efficiency of that "artifact filter" was validated in 35 of the 300 cases. Based on more than 30,000 values for each parameter, the incidence of artifacts was 3%-7%. However, only 0.1%-0.5% of the artifacts could not be eliminated by the filter. The method described here provided acceptable graphic printouts of the most important haemodynamic parameters (Figs. 1b and 2b) and would also be suitable to serve as an input filter for automatically running anaesthesia data-examination processes, which are currently being developed in our clinic.

Adult↗
PubMed1994

Real-time expert system for advising anesthesiologists in the cardiac operating room.

This paper describes the initial work towards building a distributed real-time expert system for advising anesthesiologists in the cardiac operating room. The goal of this project is to build a vigilant system that contains knowledge relevant to the practice of cardiac anesthesiology. The system is being designed to use this knowledge in conjunction with continuous automated patient data acquisition in order to provide clinically useful differential diagnoses and treatment recommendations in real time.

Anesthesiology↗
PubMed1994

Information systems support for OR product standardization.

A critical reason why many healthcare institutions cannot effectively standardize OR products is that they cannot access necessary information. An OR information system that manages, tracks and generates documentation on OR inventory is an important answer to implementing change. At least four key areas any information system should address in order to make standardization a reality are 1) clinical preference, 2) supplying a changing case mix, 3) product usage data and 4) vendor performance. OR information systems operate on various hardware platforms. Users have more software choices than ever before, because connectivity issues have been effectively solved through the development of standard electronic transaction sets.

Decision Support Systems, Management↗