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OBJECTIVE: To evaluate the use of an electronic barcode system for patient identification during blood transfusion. DESIGN: Retrospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: For all patients requiring blood transfusion between May 1999 and April 2002, with the exception of patients in the psychiatric wards and the accident and emergency department, a portable, hand-held scan-and-print electronic device was used to verify and document patients' identity at two critical points of transfusion: blood sampling for the compatibility test and blood administration. MAIN OUTCOME MEASURES: Scope of use of the electronic device, cost, effectiveness, staff compliance, problems and solution for improvement. RESULTS: In the first 3 years of hospital-wide use of the new device, no incidents of blood transfusion to wrong patients, or wrong labelling of blood samples, occurred with 41,00 blood sampling procedures and administration of 27 000 units of blood. Blood sampling took 6 minutes to complete with the use of the electronic device-similar to that taken by the conventional second-checker system. Among hospital staff, the compliance rate of using the new device approached 90%. Battery problems occurred in 12% of episodes of use of the device. CONCLUSIONS: The electronic barcode system was effective in reducing human error related to bedside transfusion procedures. The future goal is to tailor-make a more efficient device with additional functions.
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OBJECTIVES: The purpose of this study is to determine how personal digital assistants (PDAs) are used on an academic health sciences campus to define the level of training and support the library can provide to the students and faculty. METHOD: A Web-based questionnaire was developed. A total of 1,538 health sciences faculty and residents were sent an email message requesting participation. Data from the returned surveys were analyzed with SPSS. RESULTS: Sixty-one percent of survey respondents used PDAs. The address book, date book, and calculator were the most common uses reported for PDAs. Residents also reported a high use of drug databases on their PDAs. Most survey respondents indicated they would like to learn more about clinical resources for PDAs. CONCLUSIONS: Many opportunities exist for librarians to provide training and support for PDAs, in addition to evaluation and promotion of clinical software for PDAs.
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With advances in technology and the wider acceptance of computerization in physicians' offices, electronic medical records (EMRs) are now coming of age. This article describes the evolution of EMR systems during the last decade and their emergence as truly useful tools to increase practice efficiency and enhance medical care. The article also describes how an actual EMR system works in a medical practice from scheduling through care follow-up.
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This paper reports on a current project that explores how wireless and mobile technologies, in this case Personal Digital Assistants (PDAs) and Tablet PCs, may be useful in clinical practices. In particular the support and practices for just-in-time coordination and communication among members in highly mobile health teams are focused. Their practice is related to just-in-time access to information for coordination of care and treatment related to, but different from, information traditionally stored in the patients' health records and clinical information systems (CIS). To facilitate discussion and participation among various stakeholders, and between organizational contexts and responsibilities, we developed four video scenarios. The paper describes how these scenarios can be used in an organizational development setting to facilitate analysis and design of tools mindful of the relationships between complex and interwoven infrastructures of communication on one hand and just-in-time aspects of a mobile clinical practice on the other.
The Clinical Document Architecture (CDA) has proved to be a valuable and powerful standard for a structured exchange of clinical documents between heterogeneous software systems like a Hospital Information System and a Physician Office System. In this paper we want to show how the CDA can additionally be used in order to enhance the Hospital Information System's functionality: each patient related document contained in or generated from the HIS can be converted to a CDA/XML document. With the XML/XSLT-based transformation methods, those documents can be device-specifically transformed. We use this method to display HIS-content on mobile devices like Personal Digital Assistants (PDAs) by extracting the respective data fields from the HIS database, converting them to a CDA/XML document, which is transformed and sent to the mobile devices using a wireless intranet connection. Preliminary results and users' comments are promising, but further evaluation will be necessary. Our approach shows a generic model how clinical data can be dis-played on different devices independently from the underlying HIS using CDA.
Internet usage for dentistry and medicine is growing. Using search engines available on the Internet, websites for oral pathology and oral medicine information resources are explored and evaluated. A framework, whereby the personal digital assistant is used in conjunction with the Internet to enhance the practice and education of oral pathology, is proposed.
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PURPOSE: This study describes the system architecture and user acceptance of a suite of programs that deliver information about newly updated library resources to clinicians' personal digital assistants (PDAs). DESCRIPTION: Participants received headlines delivered to their PDAs alerting them to new books, National Guideline Clearinghouse guidelines, Cochrane Reviews, and National Institutes of Health (NIH) Clinical Alerts, as well as updated content in UpToDate, Harrison's Online, Scientific American Medicine, and Clinical Evidence. Participants could request additional information for any of the headlines, and the information was delivered via e-mail during their next synchronization. Participants completed a survey at the conclusion of the study to gauge their opinions about the service. RESULTS/OUTCOME: Of the 816 headlines delivered to the 16 study participants' PDAs during the project, Scientific American Medicine generated the highest proportion of headline requests at 35%. Most users of the PDA Alerts software reported that they learned about new medical developments sooner than they otherwise would have, and half reported that they learned about developments that they would not have heard about at all. While some users liked the PDA platform for receiving headlines, it seemed that a Web database that allowed tailored searches and alerts could be configured to satisfy both PDA-oriented and e-mail-oriented users.