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Results for “User-Computer Interface”

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At least 1,081 records · Page 60Linked to original sources
PubMed1993

Structured data collection and knowledge-based user guidance for abdominal ultrasound reporting.

This paper describes a system for structured data collection and report generation in abdominal ultrasonography. The system is based on a controlled vocabulary and hierarchies of concepts; it uses a graphical user interface. More than 17,000 reports have been generated by 43 physicians using this system, which is integrated into a departmental information system. Evaluations have shown that it is a well accepted tool for the fast generation of reports of comparatively high quality. The functionality is enhanced by two additional components: a hybrid knowledge-based module for "intelligent" user guidance and an interactive tutoring system to illustrate the terminology.

Abdomen↗
PubMed1993

Response to a trial of physician-based inpatient order entry.

Our group has developed a physician-operated inpatient order-entry system (BICS-OE). Mindful of the problems inherent in bringing a radical cultural change such as this to the hospital, we conducted two pilots of the system prior to its full implementation. Physicians and nurses both identified a number of benefits from the use of OE. Physicians reported a number of areas where OE use was difficult or could be improved; nurses reported fewer problems. Based on the pilot trials, we modified the interface and some data constructs. These changes have enhanced the usefulness of OE in patient care in our hospital, and can serve as a model to others developing order entry.

Attitude to Computers↗
PubMed1993

A pen-based system to support pre-operative data collection within an anaesthesia department.

This paper describes the design and implementation of a pen-based computer system for remote preoperative data collection. The system is envisaged to be used by anaesthesia staff at different hospital scenarios where pre-operative data are generated. Pen-based technology offers important advantages in terms of portability and human-computer interaction, as direct manipulation interfaces by direct pointing, and "notebook user interfaces metaphors". Being the human factors analysis and user interface design a vital stage to achieve the appropriate user acceptability, a methodology that integrates the "usability" evaluation from the earlier development stages was used. Additionally, the selection of a pen-based computer system as a portable device to be used by health care personnel allows to evaluate the appropriateness of this new technology for remote data collection within the hospital environment. The work presented is currently being realised under the Research Project "TANIT: Telematics in Anaesthesia and Intensive Care", within the "A.I.M.--Telematics in Health CARE" European Research Program.

Anesthesia Department, Hospital↗
PubMed1993

An X Window system for statlab results reporting.

We have developed a system that receives "stat" results encoded in Health Level Seven from the Laboratory Information System, prints a report in destination Intensive Care Units (ICUs), and captures the data for review in a custom spreadsheet format at color X-terminals located in ICUs. Available services include a reference nomogram plot of arterial blood gas data, printed summaries, automated access to the Clinical Information System and a Medline database, electronic mail, a simulated electronic calculator, and general news and information. Security mechanisms include an audit trail of user activities on the system. Noteworthy technical aspects and non-technical factors impacting success are discussed.

Clinical Laboratory Information Systems↗
PubMed1993

Improving the efficiency of patient recruitment with an automated telephone screening system in a client-server environment.

An automated telephone screening system was implemented at the Baltimore VA Hospital on a Local Area Network (LAN) to evaluate older adults for the GRECC research program. Using the system for decision support, a registered nurse (RN) placed 117 phone calls to older adults in the Baltimore community over a 3 month period. The modular design of the system allowed tracking of inclusion and exclusion criteria which was shared by clinicians and researchers. The design goal of the telephone screening system was to reduce time and personnel costs and increase the effectiveness of screening for recruitment for a major research project. Effectiveness is defined as avoiding under--or over--screening. Using the telephone system, it is estimated the research team saved over $6,000.00 in unnecessary medical evaluation in a 3 months period. As the system develops, the process by which older adults are assessed for research programs in the Geriatrics Service at the Baltimore VAMC will provide additional cost efficiencies.

Aged↗
PubMed1993

An intelligent interactive simulator of clinical reasoning in general surgery.

We introduce an interactive computer environment for teaching in general surgery and for diagnostic assistance. The environment consists of a knowledge-based system coupled with an intelligent interface that allows users to acquire conceptual knowledge and clinical reasoning techniques. Knowledge is represented internally within a probabilistic framework and externally through a interface inspired by Concept Graphics. Given a set of symptoms, the internal knowledge framework computes the most probable set of diseases as well as best alternatives. The interface displays CGs illustrating the results and prompting essential facts of a medical situation or a process. The system is then ready to receive additional information or to suggest further investigation. Based on the new information, the system will narrow the solutions with increased belief coefficients.

Artificial Intelligence↗
PubMed1993

A decision aid for diagnosis of liver lesions on MRI.

Abdominal magnetic resonance imaging (MRI) plays an important role in the evaluation of liver abnormalities. The interpretation of MR images requires expert training in a rapidly changing field. DAFODILL (Decision Aid for Diagnosing Liver Lesions) is a decision-support tool designed to aid radiologists in the diagnosis of hepatic lesions seen on MRI. DAFODILL uses a knowledge base of MRI findings and a belief-network inference engine to generate probabilistic differential diagnoses of the most commonly encountered hepatic lesions. DAFODILL performs limited image processing to identify clinically relevant features, which are presented to the user for confirmation before they are used by the network. Preliminary evaluation of an initial version of the system suggests that DAFODILL may be a useful tool for radiology residents and nonexpert radiologists in interpreting MR images of the liver.

Artificial Intelligence↗
PubMed1993

Evaluating the quality of a probabilistic diagnostic system using different inferencing strategies.

In this paper we describe the evaluation of a probabilistic diagnostic system for patients with renal mass. Three inference models: Multi-membership Bayesian (MB), Minimal Diagnosis (MD) and Bayesian Network (BN), and 72 patients are used to illustrate three interrelated measures of system performance: accuracy, reliability and discriminating power. The inferencing strategies we tested demonstrated the kind of trade-offs in the performance measures that can be expected from imperfect systems. Ultimately, the purpose and expected use of a system should dictate the relative importance ascribed to different aspects of system performance.

Adolescent↗
PubMed1993

Clinical, scholarly & campus information hypertext tools at Columbia-Presbyterian Medical Center.

In conjunction with other researchers at Columbia-Presbyterian Medical Center (CPMC) we have developed a number of hypertext and free text retrieval computer applications aimed at an extremely diverse audience which includes students and faculty in a university setting as well as health care providers and patients in hospital and clinic settings. Hypertext and free text systems offer features which make them ideal for presenting information in a wide variety of contexts; however, they also have several major weaknesses which must be addressed before these applications can be useful tools. We have learned to maximize the strengths and minimize the weaknesses to present material in a manner that is individualized to the needs of each user from the research scientist in the lab to the patient at the bedside.

Academic Medical Centers↗
PubMed1993

NetMenu: experience in the implementation of an institutional menu of information sources.

NetMenu is a program, developed at Yale, which enables straightforward access to online information systems. NetMenu has been deployed in several diverse settings within our medical center. In the hospital, NetMenu is functioning as a front-end for our clinical workstation providing access to the hospital information system, the clinical laboratory computer, a drug database and several bibliographic databases. The medical libraries are utilizing NetMenu for both medical education workstations and for scholarly information workstations. This paper describes our initial experience in the implementation, support, and maintenance of NetMenu as an institutional menu of information sources.

Academic Medical Centers↗
PubMed1993

Toward an interim standard for patient-centered knowledge-access.

Most care-giver "knowledge" needs arise at the point of care and are "patient-centered." Many of these knowledge needs can be met using existing on-line knowledge sources, but the process is too time-consuming, currently, for even the computer-proficient. We are developing a set of public domain standards aimed at bringing potentially relevant knowledge to the point of care in a straight-forward and timely fashion. The standards will a) make use of selected items from a Computer-based Patient Record (CPR), e.g., a diagnosis and measure of severity, b) anticipate certain care-giver knowledge needs, e.g., "therapy," "protocols," "complications," and c) try to satisfy those needs from available knowledge sources, e.g., knowledge-bases, citation databases, practice guidelines, and on-line textbooks. The standards will use templates, i.e., fill-in-the-blank structures, to anticipate knowledge needs and UMLS Metathesaurus enhancements to represent the content of knowledge sources. Together, the standards will form the specification for a "Knowledge-Server" (KS) designed to be accessed from any CPR system. Plans are in place to test an interim version of this specification in the context of medical oncology. We are accumulating anecdotal evidence that a KS operating in conjunction with a CPR is much more compelling to users than either a CPR or a KS operating alone.

Artificial Intelligence↗
PubMed1993

Critique of an evaluation of software for searching MEDLINE.

In a previous study, investigators at McMaster University compared 14 ways to search the MEDLINE database and concluded that the method that cost the least (the National Library of Medicine's ELHILL program) yielded the highest proportion of relevant articles, whereas the method that cost the most (PaperChase) yielded the least. There are serious defects in the study design that invalidate the authors' conclusions.

Bias↗
PubMed1993

An information sources map for Occupational and Environmental Medicine: guidance to network-based information through domain-specific indexing.

This paper describes a prototype information sources map (ISM), an on-line information source finder, for Occupational and Environmental Medicine (OEM). The OEM ISM was built as part of the Unified Medical Language System (UMLS) project of the National Library of Medicine. It allows a user to identify sources of on-line information appropriate to a specific OEM question, and connect to the sources. In the OEM ISM we explore a domain-specific method of indexing information source contents, and also a domain-specific user interface. The indexing represents a domain expert's opinion of the specificity of an information source in helping to answer specific types of domain questions. For each information source, an index field represents whether a source might provide useful information in an occupational, industrial, or environmental category. Additional fields represent the degree of specificity of a source in individual question types in each category. The paper discusses the development, design, and implementation of the prototype OEM ISM.

Abstracting and Indexing↗
PubMed1993

Using the Internet Gopher Protocol to link a computerized patient record and distributed electronic resources.

At Duke University Medical Center, we are developing a prototype clinical application for automated patient care plans with integrated links to electronic documents and other electronic resources. These links are implemented using the Internet Gopher Protocol, an emerging standard for distributed document search and retrieval. Use of this protocol permits storage of electronic documents in an open, nonproprietary manner. This paper discusses the architecture of the link mechanism and presents some of the advantages and disadvantages of the proposed method.

Academic Medical Centers↗
PubMed1993

The ranking algorithm of the Coach browser for the UMLS metathesaurus.

This paper presents the novel ranking algorithm of the Coach Metathesaurus browser which is a major module of the Coach expert search refinement program. An example shows how the ranking algorithm can assist in creating a list of candidate terms useful in augmenting a suboptimal Grateful Med search of MEDLINE.

Algorithms↗
PubMed1993

CaseLog: semantic network interface to a student computer-based patient record system.

We have developed a computer program called CaseLog, which serves as an exemplary, computer-based patient record (CPR) system. The program allows for the introduction of the students to issues unique to patient record systems. These include record security, unique patient identifiers, and the use of controlled vocabularies. A particularly challenging aspect of the development of this program was allowing for student entry of controlled vocabulary terms. There were four goals we wished to achieve: students should be able to find the terms they are looking for; once a term has been found, it should be easy to find contextually related terms; it should be easy to determine that a sought-for term is not in the vocabulary; and the structure of the vocabulary should be dynamically altered by contextual information to allow its use for a variety of purposes. We chose a semantic network for our vocabulary structure. Within the processing power of the equipment we were working with, we achieved our goals. This paper will describe the development of the vocabulary, the design of the CaseLog program, and the feedback from student users of the program.

Computer Systems↗
PubMed1993

Acceptance of direct physician access to a computer-based patient record in a managed care setting.

Kaiser Permanente Mid-Atlantic States has developed a fully integrated outpatient information system which currently runs on an IBM ES9000 on a VM platform written in MUMPS. The applications include Lab, Radiology, Transcription, Appointments. Pharmacy, Encounter tracking, Hospitalizations, Referrals, Phone Advice, Pap tracking, Problem list, Immunization tracking, and Patient demographics. They are department specific and require input and output from a dumb terminal. We have developed a physician's work station to access this information using PC compatible computers running Microsoft Windows and a custom Microsoft Visual Basic 2.0 environment which draws from these 14 applications giving the physician a comprehensive view of all electronic medical records. Through rapid prototyping, voluntary participation, formal training and gradual implementation we have created an enthusiastic response. 95% of our physician PC users access the system each month. The use ranges from 0.2 to 3.0 screens of data viewed per patient visit. This response continues to drive the process toward still greater user acceptance and further practice enhancement.

Ambulatory Care Information Systems↗
PubMed1993

Patient simulation using seamless digital video.

This manuscript describes a method for using digital-video technology to create patient simulations in which the simulated patient is always active on the computer screen. We outline the technical method we have developed, and we present the lessons learned in applying the method to develop a prototype patient simulation.

Computer-Assisted Instruction↗