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At least 919 records · Page 51Linked to original sources
PubMed2006

The future is now: implementation of a tele-intensivist program.

Based on overwhelming scientific evidence, The Leapfrog Group focused on 3 practices that have tremendous potential to save lives by reducing preventable mistakes in hospitals. The authors describe these practices and how they served as a driving force to create a "virtual ICU" within a Magnet hospital network. The effort combined services of a board-certified intensivist and technological advancements in telemedicine to ensure the delivery of high-quality care to all critically ill patients throughout the network. A computerized physician-order entry system, an electronic medication administration record, an electronic documentation system, and a remote ICU were the 4 programmatic phases necessary to realize the concept. The purpose of this article is to describe the process of planning and implementing the tele-intensivist program.

Critical Care↗
PubMedDate not supplied

An infrastructure for Integrated Electronic Health Record services: the role of XML (Extensible Markup Language).

BACKGROUND: The sharing of information resources is generally accepted as the key to substantial improvements in productivity and better quality of care. In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field. In the context of HYGEIAnet, the regional health telematics network of Crete, an Integrated Electronic Health Record environment has been developed to provide integrated access to online clinical information, accessible throughout the island. OBJECTIVES: To make available comprehensive medical information about a patient by means of incorporating all the distributed and heterogeneous health record segments into an Integrated Electronic Health Record that can be viewed on-line through a unified user interface and visualization environment. METHODS: The technological approach for implementing this Integrated Electronic Health Record environment is based on the HYGEIAnet Reference Architecture, which provides the necessary framework for the reuse of services, components, and interfaces. Seamless presentation of information is achieved by means of the Extensible Markup Language (XML), while its underlying capabilities allow for dynamic navigation according to personalized end-user preferences and authorities. RESULTS: The Integrated Electronic Health Record environment developed in HYGEIAnet provides the basis for consistent and authenticated access to primary information over the Internet in order to support decision-making. Primary information is always kept at the place where it has been produced, and is maintained by the most appropriate clinical information system, contrasting traditional store and forward techniques, or centralized clinical data repositories. CONCLUSIONS: Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists. XML can be introduced incrementally and its implementation is completely transparent to the end user.

Databases as Topic↗
PubMedDate not supplied

Computerized record system for electro-medical equipment management.

Commercial data-base software with a business-type microcomputer (Commodore 8096) has been used for filing electro-medical equipment inventory information. The operational experience of this system as an aid to comprehensive equipment management is described.

Computers↗
PubMed2001

PDA support for outpatient clinical clerkships: mobile computing for medical education.

This project provides educational support for students enrolled in a family practice clerkship by supplying PDA-based clinical references and tools to collect information about the patients they see and the seminars they attend. Each student is supplied with a Handspring Visor Deluxe to use during the clerkship. Supplied software includes a clinical reference (Five Minute Clinical Consult) and Lexidrugs drug reference and a medical calculator. The data collection software consists of a patient log for recording simple demographic and diagnostic information about each patient seen during the clerkship, a seminar evaluation module for recording student feedback about each didactic presentation during the course, and an evaluation form where they students supply their reactions to the use of the Visor. Despite encountering a number of problems, the devices appear to be beneficial tools. The applications provide useful references for students who do not have access to the resources of the University in their family medicine clerkship. They also provide an improved, though not perfect, means to capture data regarding patient encounters and course evaluations. However, the challenge remains to better integrate the PDA with the student s workflow in the clinic.

Ambulatory Care↗
PubMed2002

Introducing an academic data warehouse into the undergraduate medical curriculum.

There is increasing interest in integrating population health and informatics topics into the undergraduate medical curriculum, yet little consensus exists on the most effective approach to accomplish this. We introduced the use of an academic data warehouse of encrypted patient information into an existing 2nd year medical school course. Exercises were developed requiring students to retrieve and interpret information regarding local disease prevalence, practice patterns, and patient characteristics. These exercises were integrated into existing weekly problem sets in a multiple-choice format. Faculty and student perceptions were assessed with surveys, and augmented with interviews of student volunteers, and database usage statistics. Our results indicate widespread agreement among both students and faculty that population-based medicine warrants inclusion in undergraduate medical education. The majority of the students felt the exercises complemented the clinical cases around which they were structured. There was less agreement, however, that the exercises were valuable, with several students suggesting a more open-ended, discussion-oriented approach. It was clear that faculty perceptions had a significant impact on student reactions.

Attitude to Computers↗
PubMed2003

Information system interoperability in a regional health care system infrastructure: a pilot study using health care information standards.

The 1st and 2nd Regional Health Care System Authority of Central Macedonia (1st and 2nd PeSY) are two of the seventeen Regional Healthcare System Authorities in Greece. Every single PeSY aims to improve the level of quality that health care organisations offer as well as to control the expenditure of health care services provided by the health care organisations, Hospitals and Primary Care Health units. There is currently an urgent need for Regional Health Authorities to deploy integrated healthcare information system, based on secure networks. The limited interoperability of current hospital information systems (HIS) poses a risk for the management of patient related information since there is a difficulty to transform processed data into useful information and knowledge. Thus, a pilot system was developed to achieve data integration record synchronisation using the Health Level 7 protocol between the existing HIS of two Hospitals of Thessaloniki and the central Offices of the PeSY. The pilot was funded by the Third Community Support Framework (jointly funded by EU and Greece) funds in order to prepare the forthcoming major healthcare IT projects in Greece. It is shown that such a system is pragmatic, achieves data integration and provides acceptable integration costs.

Greece↗
PubMed2003

Metcalfe's law predicts reduced power of Electronic Medical Record software.

Error reduction, quality improvement and lowering of cost can all be achieved through electronic integration of health care providers. Despite the existence of clinical computing software for decades, meaningful linkage between health care providers has not occurred. We hypothesize that a major reason is reduction in network value through incompatible clinical software among hundreds of health care entities.

Adult↗
PubMed2004

Electronic medical records in solo/small groups: a qualitative study of physician user types.

BACKGROUND: There is growing recognition that physician use of electronic medical records (EMRs) is critical for improving quality of care in outpatient settings. METHODS: We inter-viewed EMR physician champions from 20 solo/small group practices to understand different types of EMR users and their EMR-related costs and benefits. RESULTS: Interviewees differed greatly in the EMR-related benefits they generated. These differences were associated with how they used the EMR, and the amount of effort they invested in making changes to complement EMR use. We defined five types of physician EMR users: Viewers, Basic Users, Strivers, Arrivers, and System Changers. The majority of interviewees were Strivers and Arrivers, physicians who have already invested substantial time in numerous process changes that help generate EMR-related benefits. CONCLUSIONS: Incentives and comprehensive support services for facilitating complementary process changes could be important for moving physicians from one user group to another. Additional research is needed to verify this user typology and to further define the relationship between user types and EMR-generated financial and quality benefits.

Ambulatory Care↗
PubMedDate not supplied

E-prescribing in clinical practice.

E-prescribing is coming of age. It promises to reduce medication errors and adverse reactions from incompatible drug combinations. This article provides an overview of the factors that have driven greater adoption of e-prescribing, principally the promulgation of HIPAA regulations and the Medicare Modernization Act of 2004. It discusses the financial considerations that have delayed the greater use of existing methodology, addresses current government and industry initiatives, and defines some of the standards that have been set forth to date.

Ambulatory Care Information Systems↗
PubMed2005

Patient note deidentification using a find-and-replace iterative process.

Medical research relies on access to clinical data. Health Insurance Portability and Accountability Act regulations require that patient information required for clinical research not have data that can be used to identify the patients from whose medical records the information has been derived. The only exception would be an institutional review board (IRB)-approved study for which the researcher has obtained a waiver to use patient data for a research study. Before requesting an IRB waiver, however, the researcher may want to search the clinical data for particular characteristics or determine whether the quantity of data warrant obtaining IRB approval. The application, the Simple PAtient Note Scrubber, or SPANS, reviews and changes line content through an iterative process. At each iteration, SPANS analyzes changes made during the previous pass and reviews changes in relation to terms adjacent to the newly altered data. Knowledge of the document domain, encompassing the different types of documents to be scrubbed, is the key to making this type of process effective.

Access to Information↗