Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Medication Systems”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources
PubMed2000

An open architecture for medical imaging systems.

Integration of medical imaging is the goal of many standards. Interfile and Digital Imaging and Communications in Medicine (DICOM) standards have made great strides in this area. The impact of DICOM is greater owing to its wider acceptance. However, the lack of conformance testing makes interoperability difficult, often requiring expensive consulting teams in a mixed-vendor environment. DICOM is difficult to learn and deploy because it does not use modern software paradigms. Many hardware and software advances in computer architectures and communications could greatly enhance diagnostic imaging if they could be quickly incorporated into medical imaging standards. These problems led to consideration of a solution able to take advantage of state-of-the-art technology and to allow diverse implementations while ensuring the accurate interchange of information between health care providers. It is an object-oriented system information model, with the common object request broker architecture (CORBA) as the vehicle to ensure interoperability between different implementations of the model. This report presents the model.

Computer Communication Networks↗
PubMed2001

ECG data reduction method for medical telemetry systems.

In current medical practice, all transmitters used for monitoring an ECG send data continuously. If transmission could be limited to only the ECG data that requires the attention of a technician, the likelihood of interference and power consumption would be reduced considerably. In this paper, we propose a new ECG telemetry system. The transmitter has a simple ECG analyzer and it only transmits data when abnormal waveforms are detected. As part of this system, we propose a simple algorithm to detect an abnormal ECG. The algorithm is composed of a baseline drift canceller (utilizing a moving average calculation), a waveform detector (using a modified second order derivative) and an ECG analyzer. In order to test the effectiveness and feasibility of the algorithm, computer simulations (with a MIT-BIH ECG database) and experiments (with microprocessor-based hardware) were performed. The results of the simulations show that the detection performance and data compression performance of the algorithm are adequate. The results of the experiment show that the algorithm even performs adequately when used with microprocessor-based hardware that is of limited size or limited power consumption.

Algorithms↗
PubMed1995

Use of the Unified Medical Language System in patient care at the Columbia-Presbyterian Medical Center.

The Unified Medical Language System (UMLS) project at the United States National Library of Medicine contains and organizes a large number of terms from controlled medical vocabularies. This study examines the suitability of the UMLS for representing patient care information as it exists in the Columbia-Presbyterian Medical Center (CPMC) clinical information system. Comparisons were made between the semantic types, semantic relations and medical concepts of the UMLS and the data model entities, semantic classes, semantic relations and concepts in the CPMC system. Results of the comparison demonstrate that the UMLS structural model is appropriate for representing CPMC vocabularies and patient data and that the UMLS concepts provide excellent coverage of CPMC concepts in many areas. Recommendations are made for enhancing UMLS structure to provide additional coverage of the CPMC model. It is concluded that content expansion to provide better coverage of clinical terminology is possible within the current UMLS model.

Academic Medical Centers↗
PubMed1987

Evaluating medical expert systems.

Approximately 90% of all computerized medical expert systems have not been evaluated in clinical environments. This paper: identifies the principal methods used to assess the performance of medical expert systems in both laboratory and clinical settings, describes the different research strategies used in the evaluation of medical expert systems at different development stages, and discusses past evaluation efforts in relationship to future applications of different decision support technologies and expert systems in health care.

Cardiology↗
PubMed1978

Quality assurance through automated monitoring and concurrent feedback using a computer-based medical information system.

A computer-based medical information system (COSTAR) has been used to support a quality assurance program where the data collection is an integral part of the patient care recording activity and, therefore, does not require a separate abstracting or encoding process. This program utilizes concurrent audit to detect deficiencies in patient care, and automatic rapid feedback to the responsible provider in time to allow the provider to correct the deficiency. This system has been demonstrated to improve follow-up of throat cultures, positive for Group A Beta hemolytic streptococcus. It is well accepted by the medical staff whose practice is being audited. Because the data are collected as part of the routine operation of COSTAR, the computer monitoring and feedback have only a small incremental cost.

Boston↗
PubMed1992

Decision support system and medical liability.

Expert systems, which are going to be an essential tool in Medicine, are evolving in terms of sophistication of both knowledge representation and types of reasoning models used. The more efficient they are, the more often they will be used and professional liability will be involved. So after giving a short survey of configuration and working of expert systems, the authors will study the liabilities of people building and the using expert systems regarding some various dysfunctions. Of course the expert systems have to be considered only for human support and they should not possess any authority themselves, therefore the doctors must keep in mind that it is their own responsibility and as such keep their judgment and criticism. However other professionals could be involved, if they have participated in the building of expert systems. The different liabilities and the burden of proof are discussed according to some possible dysfunctions. In any case the final proof is inside the expert system by itself through re-computation of data.

Expert Systems↗
PubMed1979

The computerized medical record system: meeting the challenge for nursing.

A system of computerized medical record-keeping in a health maintenance organization is described. Some problems arising in the shift from manual to computerized record-keeping are discussed. Perhaps the most important for nursing is the increase in the nursing staff's responsibility for complete, consistent documentation of patient care concomitant with the shift to a computerized system. Nurses must be comfortable with patient assessment, patient management and documentation in order to utilize the system effectively.

Computers↗
PubMed2001

American Academy of Pediatrics: Task Force on Medical Informatics. Special requirements for electronic medical record systems in pediatrics.

Electronic medical record (EMR) systems, which are usually designed for adult care, must perform certain functions to be useful in pediatric care. This statement outlines these functions (eg, immunization tracking and pediatric dosing calculations) to assist vendors and standards organizations with software design for pediatric systems. The description of these functions should also provide pediatricians with a set of requirements or desirable features to use when evaluating EMR systems. Particular attention is paid to special aspects of pediatric clinical care and privacy issues unique to pediatrics.

Child↗
PubMed1995

Emergency medical service system development: results of the statewide emergency medical service Technical Assessment Program.

STUDY OBJECTIVE: The National Highway Traffic Safety Administration developed the EMS (emergency medical services) Technical Assessment Program to assist states in developing and improving their EMS systems. The main goals of this evaluation were to document the level of improvement in EMS system development following completion of the Technical Assessment Program and to identify necessary program improvements at the National Highway Traffic Safety Administration. DESIGN: Independent investigators retrospectively reviewed the information in Technical Assessment Program reports from 35 states that participated in the program during a 5-year period. RESULTS: Training and certification programs for prehospital personnel were the most well-developed elements of EMS systems. Conversely, comprehensive quality management and EMS system evaluation programs were almost uniformly absent (89% of states). Areas of need targeted for improvement included enabling legislation for EMS (60%) or trauma system development (69%), an improved mechanism to assess system resources (71%), an established or updated state EMS plan (80%), aging and unreliable communications equipment (89%), fully operational prehospital data collection systems (89%), and consistent medical oversight for all prehospital providers (92%). CONCLUSION: Program evaluation revealed that significant recommendation-based changes occurred in all components of EMS systems. The Technical Assessment Program is one tool that states can use to promote EMS system improvements.

Certification↗
PubMed1995

Issues and challenges in the design of curriculum information systems.

Medical schools are increasingly using curriculum information systems to better manage their curricula, to incorporate alternative learning environments, to expand subject-specific instruction, or to adapt the curricula to the changing health care environment. A curriculum information system contains key features, selected by the system's designers, that describe the objectives, the specific content, and/or the educational activities that compose the curriculum. The underlying purpose of such a system is to document and describe the knowledge, behaviors, skills, attitudes, or activities students will be expected to develop or learn. While it might be ideal to have one system that would meet the needs of all possible users, the programming and maintenance requirements of such a single system would exceed most medical schools' resources. Thus, designers of curriculum information systems must first identify the primary intended-user group: students, faculty, or administrators. The system designed for one group will typically differ from the systems for other groups in the emphasis on and level of content detail and curriculum structure information. The general structure and purposes of curriculum information systems are expressed in three distinct system designs: a curriculum database (most helpful for administrators), a curriculum textbase (for faculty), and an electronic syllabus (for students). The authors describe these different designs, and they discuss challenges faced by system designers.

Curriculum↗
PubMed2005

Approaches to improving the safety of the medication use system.

Problems associated with medication use have been consistently identified in the patient safety literature internationally. The purpose of this paper is to review components of the medication use process and offer suggestions for transforming it into a safer system. Prevention strategies are suggested for improving medication use at each stage of the system. Decision criteria are proposed that can be used by administrators and healthcare providers to allocate resources for prevention strategies that will improve medication safety.

Canada↗
PubMed1985

The frontier of modern Western medicine in Nepal.

Using the concepts frontier and interface the introduction and spreading of modern Western medicine in Nepal and its relations to other medical systems are described and analyzed. Medical systems do not prevail in the same degree in all places; we may call the geographic areas of concentration the core areas or center(s) of medical systems and the remaining areas their periphery. The frontier of a medical system is defined as that part of the periphery where the presence of the system is increasing. The place of the frontier, its width and the forms in which a medical system appears at its frontier are determined by both internal dynamics and contextual factors. In non-socialist countries like Nepal the dynamics of modern Western medicine are characterized by three tendencies: centralization, expansiveness and a commercial and capitalist character. Some important contextual factors which have been shaping the frontier in Nepal are: migration, including tourism, labor-migration and trade; the role of foreign aid and geographical conditions. The situation at the frontier has an important influence on the nature of the interface between modern Western medicine and other medical systems. In the article Faith-healing, Ayurvedic medicine, Homeopathy and Tibetan medicine are described briefly and the interface between them and modern Western medicine is looked into.

China↗
PubMed1990

A provider-interactive medical record system can favorably influence costs and quality of medical care.

The Geriatric Record and Multidisciplinary Planning System (GRAMPS) is a provider-interactive computerized medical record system designed to support outpatient geriatric practice in Department of Veterans Affairs (DVA) clinics. In a controlled prospective study, physician use of the system was demonstrated to be associated with a reduction of the costs, and improvement in the quality and outcomes of patient care. The system was well-accepted by users, and provided a practical approach to physician data-entry. The system's text-handling and narrative generation capabilities support an extensive clinical content domain, contributing to overall performance. These features will be described in detail.

Aged↗
PubMed1993

Home chemotherapy. A mobile delivery system.

CareVan Medical Systems specializes in home chemotherapy, differing from other services in its physician involvement. CareVan provides increasing services and advantages to cancer patients receiving treatment at home.

Home Care Services↗
PubMed1986

Medical expert systems--knowledge tools for physicians.

Recent advances in the field of artificial intelligence have led to the emergence of expert systems, computational tools designed to capture and make available the knowledge of experts in a field. Although much of the underlying technology available today is derived from basic research on biomedical advice systems during the 1970s, medical application packages are thus far generally unavailable from the young artificial intelligence industry. Medical expert systems will begin to appear, however, as researchers in medical artificial intelligence continue to make progress in key areas such as knowledge acquisition, model-based reasoning and system integration for clinical environments. It is accordingly important for physicians to understand the current state of such research and the theoretic and logistic barriers that remain before useful systems can be made available. One experimental system, ONCOCIN, provides a glimpse of the kinds of knowledge-based tools that will someday be available to physicians.

Drug Therapy, Computer-Assisted↗
PubMed1993

Effect of full-time, specialized physician supervision on the success of a large, urban emergency medical services system.

OBJECTIVES: Despite the universal proliferation of emergency medical services programs throughout the United States since 1970, only a few have ever documented a valid lifesaving effect, particularly in large, urban centers. The purpose of this study was to demonstrate the effect of specialized physician supervision on the effectiveness of an emergency medical services system. DESIGN: Prospective, cohort study. SETTING: Large, urban municipality (population 2 million). PATIENTS: Evaluation of victims of out-of-hospital sudden cardiac death cases, before (n = 152) and after (n = 200) the introduction of specialized physician supervision for the emergency medical services system. INTERVENTIONS: The hiring of a full-time, salaried emergency medical services system physician whose principal duties would be to provide intensive individualized training, direct operational supervision, and continuous system monitoring, including frequent on-scene oversight of emergency medical services personnel. MEASUREMENTS AND MAIN RESULTS: Comparison of existing hospital discharge rates for out-of-hospital sudden cardiac death cases to those rates achieved 5 yrs after recruitment of the specialized emergency medical services system physician. A dramatic increase in hospital discharge rates was demonstrated for sudden death patients presenting with ventricular fibrillation, from zero at year 0 (0 of 152 patients survived), to 21% (42 of 200 patients) by year 5 (p < .001). This result was achieved despite the fact that all other related factors (budget, paramedic numbers, response times) significantly worsened during the comparison periods. CONCLUSIONS: The introduction of the new factor into the emergency medical services system (specialized physician supervision) was associated with significantly improved patient outcome. In view of current suboptimal outcome statistics found in most municipal emergency medical services programs across the United States, future goals of medical community leaders should be directed at efforts to properly train, certify, and establish appropriate positions for physicians who specialize in emergency medical services system supervision.

Allied Health Personnel↗
PubMed1989

Swedish physicians' perspectives on work and the medical care system--V. Comparisons across specialties.

Treating medical specialties as segments, Swedish ambulatory care physicians were interviewed to identify their perspectives on work and the medical care system. Those perspectives were analyzed and compared across segments. Physician segments differed substantially in the themes they put forward. Perspectives tended to be homogeneous within segments and sharply differentiated between segments. Both positive and negative perspectives were expressed more with respect to immediate work situations than with respect to the medical care system. Child health and maternal health physicians were more likely to express satisfactions with both work and the system, while district general practitioners were more likely to note problems. It is contended that this study has identified well grounded (valid) categories for the analysis of the Swedish medical care system.

Ambulatory Care↗