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At least 1,783 records · Page 99Linked to original sources
PubMed2006

Evaluation to the informatics system for health promotion management with MedModel simulation project.

The purpose of this study was to evaluate the efficacy of the MedModel simulation project system based on the real approach in health promotion management. Used the MedModel simulation project in the physical exam department of a medical center, it's truly promoted the client satisfaction and reduced run-time about 30 minutes, and raised the client attendance about 30%. Actual application in the real health examination, also obtained the same improvement.

Computer Simulation↗
PubMed2006

Factors associated with improved completion of computerized clinical reminders across a large healthcare system.

OBJECTIVE: To analyze the relationship of completion rates for a standardized set of computerized clinical reminders across a large healthcare system to practice and provider characteristics. METHODS: The relationship between completion rate for 13 standardized reminders at 49 primary care practices in the VA New England Healthcare System for a 30-day period and practice characteristics, provider demographics and, via survey, provider attitudes was analyzed. RESULTS: There was no difference in clinical reminder completion rate between staff physicians versus nurse practitioners/physician assistants (87.6% versus 88.1%) but both were better than residents (76.6%, p<0.0001). With residents excluded, there were no differences between hospital and community-based clinics or between teaching and non-teaching sites. Clinical reminder completion rate was lower for sites that did not fully utilize support staff in completion process versus sites that did (82.4% versus 88.1%, p<0.0001). Analysis of survey results showed no correlation of completion rate with provider demographics or attitudes towards reminders. However there was significant correlation with frequency of receiving individual feedback on reminder completion (r=0.288, p=0.004). CONCLUSION: Completion of computerized clinical reminders was not affected by a variety of provider characteristics, including professional training, demographics and provider attitude, although was lower among residents than staff providers. However incorporation of support staff into clinic processes and individualized feedback to providers were strongly associated with improved completion. These findings demonstrate the importance of considering practice and provider factors and not just technical elements when implementing informatics tools.

Computers↗
PubMed2003

Hypertension and medical informatics.

BACKGROUND: Only about 27% of Americans with hypertension have their disease under control. Hypertension in the African-American population has a higher prevalence (32%) and is less likely to be treated or controlled compared with that in the caucasian population. Hypertension places a significant burden on patients and health care systems. Applications of medical informatics can facilitate the management of hypertension. Examples that illustrate the utility, status, and future potential of medical informatics applications in the treatment of hypertension are presented. METHODS: Relevant studies and review articles were accessed through a PubMed search of the English-language literature and for current Internet-based information for the time period of 1993-2002. Search terms included, but were not limited to, hypertension, medical informatics, medical information science, electronic medical records, Internet, and managed care. RESULTS: There is evidence that medical informatics has a favorable impact on health care issues as it relates to patients and physicians. Although the use of computers to assist in managing hypertension is in its infancy, there are examples where informatics applications have a demonstrated clinical value. CONCLUSIONS: Management of hypertension needs much improvement. The use of computers and the Internet in health care is expanding and expected to have a positive impact on the management of chronic diseases, such as hypertension.

Black People↗
PubMed2002

Does pornography-blocking software block access to health information on the Internet?

CONTEXT: The Internet has become an important tool for finding health information, especially among adolescents. Many computers have software designed to block access to Internet pornography. Because pornography-blocking software cannot perfectly discriminate between pornographic and nonpornographic Web sites, such products may block access to health information sites, particularly those related to sexuality. OBJECTIVE: To quantify the extent to which pornography-blocking software used in schools and libraries limits access to health information Web sites. DESIGN AND SETTING: In a simulation of adolescent Internet searching, we compiled search results from 24 health information searches (n = 3206) and 6 pornography searches (n = 781). We then classified the content of each site as either health information (n = 2467), pornography (n = 516), or other (n = 1004). We also compiled a list of top teen health information sites (n = 586). We then tested 6 blocking products commonly used in schools and libraries and 1 blocking product used on home computers, each at 2 or 3 levels of blocking restrictiveness. MAIN OUTCOME MEASURE: Rates of health information and pornography blocking. RESULTS: At the least restrictive blocking setting, configured to block only pornography, the products blocked a mean of only 1.4% of health information sites. The differences between blocking products was small (range, 0.6%-2.3%). However, about 10% of health sites found using some search terms related to sexuality (eg, safe sex, condoms) and homosexuality (eg, gay) were blocked. The mean pornography blocking rate was 87% (range, 84%-90%). At moderate settings, the mean blocking rate was 5% for health information and 90% for pornography. At the most restrictive settings, health information blocking increased substantially (24%), but pornography blocking was only slightly higher (91%). CONCLUSIONS: Blocking settings have a greater impact than choice of blocking product on frequency of health information blocking. At their least restrictive settings, overblocking of general health information poses a relatively minor impediment. However, searches on some terms related to sexuality led to substantially more health information blocking. More restrictive blocking configurations blocked pornography only slightly more, but substantially increased blocking of health information sites.

Access to Information↗
PubMed1999

A health information network for managing innercity tuberculosis: bridging clinical care, public health, and home care.

The purpose of this study was to use a health information network and innovative technology to coordinate tuberculosis care. An innercity medical center, a local health department, and a home care nurse service in northern Manhattan were used. The organizations were linked with computer networks. An automated decision support system with a natural language processor was used to detect tuberculosis cases and report them to the health department, and to select patients for respiratory isolation. Educational materials were placed on the World Wide Web and a Web-based kiosk. Home care nurses were outfitted with wireless pen-based computers, and data were relayed to the medical center. Automated tuberculosis case reporting resulted in time savings but not improved accuracy. Automated rules resulted in significant improvements in respiratory isolation. Kiosk educational materials were well-used. Wireless computing led to better access to information for both nurses and physicians, but not to reduction of workload. The key success element was recognition of critical priorities. It is concluded that innovative technology can facilitate the coordination of clinical care, public health, and home care.

Academic Medical Centers↗
PubMed2005

[Status of telemedicine in Austria].

In an overview the situation of telemedicine in Austria is presented regarding the Austrian health service with the focus on patients. First the term "telemedicine" is defined according to the present definition of the European Union and the situation of the Austrian health service. Afterwards individual success components for the planning of telemedicine projects are presented. These are briefly shown by the "five-column concept" of the Tyrolean Government, which includes the medical, legal, economic, technical and quality management-oriented aspects during the planning and evaluation period of telemedicine projects. The conclusion gives an overview of individual committees and activities of the Austrian medical universities, the federation and states as well as individual Austrian telemedical societies.

Austria↗
PubMed2005

[The introduction of the electronic health card in Germany].

From 2006 onwards all members of the health insurance system in Germany will be issued an electronic health card which will replace the current health insurance card. The new health card will be technically upgraded to also include patient-related health data or provide access to such data in addition to its administrative functions. Therefore, it is evident that the health card be fitted with a microprocessor that permits authentication (electronic identity check), encryption and the electronic digital signature, thus ensuring maximum data safety and security. For easy identification of the insured person, the electronic health card will bear a photograph of the card holder.

Computer Communication Networks↗
PubMed1994

Writing Arden Syntax Medical Logic Modules.

The Arden Syntax for Medical Logic Modules is a language for encoding medical knowledge bases that consist of independent modules. The Arden Syntax has been used to generate clinical alerts, diagnostic interpretations, management messages, and screening for research studies and quality assurance. An Arden Syntax knowledge base consists of rules called Medical Logic Modules (MLMs), which are stored as simple ASCII files that can be written on any text editor. An MLM is made of slots grouped into three categories: maintenance information, library information, and the actual medical knowledge. Most MLMs are triggered by clinical events, evaluate medical criteria, and, if appropriate, perform an action such as sending a message to a health care provider. This paper provides a detailed tutorial on how to write MLMs.

Artificial Intelligence↗
PubMed1994

A C++ framework for developing Medical Logic Modules and an Arden Syntax compiler.

When developing a clinical decision support system that uses knowledge expressed in Arden Syntax, the availability of a robust means of translating Arden Syntax into an executable module becomes critical. This paper describes an approach where Arden Syntax is translated into an intermediate pseudo-Arden language that is in turn compiled and linked to create the executable module. The pseudo-Arden language is defined in C++ using specialized class libraries and preprocessor macros. This approach provides an alternative means of developing the code generator for an Arden Syntax compiler.

Artificial Intelligence↗
PubMed1995

Enterprise systems.

Looking to the next generation of hospital information systems (HIS), the paper first provides an overview of enterprise systems, including the concept, current developments, hospital perspectives, critical issues and requirements, and future value-added enhancements. The paper then focuses on efforts drawing upon existing expertise in these critical areas, including infrastructure, workstations, standards, computerized patient records, and security. It concludes by stressing the importance of collaborative efforts in the creating of the next generation of HIS, health information systems or HIS.

Computer Security↗
PubMed1995

Editorial.

Explore the source record for details and available documents.

Decision Making, Computer-Assisted↗
PubMed2005

Bridging the gap between medical and bioinformatics: an ontological case study in colon carcinoma.

Ontological principles are needed in order to bridge the gap between medical and biological information in a robust and computable fashion. This is essential in order to draw inferences across the levels of granularity which span medicine and biology, an example of which include the understanding of the roles of tumor markers in the development and progress of carcinoma. Such information integration is also important for the integration of genomics information with the information contained in the electronic patient records in such a way that real time conclusions can be drawn. In this paper, we describe a large multi-granular datasource built by using ontological principles and focusing on the case of colon carcinoma.

Colonic Neoplasms↗
PubMed2004

On-line variable live-adjusted displays with internal and external risk-adjusted mortalities. A valuable method for benchmarking and early detection of unfavourable trends in cardiac surgery.

OBJECTIVE: Benchmarking and early detection of unfavourable trends. METHODS: We implemented a dedicated project-orientated data warehouse, which continuously supplies data for on-line computing of the variable live-adjusted displays (VLADs). To calculate the expected cumulative mortality, we used the multi-variate logistic regression model of the EuroSCORE model. In addition to the external EuroSCORE standard, we calculated a centre-specific risk score for internal standards by analysing the data of 9135 patients, which enables both internal and external comparisons. The VLADs are embedded into the multi-purpose web-based information portal, so that the physicians can investigate several types of VLADs interactively: performance of different types of surgery and individual surgeons for different time intervals. We investigated clinically important events such as modification of operative techniques and personnel changes of the team by the VLADs. RESULTS: We found transient declines in the performance curves during major changes in patient management, indicating that systemic--rather than accidental or patient related factors--were involved in the mortality risk. The internal standard line represents these clusters more clearly than the external line. We evaluated examples of how periods of increased risk could be monitored by the VLAD curves: (1) the introduction of OPCAB surgery; (2) training of surgeons; (3) staff changes and staff-related management. CONCLUSIONS: On-line VLADs based on a day-to-day updated database, displaying both internal and external standards, are a helpful visualisation tool for earlier detection of unfavourable trends. They enable the surgeon teams and clinical management to take countermeasures at an early stage.

Benchmarking↗
PubMed2005

Biomedical ontologies: what part-of is and isn't.

Mereological relations such as part-of and its inverse has-part are fundamental to the description of the structure of living organisms. Whereas classical mereology focuses on individual entities, mereological relations in biomedical ontologies are generally asserted between classes of individuals. In general, this practice leaves some basic issues unanswered: type constraints of mereological relations, e.g., concerning artifacts and biological entities, the relation between parthood and time, inferred parts and wholes as well as a delimitation of parthood against spatial inclusion. Furthermore, mereological relations can be asserted not only between physical objects but also between biological processes and medical procedures. We analyze these ambiguities and make suggestions for a standardization of mereological relations in biomedical ontologies.

Anatomy↗