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At least 217 records · Page 12Linked to original sources
PubMed2001

[Implementation of a new electronic patient record in surgery].

INTRODUCTION: The increasing amount of clinical data, intensified interest of patients in medical information, medical quality management and the recent cost explosion in health care systems have forced medical institutions to improve their strategy in handling medical data. In the orthopedic department (3,600 surgeries, 75 beds, 14,000 consultations) software application for comprehensive patient data management has been developed. METHOD: When implementing the electronic patient history following criteria were evaluated: 1. software evaluation, 2. implementation, 3. work flow, 4. data security/system stability. RESULTS: In the first phase the functional character was defined. Implementation required 3 months after parametrization. The expense amounted to 130,000 DM (30 clients). The training requirements were one afternoon for the secretaries and a 2-h session for the residents. The access speed on medically relevant data averaged under 3 s. The average saving in working hours was approximately 5 h/week for the secretaries and 4 h/week for the residents. The saving in paper amounted to 36,000 sheets/year. In 3 operational years there were 3 server breakdowns. CONCLUSIONS: Evaluation of the saving on working hours showed that such a system can amortize within a year. The latest improvements in hardware and software technology made the electronic medical record with integrated quality-control practicable without massive expenditure. The system supplies an extensive platform of information for patient treatment and an instrument to evaluate the efficiency of therapy strategies independent of the clinical field.

Database Management Systems↗
PubMed1995

[A new software for handling surgical data in strabology].

BACKGROUND: Numerous measurements and data are the hallmark of strabismology. Handling these data is greatly facilitated by the use of computers. An adequate software should also allow surgical results analysis and quality control. Standardisation of data is mandatory. METHODOLOGY: We developed such an application based on a commercially available database (4th Dimension, ACI Paris). It uses 5 relational files. RESULTS: This software is userfriendly and can be used by anyone. No special code is necessary to enter data and these values are automatically verified. Patient's data, diagnosis, type of surgery and angle measurements (pre- and post surgery) can be entered, usually by an orthoptist, right after examination. CONCLUSION: Numerisation of strabologic surgical data can be easily realised with the help of a programmable database, but rigorous terminology is mandatory. Indeed the use of a strict terminology is helpful in teaching hospitals.

Computer Graphics↗
PubMed2000

Integrating users' activity analysis in the design and assessment of medical software applications: the example of anesthesia.

As the computers become more and more and aid for the management of medical information, some specialists like anesthetists demand specialized applications to support their own activity. Usually, these applications are developed following a Users' Requirements analysis and functional specifications. We demonstrate here that when the management of medical information is closely intertwined with the physician's activity, it is also necessary to perform a precise ergonomics analysis of this activity in order to identify the cognitive and organizational constraints that affect the usability and acceptance of the tool. We report here the results of such an analysis for the pre-operative anesthetic consultation, and illustrate this analysis with the evaluation of a computerized anesthetic record.

Anesthesia↗
PubMed1990

Will we see automated record keeping systems in common use in anesthesia during our lifetime? The automated anesthetic record is inevitable and valuable.

The automated anesthetic record is inevitable for at least three reasons: First, much of the information is in electronic form. Second, all the necessary tools for transferring this information into a computer and hence onto a piece of paper are already available. Third, the need for an improvement over the current way of keeping records is widely recognized. Manual records are often inaccurate, biased, incomplete, and illegible, and they divert attention from more important tasks of the anesthetist. Although automated record keeping will not produce perfection, it will improve the situation enough to justify the effort.

Anesthesia↗
PubMed1996

Systematic planning of clinical documentation.

All information obtained from a patient in the course of medical care is a potential part of clinical documentation. The documentation usually serves a number of different purposes. The task of a documentation system is to fulfil these purposes in a methodically correct manner and as economically as possible. This requires that the properties of the documentation system be planned systematically with a view to the goals pursued. To support systematic planning, a "documentation protocol" is proposed analogous to the "study protocol" used for controlled clinical trials. The individual sections of the proposed documentation protocol are described and the design options which exist in the corresponding planning phases are pointed out. Experience gained by the application of the documentation protocol is discussed.

Data Collection↗
PubMed1990

Will we see automated record keeping systems in common use in anesthesia during our lifetime? The automated anesthetic record will not automatically solve problems in record keeping.

The proponents of automated anesthetic records list the ostensibly logical reasons for them and then claim that automated records will make everything better. The logic goes as follows: (1) It is good to have accurate records because accurate records (a) make clinical decision making more effective and improve patient safety, (b) provide better defense against frivolous lawsuits, and (c) enable more astute medical policy decisions based on improved retrospective case reviews; (2) automatic record-keeping systems will give more nearly accurate records; (3) therefore, quality of care will improve if we acquire automatic record-keeping systems. This logic fails on several counts, which are detailed in this essay. Having said all this, however, I do believe that automated record systems will be implemented and they will be extremely useful, both for the patient and for those who care for the patient. However, we must exercise great care in their design and implementation, lest they wind up doing more harm than good.

Anesthesia↗
PubMed2000

Collection of process data after cardiac surgery: initial implementation with a Java-based intranet applet.

BACKGROUND: Using a Java-based intranet program (applet), we collected postoperative process data after coronary artery bypass grafting. METHODS: A Java-based applet was developed and deployed on a hospital intranet. Briefly, the nurse entered patient process data using a point and click interface. The applet generated a nursing note, and process data were saved in a Microsoft Access database. In 10 patients, this method was validated by comparison with a retrospective chart review. In 45 consecutive patients, weekly control charts were generated from the data. When aberrations from the pathway occurred, feedback was initiated to restore the goals of the critical pathway. RESULTS: The intranet process data collection method was verified by a manual chart review with 98% sensitivity. The control charts for time to extubation, intensive care unit stay, and hospital stay showed a deviation from critical pathway goals after the first 20 patients. Feedback modulation was associated with a return to critical pathway goals. CONCLUSIONS: Java-based applets are inexpensive and can collect accurate postoperative process data, identify critical pathway deviations, and allow timely feedback of process data.

Computer Communication Networks↗
PubMedDate not supplied

[Medical applications of electronic data processing in surgery, trauma surgery and orthopedics. Results of a survey of 1,450 clinics].

With a standardized questionnaire we evaluated 1450 orthopedic and general surgery departments. The response rate was 57.2%, 52% of the departments were using computers for different purposes. The favoured system was the MS-DOS system (73%). The computers were mainly used for word processing (58%), statistics (50%), and graphics (39%). For clinical routine the leading use was patient documentation (70%) followed by patient report generation (43%). Other applications (e.g. online use of administrative data (19.4%) or the use of other patient information like blood parameters (10%)) were relatively rarely used. However, most of the users have plans to incorporate these applications in the nearest future. For the out patients care the leading application is private billing (42.5%) and statistics (30%). The majority of the departments (42.6%) only have one PC. Most of the departments use the printer for hard copies and as hard disc a the standard storage medium. The average storage capacity of the used hard discs is 40 to 80 MB. Other peripheral tools like a laser printer, a scanner, or modems are rarely used. Most of the departments invested between 5000 and 15,000,--DM. 33.3% financed the computers only with the official budget of the department. However, 25.8% only used private funds to buy the hard- and software. The distribution according to zip codes showed a slight accommodation in Bavaria and NRW. The amount of new installations showed an almost constant increase from 1975 until 1981. Between 1981 and 1990 there was a significant increase with a small drop in 1986.

Computer Systems↗
PubMed2002

A standard XML Schema for computerised anaesthetic records.

We believe that one of the most influential developments for the practice of anaesthesia in this decade will be the introduction of a national (or possibly international) standard XML Schema for computerised anaesthetic records, and that such development should be actively promoted by appropriate professional groups. We discuss the implications of such a schema, and make suggestions regarding its requirements. We also report on one approach to the development of an XML Schema for anaesthetic records (provisionally named SnowSchema in honour of Dr John Snow), and compare the current version with the suggested requirements.

Anesthesia↗
PubMed1992

[A computerized anesthesia record system: four years' experience].

A computerized anesthesia record system is in routine use for cardiovascular procedures in our operating rooms. This system is implemented on an NEC PC-9801 personal computer and automatically collects hemodynamic variables from a polygraph as well as from intraoperative laboratory reports via RS-232C ports. Events such as intubation can be entered manually using a standard keyboard. Since the introduction of the system in 1987, the system has been used in 90 percent of the total cases performed and 2941 electronic data files were recorded in a four-year period. Excluding some short procedures for which the system was not used, failure to store records on disks resulted from system errors due to power-line troubles in the operating rooms as well as users' omission to command the system. User-acceptance of event entry was poor. In 74 percent of the cases, not a single event was entered. Advantage of an automated anesthesia record system over a hand-written record is being recognized. Wide-spread use of such a system will require ergonomic design of the system and man-machine interfaces suitable for use in an operating room.

Anesthesiology↗