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PubMed2006

Bridging the gap.

Explore the source record for details and available documents.

Medical Records Systems, Computerized↗
PubMedDate not supplied

The Clintrac medical data system.

Basically, this is a clinical data entry program. Billing is added for convenience. It would be fine for a practitioner working in an institution with an existing billing department. You could certainly use it in a private office as an all-purpose workhorse, but you'd need to apply the criteria I listed in a recent article in this jouranl [1] to rate the accounts receivable section when it's complete. Dr. Bryner says he has done this and finds my criteria met by this package. The program shows much hard work and a good deal of promise. It strikes at the core of one of today's greatest frustrations. What's more, Dr. Bryner is dedicated to improving it as he goes along. The system is sold by Clintrac, Inc., 814 Main St., Yreka, CA 96097. The company is an IBM Business Partner. The current price is $14,000. It is only sold directly by the vendor, who has four employees and has sold four systems as of January 22, 1991. Extra costs are assessed for additional users ($1,500 each), specialty modules ($2,000 each), and support (12% of price per year). Updates are included in the support price. IBM is arranging to lease the system. The current version number is 2.0B.

California↗
PubMed1991

Computerised information exchange in health care.

The slowly increasing use of computers in the management of general medical practices may be greatly accelerated if new technologies for the storage and transfer of information are introduced. Electronic data interchange promises to speed the transfer of medical data, insurance information and payments. Smart cards promise a portable, up-to-date, confidential medical record that can be carried by patients. However attractive these new systems may be to computer suppliers and government bureaucracies, it is not certain that they will be as attractive for the general practitioners who will be required to implement the changes. Smart cards may exacerbate problems with the ownership and privacy of data, rather than guaranteeing confidentiality and control. Data exchange through a computer network may allow many information services not actually essential to general practice, while creating serious new possibilities for breaches of privacy. Costs in implementing the new technologies for general practices may outweigh any gains in efficiency, which could in any case be achieved through better use of paper records. The Health Insurance Commission may see advantages in the collection of data on the diagnoses of patients that can be used in epidemiological studies and in the control of overservicing, but there will be practical limitations on the reliability of the data collected by this means. General practitioners should carefully consider their attitude to these new technologies before suppliers, governments and others make their record-keeping decisions for them.

Attitude of Health Personnel↗
PubMed1994

Database programs in general practice.

A small percentage of Australian general practices use computers for accounts and an even smaller proportion for clinical information. The author shows how to implement a simple and inexpensive computer database program that has the potential to help manage a practice more efficiently and comprehensively.

Database Management Systems↗
PubMed1996

The project ARIANE: conceptual queries to information databases.

As information databases we consider all the collections of data records indexed by key-words, stored and delivered by computer systems. In previous research works we demonstrated the interest to design a conceptual model, in the conceptual graphs formalism, and to implement a computational model for information retrieval in large information databases. These models are based on the UMLS knowledge sources. This paper reminds briefly these models and describes tests done in querying a patients database and a bibliographical database.

Databases, Bibliographic↗
PubMed1997

The rubber meets the road: integrating the Unified Medical Language System Knowledge Source Server into the computer-based patient record.

Ongoing improvements in the content of the Unified Medical Language System, coupled with the recent release of the Internet-based Knowledge Source Server (KSS), have prompted us to develop an interface between the KSS and our computer-based patient record. We confronted many challenges while developing a robust interface to an Internet-based server, and in integrating the process of codification into the workflow of clinicians. An initial evaluation of the interface in the clinical environment suggests that acceptable performance is attainable. The benefits of using an Internet-accessible tool in a clinical information system appear to justify the effort required.

Humans↗
PubMed1998

DXplain on the Internet.

DXplain, a computer-based medical education, reference and decision support system has been used by thousands of physicians and medical students on stand-alone systems and over communications networks. For the past two years, we have made DXplain available over the Internet in order to provide DXplain's knowledge and analytical capabilities as a resource to other applications within Massachusetts General Hospital (MGH) and at outside institutions. We describe and provide the user experience with two different protocols through which users can access DXplain through the World Wide Web (WWW). The first allows the user to have direct interaction with all the functionality of DXplain where the MGH server controls the interaction and the mode of presentation. In the second mode, the MGH server provides the DXplain functionality as a series of services, which can be called independently by the user application program.

Artificial Intelligence↗
PubMed2005

The impact of structured laboratory routines in computerized medical records in a primary care service setting.

Inappropriate laboratory ordering is a problem affecting medical systems worldwide. An intervention was called for as a result of increasing laboratory costs. Thus, we aimed to assess the impact of introducing computerized laboratory routines to a computerized primary care setting. The study included 380 primary care physician practices of Clalit Health Service (HMO) southern district (CHS-SD) in Israel, caring for 470,000 members. Consensus laboratory routines order sets were electronically introduced into all physicians' computerized medical record (CMR) software, after consensus and internal marketing process. The primary findings were that a previously observed annual increase in laboratory test utilization was stopped, a 2% reduction in total number of tests and a 4 % reduction in the total number of tests per age adjusted person was observed. In conclusion the wide use of CMRs and communication technology combined with an appropriate organizational process can be used to increase appropriate utilization of laboratory tests.

Diagnostic Techniques and Procedures↗