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PubMed1981

Managing computer systems.

This paper launches a 12-part series of articles on managing computer systems for the hospital pharmacy department. The series will concentrate on the evaluation, purchase, and implementation of commercial computer systems. Computer hardware and software capabilities will be reviewed, a systematic approach toward the selection of a vendor will be outlined, advice on how to justify a system wil be offered, and important considerations in implementing and managing a computer system will be discussed.

Computers↗
PubMed1984

The pharmacy computer system at the New England Medical Center.

The pharmacy computer system developed and implemented at the New England Medical Center (NEMC) is described. The system was developed to improve the department's fiscal performance and operations. It operates on NEMC's large mainframe system and has the following components-order entry, unit dose/patient profile, i.v. admixture, and financial/management. The system was designed to interface with the admissions and census system and use the pharmacy department's drug data file. It accepts medication orders from pharmacy satellites and then processes the orders according to the requirements for the i.v. admixture or unit dose procedures. Financial data are collected as a routine part of all medication order processing. The system allows for the entry of multiple medication orders on one cathode ray tube (CRT) screen, thus facilitating order entry. The use of programmed system defaults is described. Order entry, dose selection, and patient profiles are displayed on a CRT. An active order list is printed once daily at midnight to serve as a back-up for the system. The computer system has had a positive impact on the department's operational, clinical, and management functions. Future enhancements of the NEMC system are discussed.

Allied Health Personnel↗
PubMed1991

Design of a clinical laboratory computer system.

A clinical laboratory is a dynamic organization that suffers when constrained to a static environment. Its approach to information management must be predicated on an ability to deal comfortably with change whenever necessary. It is important to view an information system as a dynamic process rather than a static object to be used for some time and then discarded for a newer model.

Clinical Laboratory Information Systems↗
PubMed1984

The pharmacy computer system at The Ohio State University hospitals.

The pharmacy computer system designed, developed, and implemented at The Ohio State University Hospitals is described. The computer system was developed to make more efficient use of hospital facilities and professional staff time. The pharmacy system operates on the mainframe hospital system using computer terminals with light-pen and keyboard access. Current online applications include order entry, patient profiles, pharmacokinetic calculations, and preparation of unit dose cart fill lists. Batch processing functions include drug-use review, drug-drug interactions, and financial management reports. Approximately 95% of unit dose orders and 20% of i.v. orders are conditionally entered by pharmacy technicians for subsequent verification by pharmacists. The system saves considerable staff time in the i.v. admixture and billing areas and has relieved pharmacists from performing many clerical and repetitive tasks. Disadvantages of the system include (1) its dependence on another department for patient admission, transfer, and discharge information and (2) delays in obtaining approval for program modifications and new applications. The advantages of the pharmacy computer system lie in its ability to access information from other computerized databases in the hospital. Future modifications and enhancements to the system are discussed.

Computers↗
PubMed1993

Automated decision making: the role of expert computer systems in the future of optometry.

BACKGROUND: Artificial intelligence (AI) refers to the ability of a machine, or system, or computer program to make intelligent decisions using the same methods that humans would use. By definition, and expert system (ES) is a computer program that uses knowledge and inference procedures to solve problems which would otherwise require the application of human expertise. METHODS: The role of expert systems in current and future applications in a number of fields were reviewed. RESULTS: Expert systems have and will be making an impact in many fields, including optometry in the future. CONCLUSIONS: Expert systems present an opportunity for the profession of optometry to become more efficient or accurate, provided that their development cost could be justified.

Artificial Intelligence↗
PubMed1979

Improvement of pulse-mode photographic images in MDS computer systems.

Users of scintigraphic computer systems manufactured by Medical Data Systems (MDS) frequently experience textured distortion of oscilloscope images when scans are produced by Z-axis modulation. The source of this malfunction has been identified and a way to eliminate the problem is described. The modification is simple and inexpensive. The availability of Z-axis modulation significantly enhances the capabilities of MDS systems.

Computers↗
PubMed1993

[The present situation of the computer system for the clinical laboratory in Japan].

We report the present situation of the computer system utilization for the Clinical Laboratory in Japan. For this studies, the data were calculated to our purpose from the materials for statistics published by the Ministry of Health and Welfare, Japan Society of Medical Technologist, and so on. The results were as follows, 1) computer systems were used on the 85% of all hospitals, and the most of them were used for the medical office work included the payment office. At clinical laboratory, there was very few use the computer systems, which account for 25%. 2) In the field of the clinical laboratory, there was mostly used at clinical chemistry, next field was hematology, serology, urinalysis, and microbiology, respectively. 3) Total system for the hospital, including ordering system were used only 0.06% (208 cases) of all hospitals in Japan. We calculated the number of beds with a hundred thousand population, the spread of the computer system, the number of the out-patients, in-patients, and the utilization ratio of beds, then we compared with that data for all of the prefecture included Tokyo, Osaka and Kyoto. As a result of the calculation, the prefecture which the number of bed with a hundred thousand population was much more than another zone were the utilization ratio of beds was less than another area, and there was worth at the spread of computer system. We think there areas had the smaller hospitals than that of having highly spread of computer system.

Clinical Laboratory Information Systems↗
PubMed1984

Users' perspectives of hospital pharmacy computer systems.

A survey was conducted to determine if user characteristics affected respondents' expectations of computer systems and to identify the most and least desirable features hospital pharmacists want in computer systems. A questionnaire was mailed to 200 hospital pharmacists selected randomly. The survey was designed to gather demographic data, general systems information, and information on system features in 10 major categories. A total of 111 surveys were returned. Of the respondents, 55% had some type of computer system. The leading type of system used by the respondents was a mainframe-shared system. The majority of respondents (87.4%) indicated that they had a "moderate" amount of experience with computer systems. The most commonly preferred hardware was the minicomputer. It appeared that user characteristics did not influence the pharmacists' expectations of computer systems. In ranking the categories, the hospital pharmacists indicated that the i.v. admixture area, inpatient drug distribution, and clinical functions were the most important for computer applications.

Attitude of Health Personnel↗
PubMed1998

A comparison of a manual and a computer system in a primary health care clinic.

Previous research has shown that nurses providing primary health care in local clinics are burdened with extensive administrative duties. These administrative tasks are so time consuming that less time can be devoted to direct patient care, their primary function. Certain assertions have been made with regard to computerising the total environment of patient records, capturing statistical indicators, stock control, etc. It is said that computerising the clinic at the point of service will naturally lead to less time devoted to administrative tasks, thus increasing the time available for direct patient care. This study was done to determine whether this assertion is true. It was conducted by means of a combined quantitative and qualitative research design. The manual system and a computer system were quantitatively compared by means of various time measurements. The perceptions of patients and staff regarding computers were explored qualitatively by means of questionnaires. It was found that computerising the nurse's consulting room does not enhance the ratio between the time devoted to administrative tasks and the time devoted to patient care. In fact, the consultation time was longer with the computerised system than with the manual system. Some limiting factors in the computerisation process were discovered, the most important of which were the lack of computer literacy and typing skills of the nursing staff.

Ambulatory Care↗
PubMed1979

A modular computer system for radiologists.

A computer system was developed for two private radiology offices, consisting of six modular components, a history file, registration file, assisted reporting module, appointment management module, accounting module and statistical module. Effectiveness and efficiency of patient care have been increased substantially.

Computers↗
PubMed1981

Data handling and reporting for microbiology specimens with a small laboratory computer system.

A small laboratory computer system designed for general application in chemistry, haematology, and urinalysis has been adapted for the bacteriology section of the laboratory using the same available programming routines. Specimens are requisitioned according to predetermined common site codes, with both preliminary and final reporting allowed for where desired. Sensitivity data also appended and entered where required, even for different organisms in the same culture.

Bacteriology↗
PubMed1987

Carola, a computer system for automatic documentation in anesthesia.

A computer system has been designed for documentation and data acquisition during open heart surgery. This computer system (called 'Carola') processes all patient data during cardiac surgery. More than 50 analogue or digital signals are scanned. These are derived from a monitoring rack, a Siemens Servo 900B ventilator with its accessory devices and a heart lung machine. All these values are plotted as well as offline data, such as medications, fluids, laboratory results and user comments, on an A3 format anesthetic record using an eight pen flat bed plotter. Simultaneously all data is written onto a cassette tape. These tapes are then transferred to a database for storage and statistical processing. The sampling frequency is every 10 seconds, averages being calculated over one minute periods. The chart is updated once a minute normally or every 15 minutes for slowly changing signals e.g. temperatures. Hardware and software of the computer have modular design. The hardware consists of two Motorola 6809 based microprocessor systems. The software is entirely written in Pascal. The user interface is implemented on a menu driven basis. A terminal with a keyboard is used for the communication with the users, namely anesthetic nurses and anesthesiologists. The system was readily accepted by the users. The menu structure proved to be easy to learn and allowed fast entries, even when the users were not previously accustomed to the use of a keyboard. The clear and detailed presentation of the data on the plotted chart helped to detect trends early and facilitated therapeutic decisions. From december 1983 the first prototype was used on a routine basis, followed by a second unit in June 1984 and a third in December 1985. Up to now more than 12.500 anesthetic hours have been recorded. Since then almost 100% of all anesthetics performed in our cardiothoracic unit have been documented by the computers, including all short procedures without invasive monitoring and all emergencies.

Anesthesiology↗
PubMed1990

Computer system for equipment management.

A computer system has been developed to meet the requirements of equipment management. The system was originally developed to run on personal computers, but has been upgraded to provide true multiuser facilities and more advanced program capabilities. This has been achieved using improved hardware and a relational database. The manner in which the software operates is described, with some examples examined in more detail. The system provides a wide range of information, including inventory data, repair costs and time as well as service records and worksheets. In addition it meets the other basic requirements of the department, including wordprocessing, budgetary control and stock control. The system also provides an immediate and rapid overview of the repair state of all equipment whilst reducing administration time for many aspects of the service. Emphasis has been placed on the integrity of the data and ease of entry of additional data.

Computer Systems↗
PubMed1995

[Computer system of the electronystagmographic examination. Part III. Comparative results obtained by computer and traditional technology in the examination of the vestibular organ].

The study presents a comparison of the research into results of vestibular organ stimulated with caloric tests which had been simultaneously registered with the help of a computer system of electronystagmographic examination, as well as the traditional electronystagmographic technic. In the case of 32 healthy persons there had been counted by hand average angular velocity of the slow phase caloric nystagmus average level of reduced excitability of labyrinth and direction predominance. It had been defined that those values are comparable to the ones given by the computer. That points to the right chose of the space of time in the climax of nystagmus reaction and a good identification of the phase both slow and fast by the computer system.

Adult↗
PubMed2001

Comparison of diagnosis of early retinal lesions of diabetic retinopathy between a computer system and human experts.

OBJECTIVE: To investigate whether a computer vision system is comparable with humans in detecting early retinal lesions of diabetic retinopathy using color fundus photographs. METHODS: A computer system has been developed using image processing and pattern recognition techniques to detect early lesions of diabetic retinopathy (hemorrhages and microaneurysms, hard exudates, and cotton-wool spots). Color fundus photographs obtained from American Indians in Oklahoma were used in developing and testing the system. A set of 369 color fundus slides were used to train the computer system using 3 diagnostic categories: lesions present, questionable, or absent (Y/Q/N). A different set of 428 slides were used to test and evaluate the system, and its diagnostic results were compared with those of 2 human experts-the grader at the University of Wisconsin Fundus Photograph Reading Center (Madison) and a general ophthalmologist. The experiments included comparisons using 3 (Y/Q/N) and 2 diagnostic categories (Y/N) (questionable cases excluded in the latter). RESULTS: In the training phase, the agreement rates, sensitivity, and specificity in detecting the 3 lesions between the retinal specialist and the computer system were all above 90%. The kappa statistics were high (0.75-0.97), indicating excellent agreement between the specialist and the computer system. In the testing phase, the results obtained between the computer system and human experts were consistent with those of the training phase, and they were comparable with those between the human experts. CONCLUSIONS: The performance of the computer vision system in diagnosing early retinal lesions was comparable with that of human experts. Therefore, this mobile, electronically easily accessible, and noninvasive computer system, could become a mass screening tool and a clinical aid in diagnosing early lesions of diabetic retinopathy.

Aged↗