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PubMedDate not supplied

Current assessment and proposed improvement to emergency medical information systems in Japan.

Most prefectural governments in Japan have been implementing, or planning to implement, emergency medical information systems that take advantage of advanced information-related technologies such as computers and communication systems, in order to improve their emergency medical care systems. We studied the emergency medical information systems to analyse their present status, clarify their purpose, and present the ideal system, in view of community health care requirements. Here the results of the research are examined, and there is a discussion of what is needed to improve the system in the future. The emergency medical information system in Aichi prefecture is taken as an example, to closely survey its present situation and analyse the evaluation of the system by the residents who are the major beneficiaries of the system.

Computer Systems↗
PubMed2002

The better medication management system. Implications for Australian general practice.

BACKGROUND: The Better Medication Management System (BMMS) is a national initiative to use information technology to bring together the fragmented medication record systems currently used in Australian health care. OBJECTIVE: This article provides a brief outline of the BMMS and some of its implications for Australia's general practitioners and their patients. DISCUSSION: The BMMS has the potential to assist in achieving significantly better health outcomes by providing current information to assist prescribing and dispensing decisions and by promoting more informed medication management partnerships between consumers and their doctors and pharmacists.

Australia↗
PubMed1992

Automated ambulatory medical records systems. An orphan technology.

Automated ambulatory medical records systems (AAMRSs) have been operational for over 20 years but have not been adopted by more than a small fraction of their potential users. This paper presents a detailed analysis of the uses and benefits of the COSTAR-based AAMRS at the Harvard Community Health Plan and of the factors which have inhibited the dissemination of COSTAR. We conclude that AAMRSs have been an orphan technology and cite trends in health care that favor the future development of AAMRSs.

Ambulatory Care Information Systems↗
PubMed1980

A computerized chart management system for medical records.

A computerized system is described which improves turnaround time for completion of in-patient medical records and copes with the problem of delinquent records. Many patients seen at University Hospital are referred from throughout the State, thus the specialist must stay in contact with the referring physician for optimal patient care. The Medical Records Department assists in this effort through use of the system, which includes pertinent dates and other information concerning each patient. Several reports are generated from this information, e.g., outstanding records sorted by department/physician and outstanding records with charges pending. The total software system is comprised of 22 program, 2 sub-routines, and 4 data files; the total disk storage space required is 1413 kilobytes.

Computers↗
PubMed2003

Internet based ECG medical information system.

Physiological monitoring of humans for medical applications is well established and ready to be adapted to the Internet. This paper describes the implementation of a Medical Information System (MIS-ECG system) incorporating an Internet based ECG acquisition device. Traditionally clinical monitoring of ECG is largely a labour intensive process with data being typically stored on paper. Until recently, ECG monitoring applications have also been constrained somewhat by the size of the equipment required. Today's technology enables large and fixed hospital monitoring systems to be replaced by small portable devices. With an increasing emphasis on health management a truly integrated information system for the acquisition, analysis, patient particulars and archiving is now a realistic possibility. This paper describes recent Internet and technological advances and presents the design and testing of the MIS-ECG system that utilises those advances.

Database Management Systems↗
PubMed2001

Doctors' use of electronic medical records systems in hospitals: cross sectional survey.

OBJECTIVES: To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. DESIGN: Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. SETTING: 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. PARTICIPANTS: 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. MAIN OUTCOME MEASURES: Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. RESULTS: Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. CONCLUSIONS: Doctors used electronic medical records systems for far fewer tasks than the systems supported.

Cross-Sectional Studies↗
PubMedDate not supplied

Evaluating medical expert systems: what to test and how?

Many believe that medical expert systems have great potential to improve health care, but few of these systems have been rigorously evaluated, and even fewer are in routine use. We propose the evaluation of medical expert systems in two stages: laboratory and field testing. In the former, the perspectives of both prospective users and experts responsible for implementation are valuable. In the latter, the study must be designed to test, in an unbiased manner, whether the system is used in clinical practice, and if it is used, how it affects the structure, process and outcome of health care encounters. We conclude with proposals for encouraging the objective evaluation of these systems.

Diagnosis, Computer-Assisted↗
PubMed1989

Occupational adaptation to computerized medical information systems.

This paper explores the effects of computerized medical information systems on the occupational communities of health care professionals in hospitals. Interviews were conducted with informants from the pharmacy and nursing departments at two hospitals currently using medical information systems for communicating physicians' medication orders from the nursing station to the pharmacy. Results showed changes in tasks for both pharmacy and nursing, resulting in increased interdependence between the two departments. This interdependence was accompanied by improved communication and cooperation, providing an opportunity to encourage better working relationships between departments. The use and maintenance of the common computerized data base became a superordinate goal for the two groups, with the computer system itself as the topic of communication.

Adaptation, Psychological↗
PubMed1978

Gas identity hazards and major contamination of the medical gas system of a new hospital.

During commissioning of the medical gas system of a new hospital, fourteen connection defects were found; six of these were potentially lethal cross-connections. A major contaminant was also detected throughout the medical gas system. The methods of testing a new medical gas system described in this report highlight the need for up-grading of existing standards.

Australia↗
PubMed1997

Essential criteria for quality systems in medical laboratories.

The introduction of total quality systems in medical and clinical laboratories and accreditation of these laboratories is gaining more and more interest. In several countries laboratories have set up quality systems, and accrediation schemes are also operating. The standards of these schemes have much in common although several differences exist. There exists uncertainty in several countries on the choice of a system. Laboratory specialists are confronted with a new way of thinking concerning the management and daily practice of their laboratories. It is not clear, which standards should be used as a basis, and certainly not how to interpret such standards. Particulary in the European Union, harmonisation of criteria for quality systems is desirable. In the present paper, the document entitled "Essential Criteria for Quality Systems in Medical Laboratories" is presented. The document has been accepted in the general Assembly of the European Communities Confederation of Clinical Chemistry (EC4) and by the working group on Good Laboratory Services of the European Council on Laboratory Medicine (ECLM). The criteria in the document are focussed on the particular situation of medical laboratories, including pre- and post-analytical aspects. Reference is made, where applicable, to EN 45001, ISO 9001 and ISO guide 25 draft 3.

Chemistry, Clinical↗
PubMed2004

The economics of integrated electronic medical record systems.

The decision to adopt electronic medical record systems in private practices is usually based on factors specific to the practice--the cost, cost and timesaving, and impact on quality of care. As evident by the low adoption rates, providers have not found these evaluations compelling. However, it is recognized that the widespread adoption of EMR systems would greatly benefit the health care system as a whole. One explanation for the lack of adoption is that there is a misalignment of the costs and benefits of EMR systems across the health care system. In this paper we present an economic model of the adoption of EMR systems that explicitly represents the distribution of costs and benefits across stakeholders (physicians, hospitals, insurers, etc.). We discuss incentive systems for balancing the costs and benefits and, thus, promoting the faster adoption of EMR systems. Finally, we describe our plan to extend the model and to use real-world data to evaluate our model.

Costs and Cost Analysis↗
PubMed1999

Neural network in communication with medical computer system.

The paper presents a concept of an experimental module designed to recognise spoken utterances that cover a limited range of words indispensable in dialogues with computer medical systems. Research into the recognition of spoken words by a module based on artificial neural network is described. Usefulness of the obtained results for surgery-assisting multimedia systems and for a patient simulator supporting medical education of students in case history-taking and diagnosing is also discussed.

Artificial Intelligence↗
PubMedDate not supplied

A DBMS-based medical teleconferencing system.

This article presents the design of a medical teleconferencing system that is integrated with a multimedia patient database and incorporates easy-to-use tools and functions to effectively support collaborative work between physicians in remote locations. The design provides a virtual workspace that allows physicians to collectively view various kinds of patient data. By integrating the teleconferencing function into this workspace, physicians are able to conduct conferences using the same interface and have real-time access to the database during conference sessions. The authors have implemented a prototype based on this design. The prototype uses a high-speed network test bed and a manually created substitute for the integrated patient database.

Computer Graphics↗
PubMed1998

From French vocabulary to the Unified Medical Language System: a preliminary study.

The Unified Medical Language System (UMLS) is an extensive source of biomedical knowledge developed and maintained by the U.S. National Library of Medicine (NLM). The UMLS began to include biomedical terms in other languages a few years ago. However, providing foreign terms for existing concepts is only the first step for the UMLS to become international. The current limits of the use of the UMLS in French are analyzed (partial translation, unique source of the translated concepts, improper character set, and absence of lexical resources for lexical matching tools). Some suggestions are given for French to be better integrated into the UMLS, especially for adapting the lexical resources to French. Once completed, our present work is expected to give the UMLS the capability to be effectively queried in French.

France↗
PubMed1997

Desiderata for product labeling of medical expert systems.

The proliferation and increasing complexity of medical expert systems raise ethical and legal concerns about the ability of practitioners to protect their patients from defective or misused software. Appropriate product labeling of expert systems can help clinical users to understand software indications and limitations. Mechanisms of action and knowledge representation schema should be explained in layperson's terminology. User qualifications and resources available for acquiring the skills necessary to understand and critique the system output should be listed. The processes used for building and maintaining the system's knowledge base are key determinants of the product's quality, and should be carefully documented. To meet these desiderata, a printed label is insufficient. The authors suggest a new, more active, model of product labeling for medical expert systems that involves embedding 'knowledge of the knowledge base', creating user-specific data, and sharing global information using the Internet.

Artificial Intelligence↗
PubMedDate not supplied

An integrated medical record system.

Clear, well-organized, thorough medical records are fundamental to the success of a quality healthcare organization. This article specifically addresses the problem of integrating multiple records from several group and individual practices into a single common medical record for each patient. All aspects of the record system are described--from initial development, record protocol, and start-up and operational costs, to implementation, quality control, and results of the new system. The information set forth is valuable to all healthcare administrations interested in establishing or maintaining integrated medical record systems in their group practices.

Group Practice↗