SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The main elements of the computer system used in medical practice are discussed. Typical application possibilities of microcomputers in perinatal medicine are described.
The main computer systems used in perinatal medicine are described, with particular reference to the systems of analysis of perinatal data, analysis of cardiotocogram, obstetric ultrasonogram, assessment of the heart function of the newborn, records of respiratory activity in newborns, and use of computers in parenteral alimentation of newborns.
The computer system used by the Microbiology Service of the Clinical Pathology Department, Clinical Center, National Institutes of Health is discussed. This microbiology subsystem is a part of a dedicated on-line laboratory computer system used by the entire department. The laboratory computer is connected on-line to a hospital computer which provides patient admission, transfer, and discharge data. Mark sense worksheets and cathode ray tube terminals are used for result entry and correction. Cumulative patient reports are printed. Results for both active and completed accessions can be easily retrieved on cathode ray terminals in the laboratory. All laboratory data are archived on magnetic tape from which a research data base and microfiched laboratory records are generated. The manner in which the system is integrated in the routine operation of the microbiology laboratory is emphasized. In addition, some of the costs, benefits, liabilities, and pitfalls associated with the introduction of the computer in the laboratory are reviewed. Finally, we have presented our concept of some of the future enhancements to our present system and some of the directions in which any future microbiology system might develop.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A hospitalwide computer system that combines protocol-specific information on investigational drugs with order entry is described. A large university teaching hospital had in place a computerized clinical information system. Among other uses, physicians used the system for direct entry of total parenteral nutrient solution orders and associated laboratory tests; labels are produced automatically. Personnel from the pharmacy and information services departments met to discuss how to apply the computer system to investigational drug information. The application they designed has three components: protocol information, order entry, and patient monitoring. Protocol information, including all the standard drug data plus regulatory and investigator information, is displayed as a report on the user's terminal. The order-entry pathway allows the research pharmacist to predesign medication labels that are specific to each study and include all required information. This saves time, ensures accurate labeling, and provides a means for generating patient charges. The patient-monitoring component provides information to the research pharmacist in a daily report to assist in locating subject patients and to monitor compliance with protocols. The system has improved the access of health-care professionals to investigational drug information and decreased the time pharmacists spend dispensing these agents. The system has been well received, although up to three weeks is needed to bring the information online. A hospitalwide information system is effective in disseminating information on investigational drugs and facilitating order entry.
The computer is rapidly becoming an interactive workstation for medical research and for clinical decision-making and it has become a preferred instrument for communication and documentation throughout health care. However, when the attempt is made to use the rigid conventions of information processing to impose order on the characteristically volatile and unpredictable phenomena encountered in the clinical setting, deep seated logical issues are uncovered. This challenge has generated the new field of Medical Informatics, one major goal of which is to formulate computer logics that can properly relate the idealized descriptions of disease, the rules for medical practice and the general guidelines for health care to the intricate diversities encountered in the care of individual patients. The Integrated Academic Information Management System (IAIMS) program of the National Library of Medicine provides the most ambitious environment for research in this new endeavor.
Computer-assisted three-dimensional (3D) reconstruction of the biliary tree including extrahepatic and intrahepatic parts was performed from surgical or autopsy materials from 12 patients with hepatohilar bile duct carcinoma in an effort to visualize three-dimensionally the distribution of carcinoma and dysplasia. In each case, material including a hepatic lobe was reduced to serial slices 1 mm thick using a ham slicer, then the tumors, ducts with carcinoma in situ, and those with dysplasia were submitted to reconstruction. In a 3D map of biliary tree reproduced on a display, a dysplastic zone was shown in most cases surrounding a focus of carcinoma, justifying the assumption of a dysplasia-carcinoma sequence. The carcinoma itself proved to form multiple foci along bile ducts in as many as 42% of the patients, in some of whom the foci were independent without any intervening dysplasia. These results suggest that as extensive a surgical measure as possible should be taken in designing a strategy against this tumor.
Selection of a nuclear medicine computer system is a process that should be approached with care and forethought. The general scheme should be to define your needs and constraints, determine what is available, investigate the leading candidates, make a site visit, and, finally, submit an order. Through a series of discussions between members of the Computer Council of the Society of Nuclear Medicine and representatives from the manufacturers of computer systems, a set of important considerations emerged, which are reported in this paper. This paper is not intended to be a step-by-step guideline to the purchase of a computer system. Rather, it is a set of concepts and considerations with which the prospective purchaser should be familiar before undertaking such a purchase.
BACKGROUND: Purchasing an office computer can be time consuming and frustrating. Financial costs and time demands make it difficult for the family physician, especially in solo practice, to follow the many recommendations offered in the literature. The purpose of this study was to identify the most helpful selection factors used by family physicians who had already purchased an office computer. METHODS: In May 1990 an 18-item questionnaire was mailed to a random sample of 26 percent of the 1167 active members of the Washington Academy of Family Physicians. A final response rate of 45 percent was achieved. Twenty-three percent of the nonresponders were contacted to obtain information about practice demographics and office computer status. RESULTS: Seventy-three percent of responders reported using a computer in their practice. The mean cost ranged from $17,300 for solo practitioners to $55,000 for multispecialty groups. Respondents who reported performing a prepurchase needs assessment, involving the office staff in the decision process, and making cost comparisons were more satisfied with their computer systems than those who did not (P less than 0.05). Satisfaction and acceptance were lower and negatively related to an increasing amount of time needed for the system to become fully operational (P less than 0.01). The level of involvement by the practitioner in the decision process was highly predictive of satisfaction with a computer system: those physicians who were most involved were also the most satisfied. CONCLUSIONS: Family physicians responsible for selecting an office computer for their practices are advised to become personally involved in the decision process, evaluate the practice's needs and goals, involve the office staff, and compare costs before choosing a system. A set of guidelines for selecting an office computer is presented.
A clinical laboratory is a dynamic organization that suffers when constrained to a static environment. Its approach to information management must be predicated on an ability to deal comfortably with change whenever necessary. It is important to view an information system as a dynamic process rather than a static object to be used for some time and then discarded for a newer model.
Users of scintigraphic computer systems manufactured by Medical Data Systems (MDS) frequently experience textured distortion of oscilloscope images when scans are produced by Z-axis modulation. The source of this malfunction has been identified and a way to eliminate the problem is described. The modification is simple and inexpensive. The availability of Z-axis modulation significantly enhances the capabilities of MDS systems.
Explore the source record for details and available documents.
A computer system was developed for two private radiology offices, consisting of six modular components, a history file, registration file, assisted reporting module, appointment management module, accounting module and statistical module. Effectiveness and efficiency of patient care have been increased substantially.
A computer system has been designed for documentation and data acquisition during open heart surgery. This computer system (called 'Carola') processes all patient data during cardiac surgery. More than 50 analogue or digital signals are scanned. These are derived from a monitoring rack, a Siemens Servo 900B ventilator with its accessory devices and a heart lung machine. All these values are plotted as well as offline data, such as medications, fluids, laboratory results and user comments, on an A3 format anesthetic record using an eight pen flat bed plotter. Simultaneously all data is written onto a cassette tape. These tapes are then transferred to a database for storage and statistical processing. The sampling frequency is every 10 seconds, averages being calculated over one minute periods. The chart is updated once a minute normally or every 15 minutes for slowly changing signals e.g. temperatures. Hardware and software of the computer have modular design. The hardware consists of two Motorola 6809 based microprocessor systems. The software is entirely written in Pascal. The user interface is implemented on a menu driven basis. A terminal with a keyboard is used for the communication with the users, namely anesthetic nurses and anesthesiologists. The system was readily accepted by the users. The menu structure proved to be easy to learn and allowed fast entries, even when the users were not previously accustomed to the use of a keyboard. The clear and detailed presentation of the data on the plotted chart helped to detect trends early and facilitated therapeutic decisions. From december 1983 the first prototype was used on a routine basis, followed by a second unit in June 1984 and a third in December 1985. Up to now more than 12.500 anesthetic hours have been recorded. Since then almost 100% of all anesthetics performed in our cardiothoracic unit have been documented by the computers, including all short procedures without invasive monitoring and all emergencies.
A computer system has been developed to meet the requirements of equipment management. The system was originally developed to run on personal computers, but has been upgraded to provide true multiuser facilities and more advanced program capabilities. This has been achieved using improved hardware and a relational database. The manner in which the software operates is described, with some examples examined in more detail. The system provides a wide range of information, including inventory data, repair costs and time as well as service records and worksheets. In addition it meets the other basic requirements of the department, including wordprocessing, budgetary control and stock control. The system also provides an immediate and rapid overview of the repair state of all equipment whilst reducing administration time for many aspects of the service. Emphasis has been placed on the integrity of the data and ease of entry of additional data.
A computerized unit dose drug distribution system, part of an online hospital information system, is described. Differences between manual and computerized pharmacy distribution, and the advantages and deficiencies of the automated system are discussed. The system seems to improve pharmacy's efficiency, accuracy, control of drugs and capabilities for patient monitoring and drug use review. If mechanical failure occurs, back-up procedures keep the distribution system operational. The computer system is believed to decrease the time spent by pharmacists on routine distribution tasks, leaving time for other necessary pharmacy functions.
A long-term surveillance system using a computer system was established for the follow-up study on the protective effect of measles vaccination. More than 3,000 children, 3 to 6 years of age, who were immunized with measles vaccines by various methods have been registered in the system since 1971, and their outcomes with regard to measles have been followed up every year. The subjects were divided into three groups by the vaccination method: live vaccine alone (L), further attenuated live vaccine alone (FL), and the combined use of live and killed vaccines (KL). From comparative studies with these groups, the following results were obtained: (1) Annual measles incidence rates were found to be the lowest in L group followed by FL and KL. (2) Accumulated incidence rates of measles for 10 years in L, FL and KL groups calculated were 1.90, 2.49 and 17.84%, respectively. A linear regression was observed only from 0 to 3 years after vaccination in L and FL groups, and from 0 to 9 years in KL group. KL group showed a significantly larger regression coefficient than did the former two groups. (3) Protection rates against close contact with measles in families calculated were 97% in L and FL and 80% in KL group, respectively. (4) Low but detectable levels of antibody titers were observed in the sera for at least 4--6 years after vaccination.