The electronic medical record: a missing component of the health information infrastructure in Australia.
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Australia↗
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Results for “Medical Informatics Computing”
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Security for electronic patient record systems.
The presentation is devoted to the problem of security for Electronic patient record system with EPRS for N.N. Burdenko Neurosurgical Institute (NSI) as an example.
Computer Security↗
[Storage of patient data and images with a new computer-assisted analog procedure].
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Hospital Information Systems↗
A web interface for multimedia electronic patient record: consensual validation of the Aquitaine Health Information Network prototypes.
The PromptPR patient record originates from the research and development project DILEMMA (1992-94) and has been undertaken in the context of the research project PROMPT (4th Framework Health Telematics). Here we present the work undertaken with the doctors of the project RISA (Réseau d'Information de Santé en Aquitaine) in order to adapt the patient record to their various practical medical conditions. Effectively, there are implications for general practitioners, the private sector and hospital personnel. The richness of the workgroup and the adoption of a participative methodology, guided by the demands of the end-users allowed the creation of an electronic patient record (EPR) sufficiently simple and generic as to serve as a common base for both general practitioners and hospital medical staff. Independent of this system, the multimedia interface presented is based on frames, which enables visualization of the EPR either vertically or horizontally, with access to both the multimedia and external documentation of the patient. This web interface is the result of a consensus of opinion within the group.
Computer Communication Networks↗
Computer assisted clinical data analysis.
The Diagnosis Related Groups patient classification scheme coupled with desk top PC technology permits sophisticated analysis of patient medical data. Individuals with no programming knowledge can produce sophisticated analysis. The functionality and structure of the 3M Analytical Workstation are described and example analysis reports are presented.
Computer Systems↗
Microchips versus stethoscopes: Calgary hospital, MDs face off over controversial computer system.
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Alberta↗
[A computer-assisted obstetrics-perinatology data processing program].
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Documentation↗
Analysis of hospitalised patient flows using data-mining.
UNLABELLED: Face to the development of hospital information system in the "Hôpital Européen George Pompidou" (HEGP), computerized patients records made medical data easier to analyse than before. We use data-mining technology to analyse intra-hospital patients' paths with one year of PMSI data (a French medical information system similar to Diagnosis Related Group). METHODS: 1. "sequential patterns mining" was used to analyse the most frequent patients' paths, 2. an integrated framework of "association rules mining" and "classification rule mining" was used to build prediction rules of patients' paths. RESULT: We construct a rule based prediction model, which gives the tendency of the patient's paths between the different medical units.
Computer Communication Networks↗
Modern office design in the "information age".
This article reviews the process of reaching the goal of modernizing a new or existing endodontic office. Incorporating computer-based technologies in the office requires significant planning, best achieved by forming a technology goal that addresses budget, knowledge base, and infrastructure issues. Making the transition to the modern dental practice is expensive and time-consuming but also profitable and exciting. Soon, all dental offices will be using digital radiographic systems, video systems, and patient charting programs that use no paper documentation. As the computer familiarity and staff knowledge based increases with the growing use of computers in society overall, finding the office personnel able to harness the efficiency and power of the technology in the dental office will be easier. Through careful planning and formation of a reasonable technology goal, updating an old office or creating a new modern endodontic practice with the technologies and their patients can benefit.
Computer Systems↗
Database for gynecological laparoscopy.
Laparoscopy is a wonderful tool for performing gynecologic surgery. Whether or not laparoscopic surgery is advisable to diagnose or treat a particular gynecologic problem requires a careful consultation with an experienced gynecologist, who can help the patient weight the pros and cons of laparoscopy versus other options. For the management of this kind of surgical intervention we realise a computer based patient record.
Computer Security↗
A framework for an institutional high level security policy for the processing of medical data and their transmission through the Internet.
BACKGROUND: The Internet provides many advantages when used for interaction and data sharing among health care providers, patients, and researchers. However, the advantages provided by the Internet come with a significantly greater element of risk to the confidentiality, integrity, and availability of information. It is therefore essential that Health Care Establishments processing and exchanging medical data use an appropriate security policy. OBJECTIVE: To develop a High Level Security Policy for the processing of medical data and their transmission through the Internet, which is a set of high-level statements intended to guide Health Care Establishment personnel who process and manage sensitive health care information. METHODS: We developed the policy based on a detailed study of the existing framework in the EU countries, USA, and Canada, and on consultations with users in the context of the Intranet Health Clinic project. More specifically, this paper has taken into account the major directives, technical reports, law, and recommendations that are related to the protection of individuals with regard to the processing of personal data, and the protection of privacy and medical data on the Internet. RESULTS: We present a High Level Security Policy for Health Care Establishments, which includes a set of 7 principles and 45 guidelines detailed in this paper. The proposed principles and guidelines have been made as generic and open to specific implementations as possible, to provide for maximum flexibility and adaptability to local environments. The High Level Security Policy establishes the basic security requirements that must be addressed to use the Internet to safely transmit patient and other sensitive health care information. CONCLUSIONS: The High Level Security Policy is primarily intended for large Health Care Establishments in Europe, USA, and Canada. It is clear however that the general framework presented here can only serve as reference material for developing an appropriate High Level Security Policy in a specific implementation environment. When implemented in specific environments, these principles and guidelines must also be complemented by measures, which are more specific. Even when a High Level Security Policy already exists in an institution, it is advisable that the management of the Health Care Establishment periodically revisits it to see whether it should be modified or augmented.
Access to Information↗
The use of relational databases in health care information systems.
The relational database is especially well suited to be the cornerstone of the next generation of health care information systems. Health care organizations can take advantage of the lessons learned from major corporations that have built entire information infrastructures using it. The relational model's strength in handling the analysis of transaction data makes it ideal for fulfilling complex utilization review requirements and providing a solid foundation for the increasing operational demands of large physician-managed managed care networks.
Computer Communication Networks↗
The clinical skills resource: a review of current practice.
This review is based on the findings of the Southampton Clinical Skills Project, which was a needs assessment and feasibility study to consider the development of a multiprofessional Clinical Skills Resource at Southampton. The project spanned a period of 18 months and used a range of methods of data collection, including visits to 12 clinical skills facilities in the UK. Most existing clinical skills centres have developed in response to changing healthcare policy, curricular initiatives and increasing emphasis on the quality of assessments and competencies. There is also increasing recognition that clinicians are no longer able to teach effectively all skills to students in the traditional ways, and that clinical skills training and assessment, particularly for undergraduates, is an area of deficiency. The potential scope of clinical skills centres is broad and encompasses not only clinical and communication skills but medical informatics, computer assisted learning, multiprofessional learning and assessment. Skills centres can also promote self directed and lifelong learning methods. The planning of skills centres involves a variety of stakeholders and users, including undergraduates, postgraduates, acute and community Trusts, Postgraduate Deans and medical schools. A successful skills centre needs to be flexible in its design, integral to the curriculum and relevant to educational and training requirements. This requires planning, organization and resources. Different organizational models can be used, depending on local factors. The management of skills centres involves consideration of issues such as security, safety, supervision of learners and staff development, informed by a network of experts and everyday users. The development of skills centres should include ongoing educational evaluation of outcomes and educational research. The use of a clinical skills centre has potential benefits for staff and students, including the provision of a safe environment in which to learn and practise skills before using them in the real clinical setting. This can reduce anxiety in students and protect patients from novice practice. Clinical skills centres provide a setting for structured learning with feedback as well as assessment of competence. The limitations of a skills centre are that it can only provide simulated experiences which are an adjunct to, but can never replace real clinical experience.
Clinical Competence↗
Leveraging XML-based electronic medical records to extract experiential clinical knowledge. An automated approach to generate cases for medical case-based reasoning systems.
Case-based reasoning (CBR)-driven medical diagnostic systems demand a critical mass of up-to-date diagnostic-quality cases that depict the problem-solving methodology of medical experts. In practical terms, procurement of CBR-compliant cases is quite challenging, as this requires medical experts to map their experiential knowledge to an unfamiliar computational formalism. In this paper, we propose a novel medical knowledge acquisition approach that leverages routinely generated electronic medical records (EMRs) as an alternate source for CBR-compliant cases. We present a methodology to autonomously transform XML-based EMR to specialized CBR-compliant cases for CBR-driven medical diagnostic systems. Our multi-stage methodology features: (a) collection of heterogeneous EMR from Internet-accessible EMR repositories via intelligent agents, (b) automated transformation of both the structure and content of generic EMR to specialized CBR-compliant cases, and (c) inductive estimation of the weight of each case-defining attribute. The computational implementation of our methodology is presented as case acquisition and transcription info-structure (CATI).
Artificial Intelligence↗
Bhorugram (India): revisited. A 4 year follow-up of a computer-based information system for distributed MCH services.
Impact of a health informatics research project on the management and delivery of primary health care, focusing on maternal and child health care (MCH), was reported earlier in 1992, with encouraging results in terms of increased antenatal care coverage and decrease in Immunisation drop-outs. The software (MCHS) was based on essential data sets (EDS) to assist the care providers in information management for MCH care. The site was revisited after four years to evaluate the status of the project and to ascertain whether computers were still in use and was the dispensary staff using the MCHS package or not? The results are presented in this paper to demonstrate that 'information is a difference that makes a difference'. Information generated by the MCHS acted as a catalyst for behavioural change in the community from indifferent users to active users of the health care services. This is reflected by the increased acceptance of antenatal care, 80% fully immunised child (FIC) and participation in other primary health care activities.
Adolescent↗
Medical informatics: an introduction to computer technology in medicine.
Access and effective management of medical information have become increasingly important in the practice of medicine today. Computer technology is developing to achieve this goal. This had led to the emergence of a new specialty, medical informatics, the basic science of the use of computers in medicine. Areas of patient care to which medical informatics has been applied include history taking, medical records, medical data base information retrieval, test performance, test result retrieval, decision support, patient monitoring, medical education, quality assurance and utilization review, medical research, and medical office and financial management. It is important that these applications become integrated with existing medical information systems and that physicians take a leading role in developing and maintaining these systems.
Computers↗
The redesign of the Medical Informatics Master of Science course at the University of Amsterdam.
OBJECTIVES: To describe our new two years Master of Science (MSc) program starting in September 2006 at the University of Amsterdam- Academic Medical Center, The Netherlands. METHODS: We elaborate shortly on the mission, organizational structure and new contents of this new MSc course in medical informatics. RESULTS: Through the years, our medical informatics university program underwent some major revisions of which the transition from a four years course into a three years BSc program and a two years MSc program has been the most fundamental. The new MSc program is aimed at (international) baccalaureates in medical informatics, computer science, medicine, health sciences, and biology. Besides, health care professionals or professionals with a background in computer science may enter the program. The program length is two years, comprising four study semesters of 30 European Credits each (EC, 1 EC corresponding to 27 hours study load), equalizing 120 EC in total of which 48 EC are reserved for the master's thesis. CONCLUSIONS: With the new set up of the MSc program, that will be offered in English, we hope to both accommodate the learning needs of our own baccalaureates and to attract international baccalaureates and other professionals to this course. Our ultimate aim is to bring forth medical informatics specialists who are well equipped to make significant contributions to the field.
Curriculum↗
Computerized assessment of complications after colorectal surgery: is it valid?
PURPOSE: Historically, complication rates after colorectal surgery have been stratified by disease process, type of operation, or anesthesia risk derived after an intensive review of the medical record. Newer computer applications purport to shorten this process and predict the probability of postoperative complications by distinguishing them from comorbidities that are commingled on uniform discharge codes. We analyzed CaduCIS software, which uses discharge codes, to determine whether its predictions of comorbidity and complications were comparable to what was interpreted on the medical record. METHODS: Two-hundred seventy patients were analyzed according to the principal and secondary diagnoses coded on discharge. Coding inaccuracies of clinical occurrences were identified by physician review of each medical record. The actual incidences of 17 common preoperative comorbidities and 11 postoperative complications were compared with those predicted by CaduCIS. RESULTS: The CaduCIS-predicted distribution of comorbidities was similar to the actual occurrences in 15 of 17 categories. The overall incidence of complications obtained by physician (actual) review was 47 percent, compared with 46 percent predicted by CaduCIS. However, there was a statistical difference between the CaduCIS-predicted and the actual complication rates in 5 of the 11 categories. The most common preoperative comorbidity and complication was cardiopulmonary (47 percent and 28 percent, respectively). CONCLUSION: The overall complication rate interpreted from the medical record (47 percent) was accurately predicted by CaduCIS (46 percent). Predictions of 5 of 11 individual complications were underestimated because of charting and coding inaccuracies, not because of computerized errors. Because uniform discharge coding of commingled comorbidity and complications is increasingly used to rapidly compute surgical outcomes, colon and rectal surgeons need to ensure compatibility of the actual and coded medical records.
Comorbidity↗