Biomedical subjects
Publications and source records attributed to J J Falsone.
A three-year experience in urban telemedicine is presented. The digital technology linking a community teaching hospital to a nearby clinic is described, as is the typical protocol for the consultations. The medical advantages and disadvantages, the security implications, and the cost-effectiveness of this project are analyzed.
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In 1992, Informatics training was integrated into the medical residency program at Norwalk Hospital. The program objective was to familiarize the residents with clinical applications of information technology that could enhance their productivity in clinical practice. In its first year, the curriculum was theory oriented. Evaluation of the program at the end of the first year led to a significant restructuring of the program format and curriculum. The trainees did not find theory to be of immediate clinical value, in the second year the program emphasis was redirected toward the development of practical skills. Next year, in 1993, 'Informatics Clinics' were initiated to develop practical Informatics skills that would be useful in a clinical setting. This approach was more successful but did not offer a complete solution. The degree to which the concepts and methods learned are clinically utilized by residents will depend upon the degree of reinforcement provided in the clinical residency years. In addition, there is a need for the development of assessment standards for the evaluation of Informatics literacy levels. In the absence of assessment standards the level of Informatics literacy in medical graduates remains undetermined Consequently, it is difficult to determine whether the training received has transformed expectations into reality.
The clamor for data to study the impact of care, to evaluate clinical performance and justify resource utilization is increasing. The data in demand normally should exist in the record of a clinical encounter. Advances in information technology and software techniques have provided us with tools to develop and implement computer-based patient record systems. The issues that constrain development are integral issues of clinical medicine, such as the variability in medical data, specialized practice of medicine, and differing demands of the numerous end-users of a medical record. This paper describes an approach to develop a computer-based patient record. The focus is on identification of the essential data set by infological data modeling and its implementation in a commercially available package for a physician's office.