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PubMedDate not supplied

Evolution of the medical record format during two years' use of an open-format microcomputer charting system.

In 1988, the authors implemented a microcomputer charting system (SmartChart) within a busy dialysis unit and an outpatient dialysis practice, to be used as the primary recording instrument for physicians and nurses. The program defined the organization of the medical record as three types of titles: problems, therapies, and numerics. Each title had a variety of associated data, such as comments, dosages, values and normals. Predefined care plans were created, and keyboard entry was in a completely open format. Over the next two years, the overall format of this medical record proved to be highly effective, and strict problem orientation allowed both nurses and physicians to use the same problem list. A more specific organization of the title lists in the medical record was needed, however. Separate symbols were placed in front of: problem titles related to prior therapies; problems recorded during current therapies; History and Physical (H&P) data; Plans/Orders; and inactive problems. PRN therapies, those therapies related to patient treatments, vital signs, and numeric data recorded during treatments were identified. The basic format of the medical record that evolved has proven suitable for outpatient, inpatient, and specialized treatment centers.

Attitude to Computers↗
PubMedDate not supplied

A handheld microcomputer system for control of a jet ventilator.

High-frequency jet ventilation is a relatively new mode of patient ventilation that has seen application in critically ill patients with respiratory failure. Because of the radically different nature of this modality of ventilation, clinicians often are unsure which ventilator parameter settings are appropriate. The authors describe in this paper a handheld microcomputer system to assist in the control of jet ventilators.

Algorithms↗
PubMed1983

An interactive microcomputer program for calculation of combined parenteral and enteral nutrition for neonates.

A responsive, iterating program is described (available on diskette from first author), which enables the physician to formulate a balanced, total parenteral nutrition (TPN) for low-birth-weight and sick newborns. The program allows for the possibility of TPN or simultaneous intravenous, intraarterial, and oral feeding. It calculates the overall balance of fluids, nutrients, calories, electrolytes, minerals, trace elements, and vitamins. It features the integration of algorithms and limit tests of nutritional balance, to produce a feeding program that can be modified by clinical considerations of the physician, specific for each patient. The entire procedure can be accomplished, and a record of the entries and orders to the pharmacy and to the ward staff printed, within about 4-5 min. The program, which is written in BASIC, can be accommodated within and operated with a 16K byte microcomputer, equipped with a monitor, a printer, and a diskette or other program storage device.

Computers↗
PubMed1989

Behavioral control of visual field screening using a microcomputer.

A computer algorithm is described which automatically controls the presentation of visual field targets and analyzes the subject's responses. Data relating to the procedure's reliability and validity are reported along with experience using it with normal subjects on an IBM PC compatible. Suggestions are made for the further development of the microcomputer approach to visual field investigations.

Algorithms↗
PubMed1980

Numerical integration simulation programs for the microcomputer.

Programs for use with the Apple II Plus microcomputer that generate graphic simulations of various linear and Michaelis-Menten pharmacokinetic models are described. The programs numerically integrate sets of differential equations for appropriate pharmacokinetic models. Multiple oral (or intramuscular), intravenous bolus, or infusion doses (continuous or discontinuous) may be administered in any combination. Doses as well as pharmacokinetic parameters may be changed at the end of each simulated dosing interval. The programs can be easily modified by users familiar with the BASIC programming language and offer an economical approach to pharmacokinetic simulation.

Computers↗
PubMed1987

Microcomputer-assisted data management for multiinstitutional pediatric clinical cancer trials.

Microcomputer assisted data management techniques, utilized in the oversight of two multiinstitutional trials for children with previously untreated acute lymphoblastic leukemia and unfavorable prognostic features, are presented. In the first study, such oversight hastened identification of unexpectedly prolonged delays, so that treatment could be successfully modified. In the second study, inferiority of one therapy was rapidly demonstrated, and after careful review that therapy was halted. Performance monitoring is discussed in terms of consideration of the overall quality of a clinical trial, namely, how complete are the data submitted and how precisely was protocol therapy administered; measurement of the quality of institutional participation, and identification of deficiencies in reporting or performance in the records of individual patients.

Acute Disease↗
PubMed2007

Scalar localization of the electrode array after cochlear implantation: a cadaveric validation study comparing 64-slice multidetector computed tomography with microcomputed tomography.

HYPOTHESIS: Improved resolution available with 64-slice multidetector computed tomography (MDCT) could potentially be used clinically to localize the cochlear implant (CI) electrode array within the basal turn. BACKGROUND: In CI surgery, the electrode array should be inserted into and remain within the scala tympani to avoid injury to Reissner's membrane and the scala media. Correlating the position of the electrode in the basal turn with surgical technique and implant design could be helpful in improving outcomes. METHODS: After a standard left mastoid exposure of the round window niche through the facial recess performed on a cadaver head, an electrode array from a Nucleus Softip Contour CI was fully inserted through a cochleostomy. The head was then scanned axially on a 64-slice MDCT with 0.4-mm slice thickness and reconstructed into the oblique axial, oblique coronal, and oblique sagittal planes of the cochlea. The temporal bone was then harvested and imaged on a microcomputed tomographic scanner using 20-microm slice thickness. Identical reconstructions were made and compared with the 64-slice images to confirm exact location of the electrode array. RESULTS: The 64-slice MDCT accurately localized the electrode array to the scala tympani. This was best demonstrated in the oblique sagittal plane, identifying the electrode array in the posterior inferior portion of the basal turn, posterior to the spiral lamina. CONCLUSION: This ex vivo validation study suggests that 64-slice MDCT has the potential to allow accurate localization of the CI electrode array within the basal turn of the cochlea.

Cadaver↗
PubMed1999

Microcomputer-based workforce scheduling for hospital porters.

This paper focuses on labour scheduling for hospital porters who are the major workforce providing routine cleansing of wards, transportation and messenger services. Generating an equitable monthly roster for porters while meeting the daily minimum demand is a tedious task scheduled manually by a supervisor. In considering a variety of constraints and goals, a manual schedule was usually produced in seven to ten days. To be in line with the strategic goal of scientific management of an acute care regional hospital in Hong Kong, a microcomputer-based algorithm was developed to schedule the monthly roster. The algorithm, coded in Digital Visual Fortran 5.0 Professional, could generate a monthly roster in seconds. Implementation has been carried out since September 1998 and the results proved to be useful to hospital administrators and porters. This paper discusses both the technical and human issues involved during the computerization process.

Algorithms↗
PubMed1996

Developing microcomputer-based quality assurance systems for health care.

Points out some important issues that must be dealt with when developing microcomputer-based QA systems for health care. While no single solution to the problems associated with quality assurance (QA) system development exists, the first step towards an efficient and effective approach is problem identification and commitment to developing a strategy which addresses the issues discussed in this paper. Examines potential solution alternatives and associated pitfalls, and gives an example of designing a QA system, including a database management system with suggestions for spreadsheet templates.

Computer Security↗
PubMed1992

Microcomputer-based portable long-term spasticity recording system.

A device for long-term monitoring of muscle activity (EMG) with surface electrodes and method of its application are described in this paper. This device is called a microcomputer two-channel EMG monitor. The device can be used for up to 24 h monitoring of EMG activity, followed by data transfer to a host computer for signal analysis. This device records amplified, rectified, and integrated EMG activity. Shorter recording time allows shorter sampling periods suitable for different other EMG analysis. Recording of spontaneous EMG in complete spinal cord injured subjects was the original reason for the design of the long-term monitor. These recordings were used for estimation of spasticity in complete spinal cord patients.

Electromyography↗
PubMed1989

Microcomputer-based interactive tracking of blood cells at biomaterial surfaces.

A microcomputer-based system for analyzing the motion of human platelets and leukocytes at synthetic surfaces from a sequence of video frames on tape is described. The software is designed to provide convenient interaction with an operator to reduce the burden of manual analysis. In addition, the system computes and stores the cell movement data on disk for subsequent statistical analysis. Measurement include the number and nature of cell-to-surface collisions, residence times, and distances traveled.

Biocompatible Materials↗
PubMed1986

Three-dimensional reconstructions of objects from serial sections using a microcomputer graphics system.

A computer graphics system for constructing 3-dimensional models of tissues from serial sections has been designed around a Motorola 68000 CPU. The system consists of a Dual Systems 16-bit microcomputer running the UNIX operating system. A Scion Corporation MicroAngelo color graphics system drives the color monitor. Three-dimensional imaging is enhanced by hidden line removal and area filling by color. A computer-drawn model of a cherry angioma is compared with a previously constructed physical model of the same angioma to illustrate how the system operates.

Computers↗
PubMed1981

The microcomputer in self-assessment for examinations in anaesthesia.

A series of 30 multiple choice questions were modified for presentation on a microcomputer which was programmed to present them to the user and mark them. In a preliminary study, 15 trainee anaesthetists all agreed the system was satisfactory as an aid to preparation for the FFARCS.

Anesthesiology↗
PubMed1985

A system for storage of references. A method of storage and retrieval of references on a personal microcomputer.

A computer program, written in BBC BASIC, for storage and retrieval of literature references on a personal microcomputer fitted with floppy disc drives is described. The storage capacity is 425 references per 100K disc. A versatile search function allows ready access to references by matching any number of combinations of the following 10 items: authors, name, year and volume of journal, pages, reference number, and up to four key words. The resulting bibliographic list can be formatted to any desired house style. There is a facility for sorting the list into alphabetical order of the authors and the use of a wordprocessor for special print styles on any BBC compatible printer. These two features make retyping the list unnecessary. A search can be done manually, while browsing through the references. Advantages of this system over the existing packages are discussed. The program is totally run by on-screen menus, and it is easy to use, even by a novice.

Anesthesiology↗
PubMed1989

Automatic control of arterial pressure after cardiac surgery. Evaluation of a microcomputer-based control system using glyceryl trinitrate and sodium nitroprusside.

Arterial hypertension after cardiac surgery is common and is associated with increased morbidity. Glyceryl trinitrate may be a more suitable agent for control of hypertension than sodium nitroprusside. We have developed a closed-loop system for the Atari 1040ST microcomputer to control arterial pressure by the simultaneous infusion of two vasodilators under computer control. Use of this system with glyceryl trinitrate and sodium nitroprusside in 24 patients who required vasodilators after cardiopulmonary bypass, revealed that hypertension was controlled by glyceryl trinitrate alone in 14 of the patients and 10 required supplementary sodium nitroprusside. The results suggest that glyceryl trinitrate is a suitable agent for control of hypertension after cardiac surgery in the majority of patients. They also show that a sizeable minority required additional sodium nitroprusside, and that an automated 'dual pump' system is a satisfactory method of administering two vasodilators in this way.

Cardiac Surgical Procedures↗
PubMed1987

A microcomputer network for the differential leucocyte count and the registration of red blood cell morphology.

A microcomputer network is described for the scoring of the differential leucocyte count and the registration of white and red cell characteristics. On each terminal keyboard, keys are assigned to white cell fractions (10), erythroblasts (1), red (13) and white (3) cell morphology and for graduations 1+ to 4+. Duplicate counts on different microscopes are collected by the master, averaged and forwarded to a printer. In the future we hope to transmit results directly to the laboratory computer. The use of the system is not restricted to the differential leucocyte count. An intelligent scoring board can help to alleviate the time-consuming task of entering qualitative and descriptive results into a laboratory computer.

Cell Differentiation↗
PubMed1983

Microcomputer organization of parenteral nutrition in the neonate.

The use of a microcomputer is described to simplify the organization of neonatal parenteral feeding and extend the flexibility of the technique, providing a hard copy prescription and regime analysis for each patient. Its use can save medical and pharmacy time and conserve expensive reagents. The programme is readily adaptable to different feeding policies and the system is simple, works well in practice and is cheap to run.

Amino Acids↗