Biomedical subjects
Publications and source records attributed to D J Mishelevich.
This paper addresses the question of reliability and the TANDEM-16 approach to facilitate reliable computers. Specifically, the use of the TANDEM-16 within the medical environment is described. Three current applications within the Medical Computing Resources Center at The University of Texas Health Science Center at Dallas are developed, each characterized by different reliability considerations.
Administrative and legal requirements and, in particular, federal and state government health care assistance and social services program regulations all combine to add complexity to the management and operation of ambulatory and inpatient health programs. This paper describes how constantly changing government regulations and differences in interpretations and definitiions have been expensive, time-consuming and sometimes detrimental to health care delivery for two large management and clinical computer-based information systems.
This paper presents points brought out in a panel discussion held at the 12th Hawaiian International Conference on System Sciences, January 1979. The session was attended by approximately two dozen interested parties from various segments of the academic, government, and health care communities. The broad categories covered include the specific problems of government regulations and their impact on specific clinical information systems installed at The University of Texas Health Science Center at Dallas, opportunities in a regulated environment, problems in a regulated environment, vendor-related issues in the marketing and manufacture of computer-based information systems, rational approaches to government control, and specific issues related to medical computer science.
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The medical information, financial, and logistic aspects of a comprehensive computer-based Appointment, Registration, Information System, and Evaluation (ARISE) are analyzed for the management of a family planning program serving 30,000 patients annually. An overview of the existing computer system network is presented with descriptions of the interactive master patient index, the batch appointment process, the management statistics package, and Department of Health, Education, and Welfare (HEW) reporting. Emphasis is placed on the financial management control system which includes 1) procedures for third-party submission of claims for payment, in particular Titles IVA, XX, and XIX (Social Security Act), together with discussion of related administrative requirements; 2) technics of auditing data integrity including systematic sampling of collected data; and 3) the process of billing and receipts collection. Methodology and implementation aspects of ARISE may have wide applicability to other family planning and similarly structured clinical programs.
The use of echocardiography in the diagnosis and assessment of heart disease is increasing as greater familiarity is obtained with this noninvasive procedure. Quantitative evaluation of echocardiographic studies has heretofore required time-consuming manipulation of mathematical formulas. A simple method utilizing a sonic digitizing tablet has been developed for computer-aided analysis of M-mode echocardiograms. This device can convert a point located manually with a digitizing pen into X and Y coordinates and with use of the standard telephone network can communicate on a time-shared basis with a DECSYSTEM-10 computer. A program has been written to compute and type the results of standard calculations involving mitral valve motion and left ventricular function. The information can also be stored on disk by the computer for future use. This simple, relatively inexpensive system is valuable because of the ease with which it permits usually laboriously obtained information to be extracted from the standard echocardiogram.
There is a clinically recognizable facial morphology, the long face syndrome, which has been incompletely described in the literature. On the basis of the clinical summary in thirty-one adults with this syndrome, an analysis of esthetics, skeletal morphology, and occlusion was undertaken. Herein we report on these findings, which confirm that this basic dentofacial deformity is associated with excessive vertical growth of the maxilla. Dental open and closed bite are two variants of the syndrome. An increased mandibular ramus height is associated with the closed-bite group.
An interactive on-line computerized renal transplant matching system called RENTRAN which serves the Southwest Kidney Transplant Region is described. The region consists of one transplant center in Arkansas, two in Oklahoma, and six in Texas. The computer used is the DECsystem-10 located in the Medical Computing Resources Center at Dallas. RENTRAN participants have remotely located standard interactive computer terminals and gain access to the computer by dialing over normal telephone lines. Functions provided by RENTRAN include obtaining instructions, performing a donor-recipient match, obtaining a list of potential recipients, making a user comment or adding, updating or deleting a potential recipient record. Either long or short formats for dialog with the computer system are available for inexperienced and experienced and users, respectively. In the time period from August 1,1973, when the system went into production on February 1, 1976, there have been in excess of 232 matches attempted and approximately 142 kidneys have been transplanted according to RENTRAN results. There are about 361 recipients currently on the data base. The system was developed with funds provided by the Texas Regional Medical Program. Expenses of maintaining the system as well as occasional programmed improvements as deemed appropriate by the Southwest Kidney Transplant Region Registry Committee on the basis of user comments are provided through a $25 per year charge to patients for being listed on the data base.
Hard and soft tissue measurements were obtained for nine Caucasian women. Based on these measurements, regression formulas were derived to approximate the soft tissue covering based on hard tissue data. The results are presented iconically by computer drawings. The preliminary data presented would suggest a definite predictable influence exerted by the facial skeleton on the position of landmarks in the overlying soft tissue.