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PubMed1992

Medical records in litigation: the Dalkon Shield story.

The Dalkon Shield was manufactured by A.H. Robins Inc. in the early and mid seventies, before it was withdrawn from sale because of the influx of lawsuits against the manufacturers. The case has become the largest tort case in history, with approximately 200,000 claimants worldwide and will not be wound up for years to come. Slater and Gordon is an Australian firm of solicitors with offices in three states. They have the largest Dalkon Shield practice in the world and represent almost 3,000 claimants. One of their most difficult tasks in preparing the cases is the gathering of medical evidence to substantiate claimants' assertions. This entails collecting relevant medical records from across the country and around the world going back almost twenty years for almost 2,000 women. The project has magnified the importance of accurate and complete documentation, kept intact and made accessible. The influence of medical record administrators is highlighted.

Australia↗
PubMed2000

Versatile user interface using UMLS Metathesaurus.

One of the obstacles for a successful search in the biomedical field is that different vocabularies are used by different databases but more than one database is usually needed to respond adequately to a healthcare professional's query. A typical searcher usually is unfamiliar with these vocabularies and the sophisticated measures to narrow or broaden a search. As a result, a failed search is often due to using "inappropriate" search terms. We have developed a highly interactive and versatile user interface, SHINE Refined Search (SHINE RS). It uses medical concepts from the UMLS Metathesaurus as the building block to help searchers find "appropriate" search terms for their queries. The results of our preliminary usability assessment are promising and demonstrate the potential to improve retrieval results.

Diabetes Mellitus↗
PubMed2000

Teledentistry: what is it now, and what will it be tomorrow?

A few years ago, teledentistry involved calling an expert on the telephone for advice. Now it involves consulting experts using the Internet. This article explains the basic ideas underlying teledentistry. It involves the local dentist digitizing and electronically transmitting drawings, diagrams, photographs, and X-rays to a specialist. Along with these data, the dentist will most likely need to fill out a standard consult form from the specialist's Web site. In return, the specialist will develop and return a confidential consultation report to the dentist or physician requesting help. For this service, a time-based fee will be paid to the expert. Unfortunately, it is likely that some doctors will use the Internet to set up and seek direct patient contact, thus becoming "cyberdentists." In most cases, cyberdentistry will not be in the best interests of the public. However, teledentistry should not only be a practice builder for the local dentist, but also has the potential for helping dentists better serve their patients while increasing their own knowledge.

Clinical Competence↗
PubMed2000

The future of teledentistry.

Teledentistry is a rapidly forming subset of telehealth, a field that already has considerable impact on the health care industry. Recent advances have created new opportunities for teledentistry, and changes in diverse technologies have created new tools for the practitioner. Technologies currently available are beginning to change the dynamics of dental care delivery. As teledentistry evolves, it will offer new opportunities to improve the level of patient care and reshape current business models.

Computer Communication Networks↗
PubMed2001

Kaiser Permanente's "metadata-driven" national clinical intranet.

This paper describes the approach taken to build Kaiser Permanente's national clinical intranet. A primary objective for the site is to facilitate resource discovery, which is enabled by the use of "metadata", or data (fields and field values) that describe the various resources available. Users can perform full text queries and/or fielded searching against the metadata. Metadata serves as the organizing principle of the site--it is used to index documents, sort search results, and structure the site's table of contents. The site's use of metadata--what it is, how it is created, how it is applied to documents, how it is indexed, how it is presented to the user in the search and the search results interface, and how it is used to construct the table of contents for the web site--will be discussed in detail. The result is that KP's national clinical intranet has coupled the power of Internet-like full text search engines with the power of MedLine-like fielded searching in order to maximize search precision and recall. Organizing content on the site in accordance with the metadata promotes overall consistency. Issues currently under investigation include how to better exploit the power of the controlled terminology within the metadata; whether the value gained is worth the cost of collecting metadata; and how automatic classification algorithms might obviate the need for manual document indexing.

Computer Communication Networks↗