Biomedical subjects

S F Mandell

Publications and source records attributed to S F Mandell.

6 recordsLinked to original sources

PubMed1998

Development of a web based electronic patient record extending accessibility to clinical information and integrating ancillary applications.

Web-technology offers a powerful mechanism for providing access to clinic information. Applications need no longer to be tied to a specific client operating system. The Johns Hopkins Hospital has designed a web based electronic patient record system which seamlessly incorporates multiple web sites. This paper will discuss the motivations for building the system, the architecture, and the challenges faced in designing the architecture.

Academic Medical Centers↗

PubMed1990

The benefits and perils of system integration.

The current health care environment is complex, with no single systems solution dominating the marketplace. A new approach utilizes Networked Systems Integration to link disparate systems together. This paper discusses the Systems Integration approach and suggests that it encourages user commitment, provides greater modularity, is cost effective, and supports solutions that offer greater functionality. However, it is noted that this approach is not without problems that can dramatically effect the realization of benefits.

Competitive Bidding↗

PubMed1989

Advanced Multi-Attribute Scoring Technique (AMAST): a model scoring methodology for the request for proposal (RFP).

The continued demand for more efficient and functionally rich automated systems will force health care facilities into a changing and complex marketplace. As the Request for Proposal (RFP) will be the key document in the systems acquisition process, it is imperative that a systematic process must be established to evaluate the vast array of data collected. It is suggested in this paper that the effective application of the Advanced Multi-Attribute Scoring Technique (AMAST) will assist in this process, enhance the decision making process and reduce the risk associated with systems development and procurement.

Competitive Bidding↗

PubMed1987

Resistance to computerization. An examination of the relationship between resistance and the cognitive style of the clinician.

The introduction of computer technology into the health care environment has been fraught with difficulty. The literature has identified that while there are many applications that have been successfully implemented, there are many others that have met significant resistance. As such, the diffusion of computer technology has been scattered and uneven in the health care arena. Some scholars attribute the problems of resistance to structural variables such as value conflicts, power conflicts, and ones that involve the man-machine interface. Other view the resistance as process-oriented, citing such key factors as inadequate training, lack of user involvement, and discomfort due to organizational change. It is held here that the essence of resistance to computerization in clinical settings is based upon the difference between the cognitive style of the user and that required by the computer. It appears that since the decision-making methods of the user tend to favor intuitive processes, he or she becomes more resistant to using a system that forces qualitative information into quantitative niches. This study examines the cognitive style of two groups of health care providers within a hospital, and attempts to provide insight into how personal decision-making processes are related to resistance to computerization. It is suggested that a more thorough understanding of this relationship will enhance the ability of health care facilities to implement new systems in the future.

Adult↗

PubMed1986

The request for proposal (RFP). The key document in successful systems acquisition.

The health care industry is complex and changing. Management in this environment requires significant quantities of accurate timely data for administrators and clinicians alike. In response to this demand, health care facilities have sought to upgrade or replace their computer systems with ones that have greater ability to enhance decision making in real time. The standard development process dictates a requirements analysis, with a Request for Proposal (RFP) as a likely product. This document, which delineates the institution's needs and provides a guide for appropriate vendor responses, has been given scant attention in the literature, particularly in the health care environment. This paper attempts to provide insight into what the goals and objectives of the RFP should be and explicates those elements that are necessary to produce an effective instrument. It details what information should be included about the institution, basic hardware and software issues that should be addressed, and proposes guidelines for response and evaluation. It is suggested that the proper development of an RFP will be a key factor in the successful acquisition of an appropriate health care information system.

Competitive Bidding↗

PubMedDate not supplied

Contrasting views of physicians and nurses about an inpatient computer-based provider order-entry system.

OBJECTIVE: Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers' evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care. DESIGN: Survey. MEASUREMENTS: Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses. RESULTS: Responses were received from 85 percent of the sample. Most physicians and nurses agreed that orders were executed faster under POE. About 30 percent of house officers and attendings or fellows, compared with 56 percent of nurses, reported improvement in overall quality of care with POE. Forty-four percent of house officers and 34 percent of attendings/fellows reported that their time with patients decreased, whereas 56 percent of nurses indicated that their time with patients increased (P < 0.001). Sixty percent of house officers and 41 percent of attendings/fellows indicated that order errors increased, whereas 69 percent of nurses indicated a decrease or no change in errors. Although most nurses reported no change in the frequency of ordering tests and medications with POE, 61 percent of house officers reported an increased frequency. CONCLUSION: Physicians and nurses had markedly different views about effects of a POE system on patient care, highlighting the need to consider both perspectives when assessing the impact of POE. With this POE system, most nurses saw beneficial effects, whereas many physicians saw negative effects.

Attitude to Computers↗