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K S Culp

Publications and source records attributed to K S Culp.

7 recordsLinked to original sources
PubMed2001

Development and utilization of paperless medical records: a unique approach.

The purpose of this article is to describe the development and utilization of a unique paperless medical record system in a large multispeciality group practice setting. The Scott and White integrated health care delivery system provides care over a 34-county area in Central Texas. Since 1988, clinicians at Scott and White have developed a text-based, content-searchable electronic medical record system known as EMRx. This system provides a single clinical data repository that allows patient care activities and aggregate data analyses to occur by using the same set of data on a daily basis. Use of this approach has led to the aggregation of over 9.8 million clinical documents since 1994. Over 1,845 health care providers used the system during May 2000 for direct patient care; 866,114 patient records have been accessed since January 1, 1999 to answer questions related to patient care, quality assurance, outcomes research, and accreditation.

Group Practice↗
PubMed2000

An integrated data warehouse system: development, implementation, and early outcomes.

This paper describes a generic vision of global information flow and the development of an integrated data warehouse system, using clinical data on all patient encounters and administrative data on all operating transactions as part of an integrated health care system. This new integrated data warehouse system has been successfully used for multiple purposes, including patient care, health services research, resource utilization and feasibility studies. During 1999, core analyses included the electronic abstraction, aggregation, and analysis of data on over 400,000 patients. This approach to building a centralized data system comprised of multiple repositories efficiently meets a variety of individual and aggregate information needs, while reducing the need to create duplicate databases.

Database Management Systems↗
PubMed1999

Use of a Web-based process model to implement security and data protection as an integral component of clinical information management.

Delivery of health care at Scott and White, a large integrated health care delivery system, is supported by an Electronic Medical Record (EMR) system repository of six million SGML-based documents. Control of document access is currently based on standard commercial security and confidentiality methodologies. Given the planned release in Fall 1999 of new federal security and confidentiality requirements, we have developed a web-based security process model that "wraps" existing EMR documents with HTML-compliant security attributes. Resulting logical documents are filtered regarding user queries by mapping the security attributes of the data to specific user role characteristics. A key virtue of our approach is that source EMR data do not undergo alteration by the imposition of the security process. It also places no additional work load or query pressure on the existing EMR system.

Computer Security↗
PubMed1982

Autoimmune associations in primary biliary cirrhosis.

The prevalence of autoimmune associations was determined in 113 patients with primary biliary cirrhosis who participated in a therapeutic trial of D-penicillamine. Eighty-four percent of the patients had at least one associated autoimmune disease and 41% had two or more such diseases in addition to primary biliary cirrhosis. Keratoconjunctivitis sicca, which was present in 66% of the patients, was the most commonly associated autoimmune disease. In most of the patients the autoimmune disease was recognized after the diagnosis of primary biliary cirrhosis had been made. The prevalence of autoantibodies in selected subgroups of patients ranged from 70% (rheumatoid factor) to 22% (anti-native DNA). Polyclonal elevation of serum immunoglobulins was a consistent finding, and frequently all three major isotypes were simultaneously increased. Only IgA elevations correlated with histologic progression of primary biliary cirrhosis. The prominent involvement of epithelial tissues in the autoimmune disease of primary biliary cirrhosis suggests that an autoimmune syndrome affecting the secretory immune system is associated with the pathogenesis of primary biliary cirrhosis and the coexisting autoimmune diseases.

Adult↗