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At least 739 records · Page 41Linked to original sources
PubMed1998

The Veterans Affairs medical care system: hospital and clinic utilization statistics for 1994.

OBJECTIVES: The authors describe the role the Veterans Affairs (VA) medical system plays as a provider of clinic and hospital services by examining utilization levels and users' characteristics. METHODS: The Veterans Affairs hospital discharge database, the Veterans Affairs outpatient clinic files, and the veteran population files were used to estimate the number of persons using the Veterans Affairs medical care system in 1994 and the intensity of their clinic and hospital use. Demographic and clinical characteristics of users were tabulated. RESULTS: In 1994, 2.7 million veterans, 10.3% of all US veterans, and approximately 23% of veterans who would have met the statutory eligibility requirements for Veterans Affairs care, used the hospital and/or clinic components of the Veterans Affairs medical system. Sixty-three percent of the system's users were younger than age 65, and 10.5% were women. These 2.7 million veterans had 901,665 Veterans Affairs hospital stays, 15.5 million bed-days, and 31.2 million outpatient visits in fiscal year 1994. The average number of hospitalizations per hospital user was 1.71; the average number of visits per clinic user was 11.7. Medical, surgical, and psychiatric diagnosis-related groups (DRGs) accounted for 56%, 21%, and 23%, respectively, of hospitalizations, but psychiatric diagnosis-related groups accounted for 43% of all inpatient days. Principal medicine clinic visits and psychiatry clinic visits accounted for 21% and 16% of Veterans Affairs ambulatory care. CONCLUSIONS: Because the patient population served by the Veterans Affairs system is skewed in a number of ways, its contribution as a provider of health services in the United States varies by gender, age, socioeconomic status, and diagnosis.

Adult↗
PubMed2005

An online interactive simulation system for medical imaging education.

This report presents a recently developed web-based medical imaging simulation system for teaching students or other trainees who plan to work in the medical imaging field. The increased importance of computer and information technology widely applied to different imaging techniques in clinics and medical research necessitates a comprehensive medical imaging education program. A complete tutorial of simulations introducing popular imaging modalities, such as X-ray, MRI, CT, ultrasound and PET, forms an essential component of such an education. Internet technologies provide a vehicle to carry medical imaging education online. There exist a number of internet-based medical imaging hyper-books or online documentations. However, there are few providing interactive computational simulations. We focus on delivering knowledge of the physical principles and engineering implementation of medical imaging techniques through an interactive website environment. The online medical imaging simulation system presented in this report outlines basic principles underlying different imaging techniques and image processing algorithms and offers trainees an interactive virtual laboratory. For education purposes, this system aims to provide general understanding of each imaging modality with comprehensive explanations, ample illustrations and copious references as its thrust, rather than complex physics or detailed math. This report specifically describes the development of the tutorial for commonly used medical imaging modalities. An internet-accessible interface is used to simulate various imaging algorithms with user-adjustable parameters. The tutorial is under the MATLAB Web Server environment. Macromedia Director MX is used to develop interactive animations integrating theory with graphic-oriented simulations. HTML and JavaScript are used to enable a user to explore these modules online in a web browser. Numerous multiple choice questions, links and references for advanced study are provided in the tutorial for trainees to verify their understanding of each unit. It is expected that this tutorial will enhance medical imaging education, help trainees in subsequent analysis of image data, and form the basis for the development of more advanced technologies in the future.

Computer Simulation↗
PubMed1995

The importance of local data bases in medical expert systems: TICITL.

The database of our medical expert system, TICITL, contains the records of more than 15,000 gastroenterological patients. The data was collected over fifteen years (1977-1992) during which the patients were followed for at least three months to establish a final diagnosis. Using a new set of 230 gastroenterological cases, TICITL's first diagnosis was similar to the final diagnosis in 90% of the patients. When compared to foreign medical expert systems (M.E.S.), there is a considerable difference in diagnostic accuracy favorable to the local system. Another local program is also as accurate as TICITL. Consequently, we attribute these results to the database and strongly recommend employing real local patients whenever possible to implement M.E.S. in a new geographical area.

Databases, Factual↗
PubMed1991

An Integrated International Aerospace Medical Information System.

An Integrated International Aerospace Medical Information System (IIASMIS) is proposed. Such a system is needed to allow all appropriate resources to be brought to bear on the medical problems that must be solved for safe extended manned missions. Existing medical data bases are reviewed. The suggested approach involves the formation of an international working group that would determine the scope of the problem, identify the real needs, and design the top-level architecture of the system. Participants would develop national data bases independently. A prototype system would be developed and evaluated; upon satisfactory operation, it would be expanded to include all active partners.

Aerospace Medicine↗
PubMed1987

The origins of the gauge system for medical equipment.

The gauge system for sizing medical catheters and equipment is used widely around the world. Yet both its origins and its interpretation, in terms of conventional measurements, have long been obscure. The gauge, formally known as the Stubs Iron Wire Gauge, was developed in early 19th century England. Developed initially for use in wire manufacture, each gauge size arbitrarily correlates to multiples of .0010 inches. This sizing system was the first wire gauge recognized as a standard by any country (Great Britain, 1884). It was first used to measure needle sizes in the early 20th century. Today it is used in medicine to measure not only needles, but also catheters and suture wires. However, owing to the potential confusion inherent in using a gauge system, the iron wire gauge is rarely used in manufacture of nonmedical equipment.

Catheterization↗
PubMed1981

Computer assisted medical record retrieval system.

A medical record retrieval system for access to patients' records has been developed as the first step toward constructing a medical record data base. Since retrieval is a logical process, a logical system was used to describe the retrieval conditions. For access to a patient set having a number of medical data of interest, the patients concerned are taken as one set for each data item. and a logical computation is carried out between several selected sets to obtain the required set. The retrieval conditions can be designated in two categories, admission and history, thus enabling quite flexible retrieval condition to be described. Since retrieval is one-line, the major file key was introduced to reduce response time and file access frequency.

Computers↗
PubMed1984

An automated medical record system, 10 years later.

An automated medical record system (AMRS) at the Harvard Community Health Plan supports medical records membership and the management needs of the 146,000-member health maintenance organization. The ARMS is fully integrated into the operation of HCHP's health centers and into the clinical practice of the medical staff. User interviews conducted as part of a systems planning effort revealed a high level of satisfaction with the system. The acceptance of and enthusiasm for the AMRS was coupled with a variety of ideas for improvement and enhancements to the system. Most of these suggestions were not uniquely related to the automated technology supporting the system but rather addressed medical records issues familiar to conventional paper systems. While this distinction is subtle, it further confirms the viability of an automated system and suggests directions for future growth.

Boston↗
PubMed2003

Medication of production animals--cure of malfunctioning animals or production systems?

Medication is used in all intensive animal productions. However, the increasing problems with resistant bacteria in all animal productions and in humans are supported by a number of reports. Special attention is given to the risk for transmitting food-borne (multi) resistant zoonotic agents to humans due to failure in antibiotic treatment resulting in lower cure rates or higher case fatality rates. The use of medication in humans per se is capable of selecting for resistance in human pathogens. Nevertheless, the amount of used medication/antimicrobials in treatment of Danish production animals goes far beyond the amount used for human consumption. The increase in consumption has not been followed by a similarly increased mortality, e.g. illustrated by the number of rendered animals, increased use of injection medicine for veterinary treatments of diseased animals, or increased number of remarks on the carcasses from the slaughterhouses. Medication in animal production is facing its limits and relevant economic alternatives have to be developed. The strategy for the future must concentrate on using medication only for clinically diseased animals and not as a strategic treatment of the whole herd in order to maximise growth and camouflage of suboptimal production systems and insufficient management.

Animal Husbandry↗
PubMed1980

Identification of potentially noncompliant patients with a mailed medication refill reminder system.

A medication refill reminder system was evaluated as a tool for identifying noncompliant patients. The system anticipates the date that a fully compliant patient would be expected to exhaust his or her medication supply and sends postcard reminders to all who have not obtained refills by the anticipated date. This refill reminder system has been in operation at the Pioneer Medical Center since 1973. During a 1-month study period, responses to the postcard reminders were monitored closely. Patients failing to respond within 5 days were contacted by telephone. The status of each patient's medication supply at the time of the pharmacy visit or telephone call was determined. Of 121 anticipated medication refill visits, 49 patients were found to have refilled their medications on or before the anticipated date. Reminder postcards were mailed to 72 patients. Within 5 days, 46 patients responded. Telephone calls were placed to 24 out of 25 patients. Two types of noncompliant behavior were identified; 34 out of 70 patients exhausted their medication supply before returning for a refill and 25 out of 70 patients accumulated a 1- to 30-day excess medication supply because of omitted doses. The postcard medication refill reminder system was found to be an effective tool for identifying patients who may benefit from compliance counseling with the pharmacist.

Community Health Centers↗
PubMed1984

Networking and medical information systems.

A local area communications network (LACN) has been implemented successfully at the University of California, San Francisco (UCSF) Hospital. This technology, developed by the Applied Physics Laboratory of the Johns Hopkins University, facilitates communication among systems previously considered "incompatible". The implication of this experiment is that a modular, evolutionary approach to medical systems will soon be a viable alternative to the "total" single-vendor approach now commonly used. Substantial preparation by a medical center, however, will be required in order to use an LACN properly. This will probably be done in many cases with the assistance of a new type of medical systems vendor, i.e., one having no systems of its own to sell.

Computers↗
PubMed2004

[Development of electronic medical recording system for clinics using the internet based on patient participation in pursuit of NBM].

The current medical system does not allow sufficient time for medical interviews, a situation that can create problems in patient-doctor relationships and result in a variety of problems. The importance of narrative based medicine (NBM) has been raised as a result of the overemphasis on evidence based medicine (EBM) in recent years. From this point of view, we have developed an electronic medical recording (EMR) system for clinics that uses the Internet and is based on patient participation, in pursuit of NBM. This system enables the patient to report information prior to the face-to-face interview with his or her doctor. In this way, the patient has more time to summarize and explain physical conditions and concerns. These reports from patients are automatically saved to the EMR database, without any additional workload. Therefore, this system will provide more effective communication between patient and doctor. In addition, the doctor is able to receive the results of medical treatment directly, in addition to the patient's other records. These sets of records will contribute to more efficient operation of the clinic. At this time, we have improved this system on the assumption that outsourcing the server will avoid the burden of maintenance. This prototype system uses a personal identification number (PIN) and an encode/decode algorithm for security. The secure PIN enables us to use conventional e-mail. Through experimental clinical testing, the effects on mutual understanding in medical examinations were studied. We are confident that this system based on patient narratives will contribute greatly to the spread of EMR systems for clinics operated by family physicians.

Electronics, Medical↗
PubMed1994

Automated transformation of probabilistic knowledge for a medical diagnostic system.

Iliad is a large medical diagnostic system that covers more than 2000 diagnoses and 9000 findings. Due to the size and the complexity of this system, a robust knowledge representation is essential to consistently and efficiently model the medical knowledge involved. In this paper, we describe the knowledge representation currently used in Iliad and a probabilistic representation based on the Bayesian network formalism which can be derived using the information that the Iliad knowledge base contains.

Algorithms↗
PubMed1979

A portable medical record system for the elderly.

A portable medical record system consisting of a bracelet and wallet card, was given to two groups of ambulatory, chronically ill, mentally clear, older patients. Group 1 included 23 patients discharged from a skilled nursing facility and treated in the community; group 2, 24 patients attending the outpatient department of an acute general teaching hospital. Biweekly follow-up telephone calls to patients and subsequent discussions with physicians demonstrated the usefulness of this system in predominantly nonemergency settings. Overall, the physicians noticed the bracelet during 46% of the visits and the wallet card during 28%. Group 2 physicians, however, noticed the bracelet and/or wallet card more frequently than did group 1 physicians. Reasons for the difference in recognition among the two groups and the implications for future use of a portable medical record system for the elderly are discussed.

Aged↗
PubMedDate not supplied

User training costs in medical information system implementation.

Implementation of a Medical Information System (MIS) in a hospital environment is a complex, problematic, long-term endeavor. St. Vincent Hospital and Medical Center (SVHMC) in Portland, OR, completed the implementation of its base MIS five and one-half years after the original contract was signed. SVHMC prepared the MIS users through an extensive and well-documented training program focused on user competence and user acceptance. Over five and one-half years, 4581 individuals received 9,359 hours of training. Direct training costs were $116,000; total training costs were $317,000. There are many other costs to implement a major MIS project. Reported here are only the costs related to training the system's users. Training costs can be insidious and are often under estimated as institutions plan for large scale MIS projects.

Computers↗
PubMed1983

Cost-benefit analysis of a computerized medical record system.

This paper describes the cost-benefit analysis of a computerized medical record system for use in physicians' offices. Actual data for savings in physician time in paper work was collected. The qualitative benefits of the system were evaluated using a questionnaire. The cost-benefit ratios demonstrated that the use of a computerized medical system is justified.

Ambulatory Care Facilities↗
PubMed2000

Redesigning the medical office for improved efficiency: an object-oriented event-driven messaging system.

Medical practitioners are under ever increasing pressure to maximize patient care, while minimizing costs. One productivity area that has not previously undergone thorough investigation is the efficient utilization of time for intra-office communication. Medical office personnel typically need to communicate patient information and resource requests, as well as personal messages. An intra-office communication system is designed that reduces time-waste typically incurred in medical office environments. Redesigning medical offices with intra-office communication systems provides time savings of several man hours per day. The subsequent increase in time efficiency enables higher quality of patient care and larger patient loads to be managed by existing medical staff.

Dental Offices↗