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At least 1,297 records · Page 72Linked to original sources
PubMed1995

ARIS: integrating multi-source data for research in andrology.

Although the concept of distributed systems for the storage of patient data is more and more commonly accepted, for some considerable time yet most patient data will be stored in centralized rather than departmental systems. An important advantage of storage in a central system is hospital-wide access to much of the patient data. Disadvantages are however that these data cannot be reviewed through one user interface, and that the structure of the data does not lend itself to exploitation for other purposes. We describe the implementation of an Andrology Research Information System in which these data are integrated in a well-structured database facilitating multiple views on the patient data through a graphical user interface, and clinical research, quality control and summary reports. The data can be analyzed directly using the Hermes workstation. In this way the strengths of the centralized system are combined with those of the dedicated ARIS system.

Computer Graphics↗
PubMed1995

Enhancement of clinician workflow with computer order entry.

Physician-operated order entry systems can bring great benefits to an institution. Such systems can improve the consistency, accuracy, safety, and cost-effectiveness of orders. When building or selecting order entry for an institution, consideration must be given to the many different scenarios in which orders are written and communicated. Transfer, post-op, pre-admission and discharge orders have different communication requirements from standard inpatient orders. In certain services, orders from a very limited set (such as warfarin orders) must be written frequently for a large number of patients. Intensive-care patients, chemotherapy patients, and others have particular requirements for ordering. A computerized order entry system should respond to these requirements in order to promote correct and efficient ordering. We present a number of these issues, their specific requirements, and the approach we have taken to ensure that the system both supports and enhances workflow.

Clinical Pharmacy Information Systems↗
PubMed1995

Interaction and dialogue between the users and the patient record core of hospital information system: looking for a solution.

The lack of good user interface, in terms of both modality of dialogue and system behaviour is the major impediment to the acceptance and routine use of the computer based patient record (CPR) core of a hospital information system. We describe here the adopted approach to face the daily users' needs, overcoming the pitfalls of the paper based patient record (PPR), and giving the physicians an exhaustive modality for CPR inspection.

Hospital Information Systems↗
PubMed1995

A method for interactive medical instruction utilizing the World Wide Web.

We describe the implementation of interactive medical teaching programs in radiology and histology which utilize the Internet's World Wide Web (WWW). The WWW standard hypertext interface allows for simple navigation between related documents but does not provide a method for student tracking or question queries. Electronic forms, a recent feature of the WWW, provide the means to present question documents to remote clients and track student performance. A feature of our approach is dynamic creation of HTML documents based upon interaction with database applications. The approach allows multiple simultaneous, yet asynchronous interactions by geographically dispersed students upon the same instructional database and is scalable, providing the capability for multiple image/document servers. The security of the database is assured given that it is not accessible through the Internet.

Computer Communication Networks↗
PubMed1995

The interactive image tool: adding structure to images.

The interactive image format and tool were developed by the Stanford University Medical Media and Information Technologies (SUMMIT) group to allow medical educators to add interactive annotations and outlines to medical cross-sections, gross dissections, and clinical images. The interactive image tool (IIT) format offers a general specification for adding structural information to images. The IIT format has been used to create rich databases of image/structure information which are employed in educational software created at SUMMIT. These databases consist of information which is re-usable in other applications as well as a standalone image database. Future extensions to the IIT format will provide a means to organize information based on the structure of that information rather than on the arbitrary or haphazard links of current hypertext and hypermedia information networks.

Anatomy↗
PubMed1995

Supporting ad-hoc queries in an integrated clinical database.

Whether caring for patients or conducting research, medical decision-makers need access to clinical data. To fulfill that need, commercial software developers have produced a wide range of database query tools that differ greatly in functionality and cost. Generally, tools that have a greater ability to conceal database complexity from the user also require more effort for administrative setup. We describe a cost-effective, commercially-available query tool that requires no special setup to perform most simple queries, yet can be customized to satisfy users' more complex querying requirements.

Clinical Pharmacy Information Systems↗
PubMed1995

MCAT--a multimedia cardiac angiogram tool.

In this article, we present the prototype of the Multimedia Cardiac Angiogram Tool (MCAT). The MCAT provides capabilities for reviewing angiograms recorded at a cardiac catheterization laboratory. A doctor can use MCAT to annotate angiograms with audio, text, and graphics. He/she can selectively package the annotated multimedia angiograms into a document, save it as the record for the visit or use it for case presentations, or send it to another doctor over a network. MCAT streamlines data collection at a cath lab and is intended to improve the efficiency of communication and collaboration between doctors. This paper describes the design, implementation, and future directions of the prototype.

Computer Systems↗
PubMed1995

Evaluating the impact of structured text and templates in ambulatory nursing.

This evaluation looks at the use of templates for entering structured text nursing notes that generate both a legal text note that is the chart record and an underlying coded form of the note to support analysis and research. This study reflects the first phase of a prototype project of an integrated, computerized health record. Templates are notes that have been prewritten using a standard clinical vocabulary. Templates can be used as the basis of a new clinical note and can be either signed unchanged or modified to represent variations in clinical presentation. The prototype setting is a Primary Care clinic where both physicians and nurses are using the computer to enter clinical notes. In the prototype clinic team, nursing utilized the CPR for 100% of all documentation from day one. Use of templates was found to be the most frequent method of initiating a note.

Documentation↗
PubMed1995

Problems with integrating legacy systems.

The economic and organizational impact of imposing state-of-the-art technology to the large number of proprietary legacy systems operational in most hospitals requires integrated clinical professional workstations to provide flexible encapsulation mechanisms for these systems rather than reengineering these systems to this new technology. In this paper the implications of different input/output and translation models of legacy systems for their integration into a clinical workstation is described. Examples of legacy systems that have been integrated in the HERMES clinical workstation are presented as examples of the range of difficulties one might encounter. The features that an integrated workstation should offer for integrating a broad range of legacy systems are also addressed in this paper.

Computer Systems↗
PubMed1995

The deployment of a World Wide Web (W3) based medical information system.

The development of Web technologies has revolutionized information dissemination on the Internet. The University of Minnesota Hospital and Clinic's Web Clinical Information System (CIS) demonstrates the use of the Web as an infrastructure for deploying a medical information system at a fraction of the developmental cost of more traditional client server systems. This Web CIS has been deployed since December 1994. It makes available laboratory results, including a radically improved clinical microbiology reporting system, ad hoc laboratory order entry, and an embedded expert system protocol laboratory ordering system. It provides these services to any physician or patient care area with TCP (or SLIP/PPP) connection to our hospital network backbone, whether the client computer is running MS Windows, the Macintosh OS, or X-Windows. A formal evaluation of one of this systems subcomponents, the display of clinical microbiology information, demonstrated a significant savings in clinician time (43% p < .001) and substantial reduction in interpretive errors (0 vs 15 p < .01).

Clinical Laboratory Information Systems↗
PubMed1995

A client/server approach to telemedicine.

This paper describes the Medical College of Ohio's efforts in developing a client/server telemedicine system. Telemedicine vastly improves the ability of a medical center physician or specialist to interactively consult with a physician at a remote health care facility. The patient receives attention more quickly, he and his family do not need to travel long distances to obtain specialists' services, and the primary care physician can be involved in diagnosis and developing a treatment program [1, 2]. Telemedicine consultations are designed to improve access to health services in underserved urban and rural communities and reduce isolation of rural practitioners [3].

Computer Communication Networks↗
PubMed1995

Cat 6 mo increases symptoms: online physician charting and more.

The physicians of the Children's Asthma Center and the computer scientists of Information Services at Texas Children's Hospital set out to design a system that is comfortable to use, structured enough to effectively measure outcomes, yet flexible enough to conserve the individuality of the patient. To achieve these goals, we examined how the differential diagnosis process is applied to clinical decision making and implemented it in a clinical workstation. Unique patterns representing the state of the patient's disease are formed by dynamically selecting pertinent sets of observations, assigning attributes to these observations, and describing relationships between observations and/or sets of observations.

Asthma↗
PubMed1995

Using a pen-based computer to collect health-related quality of life and utilities information.

We have developed a system that uses the Newton MessagePad technology as part of a client-client-server paradigm to collect health-related quality of life information from breast cancer patients attending an outpatient clinic at the Dana-Farber Cancer Institute. Patients are asked to fill out an electronic questionnaire on the Newton, which then uploads the information into the institution's Oracle database. The program consists of a separate questionnaire engine and question base, facilitating questionnaire design and allowing us to give different questionnaires to different patients dynamically. The results of a preliminary trial show excellent user-acceptance of the device. Finally, we present a general framework for such systems and discuss issues that developers must consider when implementing a pen-based computer project.

Adult↗
PubMed1995

A model of clinical query management that supports integration of biomedical information over the World Wide Web.

A model of clinical query management is described that supports the integration of various types of biomedical information and the delivery of that information through a common interface. The model extends the architecture of the World Wide Web to include a Common Gateway Interface (CGI) mediator, which takes in user queries, performs syntactic and semantic processing to transform the input to a canonical form, selects the appropriate information sources to answer the query, translates the canonical query statement into a query of each information resource, queries the chosen information sources in parallel, and controls the analysis and display of results. We describe WebMedline, a CGI mediator that implements portions of this model, and discuss the benefits and limitations of this approach.

Computer Communication Networks↗
PubMed1995

Medical information retrieval and WWW browsers at Mayo.

Medical information retrieval from "Master Sheet" entries specially indexed for research retrieval has been part of the Mayo culture since 1909. Providing easy to use and universally available WWW access to these and other patient information databases at Mayo via browsers, shines a bright light on issues of privacy and confidentiality, user authentication, need to know, data transmission security, and technical details of interfacing disparate databases on a spectrum of platforms to many types of workstations using a variety of browsers. We review our recent experience, and generalize pertinent issues.

Computer Communication Networks↗
PubMed1995

Design considerations for intelligent data entry: development of MedIO.

Capturing clinical data is a multi-faceted problem. This paper discusses clinical data entry problems encountered during the development of an intelligent clinical data entry system. Based on a review of the problems, recommendations are made for an approach to the design of clinical data entry programs. These recommendations include a discussion of key components in the design process as illustrated by the development of MedIO, a C++ computer program for the entry of history and physical exam information.

Data Collection↗
PubMedDate not supplied

Development of a knowledge-based electronic patient record.

To help clinicians care for patients with HIV infection, we developed an interactive knowledge-based electronic patient record that integrates rule-based decision support and full-text information retrieval with an online patient record. This highly interactive clinical workstation now allows the clinicians at a large primary care practice (30,000 ambulatory visits per year) to use online information resources and fully electronic patient records during all patient encounters. The resulting practice database is continually updated with outcome data on a cohort of 700 patients with HIV infection. As a byproduct of this integrated system, we have developed improved statistical methods to measure the effects of electronic alerts and reminders.

Acquired Immunodeficiency Syndrome↗