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[Electronic data processing-assisted serial automation of current methods in blood group serology].

The introduction of special centrifugable racks with a transparent bottom into the conventional typing of blood groups in glass tubes facilitates the simultaneous work on and reading of a maximum of 32 complete ABO, Rhesus and Kell typings in one series. As a result of the facts that it is unnecessary to label the individual tubes and that the pipetting of serum and erythrocyte suspensions is done automatically and through the unmistakable classification of the samples by means of bar-coding, the manual work is reduced to about 50%. This modified typing method combines the advantages of the conventional typing method in glass tubes with the advantages of an efficient microplate technique. There is no qualitative loss in the implementation and reading of the analysis.

ABO Blood-Group System↗

[Implementation of the multi-center basis documentation CL-BaDo for conciliar and liaison services: generating data for internal quality management and cost calculation].

In the German DRG system the funding of CL services is not ensured. The documentation of psychiatric comorbidity and CL care delivery is a pre-condition to the development of funding models for CL-services. A task force of several German psychosomatic associations (German College of Psychosomatic Medicine, German Society of Psychosomatic Medicine and Psychotherapy, General Medical Society for Psychotherapy) developed a new documentation form for CL-services (CL-BaDo). The pilot study explored the multicenter implementation of CL-BaDo and the use of the documentation form for quality management and cost calculation. Over a period of at least three months, participating CL-services documented all CL cases consecutively with the CL-BaDo. One site applied full electronic data processing. 2116 CL cases from eight psychosomatic CL-services were analysed. The CL-BaDo is a time-efficient, feasible and acceptable documentation form for CL-service delivery. The full electronic data processing enables networking with a hospital information system to produce higher data quality. The data of CL-BaDo can be used locally for quality management, development of management strategies and communication with consultants, as well as nationwide for health policy questions and research.

Austria↗

[The information system of the Deutsche Klinik für Diagnostik (author's transl)].

Data processing in medicine includes the administration, patient control and medical documentation. The introduction must be made step by step, lead to selective editing of information and promote the standardization process through the application of electronic data processing. Data acquisition can be done automatically by activating the computer or feeding from the information flow. Patient-linked information, including clear text, can be inverted, i. e. edited for retrieval by automatic description in a diagnosis orientated form.

Diagnosis, Computer-Assisted↗

Development of an audiometry data processing system.

The development was reported of an electronic data processing system of computerized automatic audiometry and of Bekesy audiometry. This system using a microcomputer has the following features: (1) The large amount of data obtained through (a) automatic audiometry, (b) Bekesy audiometry (measurement at fixed or continuous frequency plus test practice, and (c) the Temporal Tone-Decay test can be stored on-line in real time, and are processed and displayed off-line at any time. (2) When retrieved, the output format of these audiometric data is of the same pattern as the conventional audiogram. (3) The output pattern on the CRT graphic display can be hard-copied whenever desired. (4) The system can be operated manually in the same way as the conventional method. (5) The SISI and DL tests can be executed manually and the resultant data keyed into computer storage. And (6) The operation from the data input to the retrieval output is performed interpretively through the CRT display, so that anyone even without special computer or audiological training can operate it at any time.

Audiometry↗

Development of an outcome assessment and informational system for physical therapy. A multi-institutional project.

The profession of physical therapy needs an outcome assessment and informational system developed specifically for it. The goal-oriented assessment system and data collection procedures which use electronic data processing are an attempt to satisfy that need. The purpose of this project was to demonstrate that an electronic data processing of physical therapy services system could be adapted and implemented on a multi-institutional basis. Physical therapy departments in four community general hospitals in New Jersey implemented the program by applying the data base to all discharged patients during a six-month period. The program was again modified at the conclusion of actual use so that the requirements of all participating institutions would be satisfied. This outcome assessment and informational system can contribute to objective evaluation of physical therapy care.

Hospital Departments↗

[Anesthetic data processing--the Bad Säckinger model].

A cost-effective computer program for district hospitals has been developed to process data from anesthetic charts. Apart from monthly and annual statistics relevant to clinical anesthesia and hospital administration, the described system allows free data handling of all material stored in the data base. The possibilities and limitations of electronic data processing are discussed.

Anesthesiology↗

[The problem of documentation in traumatology].

An exact documentation is a necessary demand of modern medicine. Different methods of the registration of information, for example the conventional sick-paper, the punch card and the electronic data processing documentation are opposed with their pros and cons. The own experiences of the surgical hospital of the Friedrich-Schiller-University with the documentation of injured patients is shown and explained. The text points to the importance of the electronic data processing registration and evaluation of the many facts of the injured patients concerning the therapeutic, epicritical, but also epidemic and legal questions.

Accidents↗

Stepwise evaluation of information systems in an university hospital.

A prospective intervention study with historical control has been performed at Giessen University Hospital, Germany, to investigate the influence of electronic data processing systems on nurses' working environment. Two wards of the medical department were selected for this study, using the combined approach of work-sampling methods and questionnaires. In the first intervention a central information system with restricted functions was introduced. For the second intervention an additional nursing information system was installed. The distribution of nurses' worktime into the fields of general nursing care, specific nursing care and administrative activities was not influenced by electronic data processing. No time saving could be measured. Results of the questionnaires did, however, indicate a positive influence of the hospital information system on nurses' working environment.

Adult↗

[Compiling the data of vitrectomy patients. Waiting list organization and quality assurance].

Owing to an increasing frequency of ophthalmological operations and the necessity of shortening the patient's stay in hospital surgical scheduling and data compilation in ophthalmology can only be managed by means of electronic data processing. We present a computer program that compiles a waiting list for vitrectomies and organizes the scheduling of operations. On each patient's first visit a standardized form containing the essential clinical findings if filled out. On the basis of these data the computer, using a specially designed algorithm places the patient in an appropriate position on the waiting list and eventually informs him or her of the date of the operation. In a similar manner the postoperative findings and the results of the follow-up examinations are documented. The system allows effective scheduling based on the urgency of the operation and the prognosis of the disease. Furthermore, it facilitates prospective recording of the clinical course and the treatment outcome. The use of electronic data processing does not only mean an improvement in clinical organization and, especially, in surgical planning, but also facilitates a quick evaluation of clinical studies with a large number of patients.

Algorithms↗

[Electronic data processing-assisted organization of interdisciplinary universal hearing screening in Saarland].

BACKGROUND: Despite many recommendations and obvious advantages universal auditory screening in new-born children is only beginning to be implemented in the German health system. METHOD: We report on a multistage screening project based on otoacoustic emission measurements. One of the major disadvantages of such programs is the comparatively low specificity of otoacoustic emission measurements which leads to the need for a large number of re-measurements. Thus, the organisation of follow up screening failures is one of the most important factors that influence the effectiveness of screening programs. An additional problem is a drop-out rate which can be as high as 30% of the children that have to be retested. RESULTS: In our program we tried to solve these problems by combining primary screening in maternity wards with retesting by paediatricians using the routine examinations of children (U3 and U4) that are done for almost 100% of German babies. In addition, the data from the children that were screened and that have to be screened are transferred to a central data management system. CONCLUSION: Using this system, the follow up of any individual child can be monitored until a hearing loss has been diagnosed or excluded. Therefore early therapy of children with impaired hearing is possible and psychological and social defects can be avoid.

Audiometry, Evoked Response↗

[Analysis of diadochokinetic movement. Electronic data processing-aided diadochometry--a contribution to developmental neurologic diagnosis].

A method of objective registration and analysis of diadochokinetic arm movement was tested in normal children and those with signs of minimal cerebral dysfunction (MCD). 44 children aged 4-10 yrs. (9 with the diagnosis of MCD, 31 controls) were investigated. By means of a special device 270 deg. twisting of the forearms were transduced linearly by foam-cushioned clamps at the wrists and a potentiometer into a direct current of 0-2,7 V, respectively. The analog DC signal was digitalized by 0.7 kHz and stored in a calculator, the identification of the first and last sectors were performed on monitor. After removing artificial currents by a special filtering program, the remaining sinus-like curves could be analyzed by a special program (BEWESI). Mathematical analysis was performed by 11 factors respecting right and left arm, unilateral or bilateral twisting. Statistical analysis showed significant differences in some parameters between normal and MCD-children. In addition, a significant difference between the velocity of pronation and supination was evident. The fact that a clear age relation of parameters was found, proves the practicability of this diagnostical method in developmental neurology.

Attention Deficit Disorder with Hyperactivity↗

[Computer-assisted patient management. Individual electronic data processing-assisted documentation in gynecology].

EDP-supported documentation of patients has become increasingly important over the last several years. Seven autonomous wards of the gynecological department of the Hospital Rudolfstiftung were equipped with a clinical documentation system. The integration of this new system into the infrastructure of the KIS (Krankenhausinformationssystem) was accomplished with the help of the MD-ADV. We also implemented one of the best-known statistical analyzing systems, SAS, so that we have simple possibilities for statistical calculation and graphical plots.

Computer Graphics↗