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Biomedical subjects

Denis Protti

Publications and source records attributed to Denis Protti.

17 recordsLinked to original sources

Primary care computing in England and Scotland: a comparison with Denmark.

This paper compares the status of primary care computing in England and Scotland with that of Denmark. The rate of utilisation by Danish GPs is among the highest in the world and the MedCom national health network handles over 90% of the country's primary sector clinical communications. A high proportion of English and Scottish GPs also use computers in their clinical practices, and like their Danish colleagues, they benefit from more accurate and streamlined medications management, particularly in terms of repeat prescriptions. The historical forces and factors which influenced the development of primary care computing are identified and discussed.

Attitude to Computers↗

Clinical electronic communications: a new paradigm that is here to stay?

The authors discuss the current status of clinical electronic communication, including e-mail and secure Web messaging, among physicians and between physicians and their patients. The paper provides a concise summary of what is known about clinical electronic communications in healthcare: what is working, what the challenges are and what is promising.

Canada↗

A review of information management practices for health ministries.

This is a review paper on best practices in information management for health ministries in governments. It is based on a recent study in which we examined information management (IM) and information technology (IT) functions inside a provincial health ministry. In order to foster best IM practices we offer five key guiding principles followed by five recommendations for action. We urge governments to consider these principles and recommendations when planning the IM function for their health ministries.

Benchmarking↗

Bioinformatics meets clinical informatics.

The field of bioinformatics has exploded over the past decade. Hopes have run high for the impact on preventive, diagnostic, and therapeutic capabilities of genomics and proteomics. As time has progressed, so has our understanding of this field. Although the mapping of the human genome will certainly have an impact on health care, it is a complex web to unweave. Addressing simpler "Single Nucleotide Polymorphisms" (SNPs) is not new, however, the complexity and importance of polygenic disorders and the greater role of the far more complex field of proteomics has become more clear. Proteomics operates much closer to the actual cellular level of human structure and proteins are very sensitive markers of health. Because the proteome, however, is so much more complex than the genome, and changes with time and environmental factors, mapping it and using the data in direct care delivery is even harder than for the genome. For these reasons of complexity, the expected utopia of a single gene chip or protein chip capable of analyzing an individual's genetic make-up and producing a cornucopia of useful diagnostic information appears still a distant hope. When, and if, this happens, perhaps a genetic profile of each individual will be stored with their medical record; however, in the mean time, this type of information is unlikely to prove highly useful on a broad scale. To address the more complex "polygenic" diseases and those related to protein variations, other tools will be developed in the shorter term. "Top-down" analysis of populations and diseases is likely to produce earlier wins in this area. Detailed computer-generated models will map a wide array of human and environmental factors that indicate the presence of a disease or the relative impact of a particular treatment. These models may point to an underlying genomic or proteomic cause, for which genomic or proteomic testing or therapies could then be applied for confirmation and/or treatment. These types of diagnostic and therapeutic requirements are most likely to be introduced into clinical practice through traditional forms of clinical practice guidelines and clinical decision support tools. The opportunities created by bioinformatics are enormous, however, many challenges and a great deal of additional research lay ahead before this research bears fruit widely at the care delivery level.

Computational Biology↗

Patient safety: is the evidence strong enough that information technology can help?

It is not difficult to prepare a commentary on Dr. Morgan's invited essay "In Pursuit of a Safe Canadian Healthcare System" if one agrees with almost everything he reveals and postulates. When a respected young practising physician candidly and forcibly makes a case for the need for significant healthcare system reform, one must sit up and take notice. If nothing else, his statement "outpatient medical errors are the bread and butter of internal medicine hospital admissions" should cause us to be deeply concerned. Dr. Morgan pleads for a number of reforms, such as the creation of a Patient Safety Board akin to Canada-s Transportation Safety Board, the demonstration of an ROI for the electronic health record, the introduction of computerized physician order entry, and a number of other suggestions. Due to limitations of time and space, we will react to only a few of his views, mildly disagreeing with some while strongly reinforcing others.

Canada↗

A proposal to use a balanced scorecard to evaluate Information for Health: an information strategy for the modern NHS (1998-2005).

The author was invited to assist in the development of an evaluation methodology for the Strategy. One of the conundrums of measuring the information management & technology (IM&T) function is that infrastructure investments cannot be cost justified on a return on investment basis. The balanced scorecard (BSC) is a means to evaluate corporate performance from four different perspectives: the financial perspective, the internal business process perspective, the customer perspective, and the learning and growth perspective. An IM&T BSC for Information for Health was recommended as means of allowing managers to see the positive and negative impacts of IM&T activities on the factors that are important to the NHS as a whole.

Benchmarking↗