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Providing information and detecting concerns about health in general practice populations using a computer system in the waiting area.

Theoretical and practical problems for general practice exist following the increased emphasis placed upon preventive care in the 1990 contract for general practitioners. In particular, the risk that questionable systematic activity is encouraged while opportunistic prevention is discouraged, suggests the need for better targeted and more efficient methods of health promotion. This paper describes computer software which provides a broad range of information about health on a patient-dedicated terminal in general practice waiting areas. The software is interactive and monitors both the level of use of the component parts of the database and specific information sought but not found. In this way the system generates an indicator of 'health concerns' in the practice population. Experience of the system at four contrasting sites in Merseyside is reported. Data from the first year suggest that site-specific differences in use and perceived need are emerging, and could lead to an information source which evolves in response to local demand. In addition, the system should provide a resource for opportunistic prevention in primary care and a way of monitoring the emergence of new concerns about health.

Computer Terminals↗

Patient-interactive computer system for obtaining medication histories.

A portable, patient-interactive computerized system for obtaining medication histories is described. A comprehensive interview script modeling pharmacist-conducted medication-history interviews was written in lay language. The script contains sections on demographics, current medical conditions, medication regimen, medication compliance, symptoms, allergy history, dietary history, psychosocial history, and occupational and environmental exposure; it also asks the patient to evaluate the system. Some of the information requested is often not obtained by physicians during the history and physical examination. A program that conducts the interview by processing a computerized version of the script was developed with Microsoft QuickBASIC. The program was designed to be run on a personal computer microprocessor so that an interview can be conducted virtually anywhere by using a desktop or laptop computer. Summary reports suitable for inclusion in the medical record are generated after each interview. Patients using the system took an average of 40 minutes to complete an interview. They entered data easily and accurately, and they gave the system a high overall rating. The medication-history interviewing system described produces useful, comprehensive, and consistent reports and requires about the same amount of time to conduct an interview as a human interviewer.

Adult↗

NCTR computer systems designed for toxicological experimentation. II. Experiment start-up system.

The Experiment Start-Up System (ESS) developed and implemented at the National Center for Toxicological Research constructs models from information contained in experimental protocols. These models may then be used to project resource requirements and related schedules. Each experimental model provides information from which management can determine the raw resources such as quantity of food, water, bedding, cages, animals (sex, strain, species), chemical, facilities, and manpower needed for conducting the experiment. Based upon this information, management can determine if the required resources are available and determine the most feasible "start" date for the new experiment. In addition, the information provided by the experimental model assures the Principal Investigator that the protocol requirements are thoroughly understood by participating technical support groups and that quality control elements of the ESS and other integrated systems will provide a means for accurately monitoring the experiment.

Computers↗

Computing system for pediatric cardiology (CathEcho 2.5).

CathEcho version 2.5 (CathEcho 2.0) was developed as database system of clinical data for pediatric cardiology patients including X-ray and echocardiogram picture for a scientific purpose. We classified congenital heart defects and combined these data to meet any diagnosis or syndrome and any diagnostic coding system. Anatomical data was saved systematically along the anatomical hierarchy of heart. Laboratory data were calculated automatically after the validation. All congenital defects were revised and diagnosis was made automatically. In this system the determination of operation can be suggested according to the cardiac indexes and data can be reported as clinical charts. We can monitor the statistics of patient data and obtain information about patient clinical data easily even at emergency state. This system can make physician to have complete examination about congenital heart disease as well as other heart state. The followings are the main constitutions of the CathEcho version 2.5. BASIC INFORMATION RECORDS. In this part, the unique number is given to any patient. The basic patient informations are checked and stored as clinical data for the management of patients and for the research purposes. CARDIAC CATHETERIZATION RECORDS. Cardiac catheterization data are recorded in this part. The cardiac anatomical data are recorded in according to the segmental steps and the anatomical relationships. Laboratory data are recorded and the cardiac indexes are calculated automatically. This system can recommend the therapeutic plans on operation. Final diagnosis can be automatically arranged by a complete revision of anatomical and laboratory data. CARDIAC ECHOCARDIOGRAM RECORDS. Echocardiogram data are recorded systematically and the cardiac indexes can be calculated automatically. This system also can recommend the necessity of the operation. Full anatomical and laboratory data are completely revised and diagnosis can be made automatically. ELECTROCARDIOGRAPHY (EKG) RECORDS. EKG data are stored systematically and reported with catheterization data, echo data and X-ray data. X-RAY RECORDS. X-ray data of patients also are stored for the complete clinical data. With CathEcho 2.5 we are now storing the formatted clinical data for the expert systems which are now being developed to assist the therapeutic planning and updated to link to cardiac electrophysiology.

Cardiology↗