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At least 919 records · Page 51Linked to original sources
PubMed1986

[Two-year clinical experience with Mevamatic 3--development of a verification and protocol system for irradiation units].

Since 1983 the computerized record and verify system Mevamatic 3 was tested in connection with the linear accelerator Mevatron 77 (Siemens Company). In consequence of the software development the handling of the system was improved for the clinical routine with the result of a fully utilizable system. The topics of this report are the description of the hardware, the functions of the system, the software development and some possibilities for improvements in the future.

Germany, West↗
PubMed1995

[Utilization of computerized classification system of primary care: three years of experience].

OBJECTIVE: To develop and implement a computerized version of the International Classification of Primary Care. To create a data bank and to conduct a descriptive study of our clinic's clientele. DESIGN: Testing a software program and creating a data bank. SETTING: Family Medicine Unit at Enfant-Jésus Hospital, Quebec City. PARTICIPANTS: All Family Medicine Unit doctors and patients seen between July 1, 1990, and June 30, 1993. MAIN OUTCOME MEASURE: Description of our clientele's health problems using the ICPC. RESULTS: During the study, 48,415 diagnostic codes for 33,033 visits were entered into the bank. For close to 50% of these visits, two or more health problems were coded. There was good correlation between the description of our clientele and descriptions in other studies in the literature. CONCLUSION: This article describes the development of a data bank in a family medicine unit using a software program based on the ICPC. Our 3-year experiment demonstrated that the method works well in family physicians' daily practice. A descriptive study of our clientele is presented, as well as a few examples of the many applications of such a data bank.

Databases, Factual↗
PubMedDate not supplied

A joint hospital/vendor project brings CQI and point-of-care technology to home care.

A joint project team consisting of personnel from Parkview Episcopal Medical Center, Pueblo, Colorado, and Patient Care Technologies, Atlanta, Georgia, a software vendor, codeveloped a point-of-care based system of electronic patient records and administrative data capture for home health care. Well established continuous quality improvement techniques, in use at Parkview for approximately 6 years, guided the development project and the subsequent alpha and beta testing of the system. Significant results to date include an overall productivity gain approaching 20%, the potential to increase annual home care revenue $876,000 with the same staffing level, and an 83% reduction in billing errors. Although not directly measured as a part of the study, the project team believes the quality of charting has improved because it is now done at the point-of-care in the home rather than in the office--some period of time after care is delivered. Anticipated future development includes integration of the home care clinical record with the hospital's clinical data repository and explicit support of critical pathways.

Accounting↗
PubMed1995

HOROPLAN: computer-assisted nurse scheduling using constraint-based programming.

Nurse scheduling is a difficult and time consuming task. The schedule has to determine the day to day shift assignments of each nurse for a specified period of time in a way that satisfies the given requirements as much as possible, taking into account the wishes of nurses as closely as possible. This paper presents a constraint-based, artificial intelligence approach by describing a prototype implementation developed with the Charme language and the first results of its use in the Rouen University Hospital. Horoplan implements a non-cyclical constraint-based scheduling, using some heuristics. Four levels of constraints were defined to give a maximum of flexibility: French level (e.g. number of worked hours in a year), hospital level (e.g. specific day-off), department level (e.g. specific shift) and care unit level (e.g. specific pattern for week-ends). Some constraints must always be verified and can not be overruled and some constraints can be overruled at a certain cost. Rescheduling is possible at any time specially in case of an unscheduled absence.

France↗
PubMed1995

A portable, GUI-based, object-oriented client-server architecture for computer-based patient record (CPR) systems.

Software applications for computer-based patient records require substantial development investments. Portable, open software architectures are one way to delay or avoid software application obsolescence. The Clinical Management System at Temple University School of Dentistry uses a portable, GUI-based, object-oriented client-server architecture. Two main criteria determined this approach: preservation of investment in software development and a smooth migration path to a Computer-based Patient Record. The application is separated into three layers: graphical user interface, database interface, and application functionality Implementation with generic cross-platform development tools ensures maximum portability.

Humans↗
PubMed1995

Initial experience of using a knowledge based system for monitoring immunization services in Papua New Guinea.

A knowledge based system (KBS) which helps health service managers to interpret immunization coverage rates was installed in two provinces of Papua New Guinea. It was assessed over a period of 4 months to determine whether it was a potentially useful management tool. One province used the system but did not adjust its activities significantly because it was meeting its targets for immunization. In the other province the KBS helped provincial managers to detect problems and respond to them. Consequently, improvements in performance indicators were detected. It is difficult to attribute the improvements entirely to the KBS but several actions were taken to strengthen immunization services and the KBS appeared to support these. It appears that interventions which make routinely collected data more understandable and readily usable by health service managers can lead to improvements in the delivery of health services.

Follow-Up Studies↗
PubMed1994

Development and testing of computer software for nursing assessment and care planning at a spinal cord injury center.

This paper describes a pilot project using a Macintosh personal computer and customized software to computerize nursing admission assessment and care planning data. The project setting is a 47-bed Spinal Cord Injury Center with two inpatient units and an outpatient department serving approximately 1,000 patients with spinal cord injury at a Department of Veterans Affairs Medical Center in northern California. The computer software development, implementation, and evaluation are described. This software (MacNursing) was found to be a low cost, customized approach to computerizing spinal cord injury admission assessment data and care planning which reduces repetitive writing and facilitates continuity of care. Personal computers and this software have provided the mechanism for establishing a spinal cord injury patient database.

Humans↗
PubMed1993

Computer supported analysis of cardiovascular parameters by impedance cardiography and plethysmography.

A fully automated system for computer supported analysis of cardiovascular parameters on the basis of impedance technique, which is confined to the analysis of relative changes of stroke volume and cardiac output, has been developed and tested. The evaluation showed good agreement between automatic and manual calculation. As the whole computational procedure is done by software, which is written in a common language (BASIC), a maximum of flexibility and portability is guaranteed. Estimation of relative changes of stroke volume and cardiac output as well as peripheral blood flow is possible without any manual interaction. Extension from physiological measurement of healthy individuals to clinical application has been started.

Cardiac Output↗
PubMed1993

Automated linkage of free-text descriptions of patients with a practice guideline.

The process of applying a practice guideline to a patient requires a great deal of clinical data. AAPT (Appropriateness-Assessment Processing from Text) is an experimental computer program that can assess the appropriateness of coronary-artery bypass grafting surgery (CABG) in patients with coronary-artery disease (CAD) and chronic stable angina from the admission summaries of those patients. The AAPT architecture combines natural-language processing (NLP) and probabilistic inference. The NLP module identifies single clinical concepts of interest in the free-text document. The probabilistic inference module, a Bayesian belief network, estimates values for variables not specifically mentioned. AAPT produces a patient's summary of CAD that is similar to a manually generated clinical summary. Work is ongoing to improve AAPT and evaluate it as a tool to assist in the dissemination of guidelines and as a tool to encourage adherence to practice guidelines.

Angina Pectoris↗
PubMed1994

Occupational health software: selecting the right program.

1. Occupational health nurses who are selecting software should identify specific goals for computerization, such as tracking compliance activities or analyzing trends. 2. Nurses should evaluate software programs by the extent to which each achieves these goals without exceeding available resources. 3. Successful software installations require commitment from an on site project manager to ensure that the program meets specifications and that the vendor provides adequate user training and ongoing support.

Humans↗
PubMed1994

Tools and techniques for the development of secure software.

System development projects in health care have not properly addressed the issues of availability, confidentiality and integrity. The safety critical aspects of health care have not been well recognised in the context of information systems, as opposed to medical devices where considerable effort has been made to ensure the 'correctness' of the device before it is authorized for use. Consideration should be given at the start of the development process to the particular requirements of the project and the project should be structured to ensure that the specific functional requirements for security are satisfied. In addition the development process itself must be conducted in a rigorous fashion in order to ensure-and to demonstrate--that the end product has the appropriate degree of 'correctness'. Suitable tools and techniques will be required to assist the efficiency and the integrity of this process.

Computer Security↗
PubMed1993

Evaluating instructional software.

The purchase of educational software for use in the hospital is a major decision. A careful evaluation will prevent the purchase of an expensive program that is not used. There are many questions to be considered, but there is also a great deal of help available.

Education, Nursing, Continuing↗
PubMedDate not supplied

Hybrid expert-system approach to nurse scheduling.

The objective of this research was to develop a hybrid expert system entitled NURSE-HELP to achieve flexible and effective scheduling for nurses. NURSE-HELP was developed with the emphasis on following the ergonomics guidelines, which will improve the performance of nurses. Moreover, the combination of linear zero-one goal programming and an expert system program reduces the program run time while maintaining the quality of the schedule. The system was evaluated by comparing 18 sets of 4-week schedules generated by the head nurses manually and by NURSE-HELP. Concerning the amount of time required to generate the schedules, NURSE-HELP averaged less than 20 minutes, whereas head nurses spent from 2 to 4 hours. The quality of the schedules was measured using the following four criteria: 1) minimum staff level not satisfied, 2) day off request not granted, 3) backward rotation, and 4) maximum consecutive work periods on the night shift. NURSE-HELP was superior in all these aspects.

Ergonomics↗
PubMedDate not supplied

FLORENCE: synthesis of case-based and model-based reasoning in a nursing care planning system.

In this article, the data structures and reasoning methodologies of FLORENCE, an expert system that advises on the identification of nursing diagnoses in a new client, are described. FLORENCE is primarily a case-based reasoning system, but has an ancillary model-based reasoning system to advise on complex problems. The use of multiple reasoning methods allows for better simulation of the reasoning process of the expert clinician.

Decision Making, Computer-Assisted↗