Biomedical subjects

E M O'Connell

Publications and source records attributed to E M O'Connell.

7 recordsLinked to original sources

PubMed2000

A knowledge-based patient assessment system: conceptual and technical design.

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring.

Artificial Intelligence↗

PubMed1998

Modifiable templates facilitate customization of physician order entry.

Physician order entry is a key factor in improving the quality of healthcare, while simultaneously reducing its cost. This paper describes an editor, a database, and a run-time system for creating and executing highly customized, user modifiable, order entry templates. The system allows non-programmers to create new order entry templates rapidly. Over the past 18 months, the templates have been used on over 2500 patients to enter over 40,000 separate orders.

Database Management Systems↗

PubMed1996

An information system to improve the safety and efficiency of chemotherapy ordering.

We developed a computer application to support the ordering of chemotherapy. Key goals were to guard against errors in chemotherapy ordering and dosing, to, coordinate the outpatient and inpatient chemotherapy services, and to support the overall process flow of a chemotherapy cycle. In a six-month period, 512 daily-dose and 386 weekly-dose warnings were generated; 167 (19%) resulted in a cancellation or re-evaluation of the dose. The system has been well accepted, and has helped to coordinate the efforts of the many members of the oncology care team.

Antineoplastic Agents↗

PubMed1996

A comprehensive inpatient discharge system.

Our group has developed a computer system that supports all phases of the inpatient discharge process. The system fills in most of the physician's discharge order form and the nurse's discharge abstract, using information available from sign-out, order entry, scheduling, and other databases. It supplies information for referrals to outside institutions, and provides a variety of instruction materials for patients. Discharge forms can be completed in advance, so that the patient is not waiting for final paperwork. Physicians and nurses can work on their components independently, rather than in series. Response to the system has been very favorable.

Continuity of Patient Care↗

PubMed1995

Evidence for lineage commitment and initiation of positive selection by thymocytes with intermediate surface phenotypes.

Previous studies have shown that both MHC class I and class II molecules can stimulate CD4+CD8+ thymocytes to develop into TCRint cells with surface phenotypes, suggesting initial differentiation along either the CD4 or CD8 developmental pathways. In accord with the view that these cells have undergone lineage commitment, we show here that CD4intTCRint cells generated by recognition of either MHC class show the same partial down-regulation of CD8 from the level on precursor double positive thymocytes as do almost mature CD4intTCRhigh cells positively selected only by MHC class I recognition. As expected of cells undergoing positive selection, we find that either class I or class II MHC molecules on radioresistant thymic stromal cells alone are sufficient for generation of both types of transitional phenotype cells. Biases in V beta representation associated with allele-dependent positive selection are seen only in the TCRhigh and not the TCRint cohorts, however. These findings are consistent with the hypothesis that transitional phenotype thymocytes have begun but not completed positive selection, and that entry into the CD4 vs CD8 pathways is not uniquely determined by the specific coreceptor-MHC molecule interaction involved in precursor thymocyte activation.

Animals↗

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↗

PubMed1977

Vision tests as predictors of learning disabilities.

Three relatively new screeening tests for visual problems are described. They are color matching, visual language field development, and the speed of the visual language field development, and the speed of the visual scan. The visual problems so measured were found to be associated with poor school achievement. In color matching, only blue was involved, not red or green, and proficiency was relatively undeveloped before age 10. Throughout, blue matching difficulty was associated with poor visual language field development, but not with slow scanning. Early screening with these tests offers possibilities for early detection of students with potential learning problems.

Adolescent↗