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A computer system for the storage and retrieval of clinical pharmacokinetic data.

A computer system is described which stores patients data relating to clinical pharmacokinetic assessments made by clinical pharmacists, who are participating in a clinical pharmacokinetics service. The system was developed to assist in the documentation of service activities and storage of patients' pharmacokinetic data. An additional component of the system is the ability for retrospective review of the stored data. Application of this system to the derivation of new information on drug pharmacokinetics and drug efficacy/toxicity in various patient groups is discussed. The implications for phase IV drug studies and toxicity screening studies is also described.

Computers↗

Will HIV-positive people use an interactive computer system for information and support? A study of CHESS in two communities.

A study of use of an interactive computer system (CHESS--Comprehensive Health Enhancement Support System) by HIV-Positive people was conducted in Madison and Milwaukee during Fall 1992 and Winter 1993. Computers were placed in homes, and use monitored by the computer. Results showed that the system was used heavily by both samples, and that gender (women used it more) age, (younger used it more), living arrangements (those living alone used it more), and need for health care information (those who felt the most need used it more) but not education predicted use of CHESS. The authors argue that heavy CHESS use by a wide variety of HIV-positive people suggests that the computer can overcome "information poor" barriers in health information campaigns.

Adult↗

Control of antibiotic therapy in pediatric patients. I. A computer system to collect and analyze antibiotic prescriptions in hospitals.

A computer system to record and analyze antibiotic prescriptions in hospitalized children is described. This system is especially organized in order to obtain simultaneously a quantitative evaluation of antibiotic use and a qualitative analysis of the process by which the physician makes his decision for therapy. The practical employment of this program has been demonstrated by analyzing 765 prescriptions given in nine different pediatric hospital wards. Many errors of prescription have been demonstrated: antibiotic therapy was based on the clinical impression alone in 31.5% of the prescriptions, antibiotic choice was rational in 20.1% and the posology prescribed complied with the usually applied schemes in 22.4%. Finally, the physician's attitude regarding laboratory monitoring of side effects was adequate in 52.8% before treatment and 33.4% during antibiotic treatment.

Aging↗

Providing financial justification to support a stand-alone computer system in a large tertiary-care hospital.

An assessment of the pharmacy's needs and an evaluation of the pharmacy's batch-oriented data processing system supported the acquisition of a new computer system to meet the pharmacy's requirements in the areas of: Medication order entry Response time Capability to interface a materials management system Capability to interface to a patient billing program Development of an audit trail for patient charges Management reports Flexibility for future needs Conversion from a dated batch-oriented system to a medication on-line computerization system has provided enhanced benefits in the areas of fiscal accountability, inventory management, improved quality of pharmaceutical services (drug distribution and drug therapy monitoring), and employee productivity.

Capital Expenditures↗

A comprehensive laboratory computer system working round the clock.

The special features of a laboratory computer system operated by laboratory staff around the clock are presented. The system provides registration of work, production of worksheets, on-line data acquisition and reporting results. The reasons for the special design features are discussed.

Allied Health Personnel↗

How not to select a computer system.

Deciding whether you should computerize the laboratory is a decision of the past. Today the question is which system to select. Here is a simple, practical approach to choosing a computer system.

Computers↗

Comparing user acceptance of a computer system in two pediatric offices: a qualitative study.

The purpose of this qualitative study was to examine user acceptance of a clinical computer system in two pediatric practices in the southeast. Data were gathered through interviews with practice and IS staff, observations in the clinical area, and review of system implementation records. Five months after implementation, Practice A continued to use the system but Practice B had quit using it because it was unacceptable to the users. The results are presented here, in relation to a conceptual framework, which was originally developed to describe the process of successful implementation of research findings into practice. Five main themes were identified relative to the differences in user acceptance at the two practices: 1) Benefits versus expense of system use varied, 2) Organizational cultures differed, 3) IS staff's relationship with practices differed, 4) Post-implementation experiences differed, and 5) Transfer of technology from the academic center to private practice proved challenging in Practice B. The findings indicate a need for the development and validation of tools to measure healthcare organizational climate and readiness for change.

Ambulatory Care Facilities↗

A comprehensive interactive on-line computer system for research and clinical practice in orthodontics.

An interactive on-line computer system for the measurement of cephalometric radiographs, and facial and plaster cast photographs is described. The details of the hardware (computer and peripherals) and software are provided. Numerical and graphical analysis and presentation of the resultant data are discussed. Many research and clinical applications of the system are outlined.

Cephalometry↗

AUTOGRP: an interactive computer system for the analysis of health care data.

AUTOGRP is an interactive computer system designed to facilitate rapid analysis of complex medical information. AUTOGRP allows the clinical or administrative expertise of the user to be combined with sophisticated computer techniques to permit rapid information retrieval, hypothesis testing, development of norms, and identification of deviant cases. This interaction yields results of a uniquely high statistical and medical quality. AUTOGRP has been used to aid in understanding the process of patient care management in a variety of settings in order to enhance the effectiveness of decision-making from both a medical and management point of view.

Computers↗

Medical office computer systems. The selection process.

This article highlights the process that a physician should undertake in selecting and implementing a business computer system for the office. Included are suggested approaches to identifying needs, establishing priorities, and communicating requirements to prospective vendors. Methods for reviewing various systems to evaluate whether they meet the practice's defined requirements are suggested.

Computer Systems↗

Computational systems biology.

To understand complex biological systems requires the integration of experimental and computational research -- in other words a systems biology approach. Computational biology, through pragmatic modelling and theoretical exploration, provides a powerful foundation from which to address critical scientific questions head-on. The reviews in this Insight cover many different aspects of this energetic field, although all, in one way or another, illuminate the functioning of modular circuits, including their robustness, design and manipulation. Computational systems biology addresses questions fundamental to our understanding of life, yet progress here will lead to practical innovations in medicine, drug discovery and engineering.

Animals↗

[EXPR: a simple computer system for recording animal behavior].

A number of different methods for recording animal behaviour are briefly reviewed and the computer system "EXPR" for the ethological recording of the sequences of behavioural events is described in this article. The main peculiarities of the system are: (a) recorded data are saved to the files created by a data analysis package, (b) it is possible to record simultaneously behaviour of a number of individuals, which is crucial for the analysis of social interactions. The user can specify the options for different recording tasks through the setup file written with using special notation. The program functioning is illustrated by an artificial example.

Animals↗

A computer system for analysis and integrated description of regulation of the molecular-genetic system of interferon induction and action.

A new theoretical approach to elaboration of an information-analytical integrated knowledge base containing data on regulation and function of biological systems is presented. The knowledge base incorporates: (i) a reference database containing experimental data on the structural-functional organization of a biological system; (ii) a dynamic mathematical model for analysis of the evolution of the system over time; and (iii) an interpretation module of simulation results. Application of this approach to theoretical investigation of the interferon system in the case of viral infection is discussed. The approach is specific in that it uses mathematical modeling technology, which allows one to generate mathematical models of different degrees of complexity in the analysis of the diverse aspects of biological system behavior. This approach allows one not only to store and to treat available experimental data, but also to acquire new knowledge about the behavior of a biological system. The proposed approach is implemented as a computer system for the IBM PC and compatibles.

Algorithms↗

PEN-Ivory: the design and evaluation of a pen-based computer system for structured data entry.

PEN-Ivory is a pen-based computer system that uses structured data entry for creating patient progress notes. Users make simple gestures such as circles, lines, and scratch-outs to enter medical findings from a controlled vocabulary. The result of an interaction with PEN-Ivory is a computer-generated patient progress note in English prose. We designed PEN-Ivory's user interface in a principled way. We first created multiple working prototypes, each differing in one of three user-interface characteristics. Then we empirically evaluated the prototypes in a controlled, experimental setting for their efficiencies in enabling users to create patient progress notes. The prototype that allowed the fastest data entry had the following three user-interface characteristics: it used a paging form, used a fixed palette of modifiers, and made available all findings from the controlled vocabulary at once.

Handwriting↗

[Results of the marketing research study "Acceptance of physician's office computer systems"].

We report on a market research study on the acceptance of computer systems in surgeries. 11,000 returned questionnaires of surgeons--user and nonuser--were analysed. We found out that most of the surgeons used their computers in a limited way, i.e. as a device for accounting. Concerning the level of utilisation there are differentials of Men-Women, West-East and Young-Old. In this study we also analysed the computer using behaviour of gynaecologic surgeons. As a result two third of all nonusers are not intending to utilise a computer in the future.

Adult↗

Initial experience with a small dedicated computer system in a diagnostic x-ray department.

The operation of a small computer system involved in day to day management in an X-ray department is described. The system consists of the following equipment: PDP 8/F central processor with 8K core storage, 32K magnetic disc storage, High-speed paper tape reader (300 characters/s) and punch (50 characters/s), 3 Olivetti TE318 terminals with sprocket feed, paper tape reader and punch (10 characters/s). The system stores patient data relating to name, address, age, ward, referring physician, examination(s) requested, date of request, date of examination, date of report. From this data a large volume of relevant statistics is made available to the department and to the health authority. Labels for identifying record card, film envelope and X-ray films are automatically typed. During reporting coded phrases can be used by the radiologist. Interesting films can be recorded and recalled for library or consultation purposes as can research items. At report typing stage, the report heading is automatically recalled from the computer store. Coded phrases are typed automatically as is the radiologist's name and the date of the report. A 'DAYBOOK' IS TYPED AUTOMatically at the end of each working day. Problems encountered in running the system and future developments are described.

Computers↗

Hospital pharmacy computer systems: request for proposal and the selection process.

In this paper the various steps necessary for selecting a hospital pharmacy computer system are briefly outlined. The major steps include: establishment of the project leader and team; preparation of functional specifications for the pharmacy department; solicitation of vendor presentations; and site visits. Following this, functional specifications are refined and the Request for Proposal is prepared. The Request for Proposal outlines to each prospective vendor the conditions and terms the hospital will agree to enter with the chosen vendor. Evaluation of vendor proposals includes such factors as cost, software applications, interfaces, maintenance, and vendor stability. Vendor evaluation can be quantified based upon pre-defined selection criteria utilizing the application of weight factors to each criteria and scoring each vendor. Therefore, the final decision should be based on which vendor best meets that hospital pharmacy's specific needs as determined by both informal and formal mechanisms.

Canada↗