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PubMed1994

The emerging role of the health information management professional in data quality and analysis of an electronic medical record system.

The role of the health information management professional is changing with the advancement of the electronic medical record system (EMRS) and electronic financial database systems. The Medical ARchival System, a longitudinal EMRS developed at the University of Pittsburgh Medical Center, was used to describe the methodology that the health information management professional should use when performing data quality evaluations and data analysis of an EMRS. Specific examples of steps used to integrate databases to collect the data and generate appropriate reports and tables are also described and discussed.

Academic Medical Centers↗

PubMed1994

Evaluation of the use of induction in the development of a medical expert system.

In an earlier study, two medical expert systems for diagnosing thyroid disorders, developed by the application of induction on a sample of previously diagnosed cases and on expert-generated rules, diagnosed a set of test cases better than an expert system developed by the more traditional method of collaboration between a knowledge engineer and an expert. In this paper, an alternative measure of the accuracy of diagnosis of each system is used to evaluate the systems. Diagnoses for every distinct case represented by a combination of indicating factors are compared with diagnoses that the expert made. The induced systems provide diagnoses for many more distinct cases, but a much higher proportion of these diagnoses are incorrect. It is argued that generalizing to unseen cases is an inappropriate use of induction algorithms. The systematic development of a decision table is a more appropriate method for devising a medical expert system.

Decision Making, Computer-Assisted↗

PubMed1994

Comparison of automated medication-management systems.

Automated devices for managing medication distribution are described. Shrinking operating budgets are causing many departments of pharmacy to consider automation to maximize the cost-effective use of professional personnel. Many devices and systems that are currently available or under development can help with (1) distribution of medication to and from the patient care area, (2) distribution of medication directly to the patient, (3) inventory control, (4) management of controlled substances, or (5) documentation of medication administration. Medication-management devices based in the patient care unit (Lionville CDModule, Access, Meditrol, Argus, MedStation, Sure-Med, and SelecTrac-Rx) are designed to replace manual filling of unit dose carts or to increase control over floor-stock medications and controlled substances. They provide immediate access to medications but can take extra time to fill. Centrally located medication-management systems (Automated Pharmacy Station, ATC-212, and Medispense) are designed to replace or improve a manual system for filling unit dose carts. They may have financial and practical advantages over systems based in the patient care unit because they avoid redundant inventories. However, a manual system is still needed for some medications, particularly those that need refrigeration. Several point-of-care information systems also have medication-management components (MedTake, CliniCare, Automated Medication Administration Tracking, and MedLynk). They provide rapid access to patient information and facilitate documentation. Many incorporate bar-code technology and radio-frequency transmission of data. An automated management system can combine increased efficiency with decreased risk of error. Descriptions of available systems may help pharmacists choose a system that meets their needs.

Automation↗

PubMed2000

[Integration of quality assurance procedures into medical documentation systems--from quality indicator to improved medical quality].

Medical and commercial data are essential for sufficient clinical management. While regional quality studies--for example the German Perinatal Data Study--are mighty tools to compare the quality of departments in total--the integration of evaluated individual quality indicators in data processing systems can highly improve clinical results and clinical management. The evaluation of quality indicators improves the benefit of quality management. Parameters monitoring the contentment of patients are extremely valuable information. Quality management and information management are closely linked.

Data Collection↗

PubMedDate not supplied

[Current status and trends in the development of medical information systems for morphological research].

The time of cooperative action of the information medical systems is coming. Standardization of clinical laboratory information systems is one of the most difficult but important problems for clinical laboratory community and technicians. Electronic data exchange requires agreement on the data element format by which healthcare institutions can exchange. Computerization of health care service raises the problem of security because the risk of violation of medical privacy is dramatically increasing. Unauthorized users can access, copy, alter, delete or distort hundreds or thousands of medical records within minutes. Information can be faulted by individuals or system failure. It is necessary to discuss and make a final decision of joining some standard for the purpose of integration.

Delivery of Health Care↗

PubMed1995

User interface design and evaluation for electronic medical record system.

A user interface for an electronic medical record system (EMRS) is proposed. A pen-based device adopted for data input and the GUI windows layout simulate conventional paper forms, so that doctors can quickly grow accustomed to the EMRS. A comparison study shows the proposed interface does not significantly delay the examination, even when used in hospitals with many outpatients.

Ambulatory Care↗

PubMed1997

Medication compliance among the seriously mentally ill in a public mental health system.

Medication non-compliance, a pervasive problem among persons with serious, chronic mental illness, has been linked to increased inpatient resources use in public mental health systems. The objective of this analysis was to determine which factors are associated with medication compliance in this population so that more appropriate screening and intervention programs can be designed. Using knowledge gained from clinical research on compliance in schizophrenia and research testing the Health Belief Model as a conceptual framework in studying compliance behavior, we conducted a secondary analysis of data collected in the Mississippi public mental health system in 1988. The study subjects were schizophrenic patients (n = 202), the majority of whom were low-income, African-American males. Data sources included structured interviews with patients and family members, as well as state hospital and community mental health clinic administrative records. Receipt of consistent outpatient mental health treatment and belief that one had a mental illness were significantly associated with higher levels of medication compliance in this population of seriously mentally ill patients. Our results suggest that screening programs to identify those at highest risk for non-compliance in this population might be more productive if they included a review of inpatient and outpatient mental health service utilization patterns, in addition to formal assessment of patients' attitudes and beliefs about their illness. This study illustrates an approach to examining predictors of a policy-relevant health behavior in a minority population within a public mental health system.

Adult↗

PubMed1991

[Medical expert systems. Developmental activities in the Scandinavian countries].

Medical expert systems is a term for computer programs which represent and structure medical knowledge, and which can supplement or replace man in decisionmaking. Several research groups in Denmark, Finland, Norway and Sweden are developing such systems. Many of the projects emphasize educational aspects and also serve to qualify the participants in the project. The medical expert systems are applied to clinical chemistry, neurophysiological testing or intensive care. Within this field of medical expert systems there is much duplication of activities and too little practical application. Usually the systems are developed to be used as functional prototypes and are often not good enough or not intended to be used in daily hospital routines. There should be good prospects in this field in the near future.

Decision Making, Computer-Assisted↗

PubMedDate not supplied

A multicenter evaluation of commercial attenuation compensation techniques in cardiac SPECT using phantom models.

BACKGROUND: Our goal was to evaluate the ability of current commercially available attenuation compensation (AC) techniques to correct for the effects of attenuation, scatter, and loss of resolution with depth, in a series of standardized phantom experiments. METHODS AND RESULTS: The following systems were evaluated: Hawkeye (GE Medical Systems), Profile (Siemens Medical Systems), Vantage Pro (ADAC Laboratories), TAC (SMV America), M-STEP (University of Michigan, Ann Arbor), TransAct (Elscint), Beacon (Marconi Systems), and PET Advance (GE Medical Systems). Studies were performed with the use of normal and ischemic myocardium in air and with technetium 99m or fluorine 18 in torso phantoms. There was considerable variation in the uniformity of short-axis slices and defect contrast for images acquired in air (no AC). AC improved the uniformity of activity throughout normal myocardium. A simulated hot liver resulted in severe artifacts and was only partially corrected by many systems. A high-quality attenuation map appears to be an important determinant of image quality. No system produced AC images of comparable quality to those obtained in the absence of scatter/attenuating media. CONCLUSIONS: There are significant differences in the ability of commercial AC systems to reduce artifacts due to attenuation and scatter. These differences are partly the result of non-AC factors (collimation, orbit, etc). In general, systems that generated high-quality attenuation maps yielded the best results.

Algorithms↗

PubMedDate not supplied

Total medical record: an automated medical information system.

The strength of the TMR system lies in its integration of medical and business information in a practical, easy-to-use design. It eliminates the delay, inefficiency, and bulk found in other medical information systems.

Appointments and Schedules↗

PubMedDate not supplied

[Visual system as the terminal element of medical introscopy systems].

A model of color vision based on classification of spectra into several groups is suggested. Each group of spectra is characterized with the mean number and mean energy of photons. The model can be used in spectrozonal introscopic systems with color imaging for interpretation of the physical meaning of color parameters.

Color Perception↗

PubMed1972