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PubMedDate not supplied

A database design for community health data.

The ability to collect, store, and retrieve community health data is critical to providing health services in a timely and efficient manner. With the widespread availability of computer hardware and software that can assist in this process, the task is becoming easier. One important tool is the database management system (DBMS). A DBMS provides a conceptual framework to assist in organizing data and software that can physically store, maintain and retrieve data. The most popular DBMSs available today support the Relational Data Model, which has a conceptual framework that provides for the organization of data in tables. The authors present a database design, using the Relational Data Model, for a database of community health data.

Community Health Nursing↗
PubMed1992

A prototype radiation oncology clinical information processing system on a personal computer (network).

Software has been developed that facilitates prospective computer entry of the clinical contents of a radiation oncology chart in a way that assists in retrospective analyses. This software, which has been operational since 1988, now contains detailed clinical information on over 500 patients treated since that time, and limited information on over 3000 children treated since 1970. The system has been programmed using the FoxPro database management system, and may be run on an IBM compatible or Macintosh personal computer either alone or in a networked environment. Information is transcribed as routine patient dictations that require no extra personnel for entry. Standard printouts are the conventional notes compatible with the existing paper chart. Exportation of patient records is facilitated by means of built-in facsimile. The software has been designed to generate detailed reports automatically, including the statuses of selected patients or groups, lists of those who are behind in follow-up, and reports of specific events (e.g., mucositis) that occur before, during, or after therapy using free-text searches. Complete reconstruction of the patient's clinical radiation oncology chart is also included. Other abilities include calculation of Kaplan-Meier survival, relapse-free survival, and local control rates, statistical comparison between survival curves, and radiation dose-response. Exportation of data to statistical and graphics packages is also possible. For pediatric patients, a program to predict stature loss has been incorporated. Use of this system can enhance one's ability not only to follow patients but also to monitor and report their outcome continually. With the need to report institutional experiences and increasing demands to monitor quality assurance, such a system can be of great benefit.

Electronic Data Processing↗
PubMed1991

[The forensic medicine data bank--the Dresden model].

A data bank of forensic medicine is reported, which recreation is possible without any separate treatment. Informations available by computer-aided writing of autopsy-protocols are recorded automatically by a special programme. Coding is made by the SNOMED and METAS systems.

Autopsy↗
PubMed1991

Extensions to the time-oriented database model to support temporal reasoning in medical expert systems.

Physicians faced with diagnostic and therapeutic decisions must reason about clinical features that change over time. Database-management systems (DBMS) can increase access to patient data, but most systems are limited in their ability to store and retrieve complex temporal information. The Time-Oriented Databank (TOD) model, the most widely used data model for medical database systems, associates a single time stamp with each observation. The proper analysis of most clinical data requires accounting for multiple concurrent clinical events that may alter the interpretation of the raw data. Most medical DBMSs cannot retrieve patient data indexed by multiple clinical events. We describe two logical extensions to TOD-based databases that solve a set of temporal reasoning problems we encountered in constructing medical expert systems. A key feature of both extensions is that stored data are partitioned into groupings, such as sequential clinical visits, clinical exacerbations, or other abstract events that have clinical decision-making relevance. The temporal network (TNET) is an object-oriented database that extends the temporal reasoning capabilities of ONCOCIN, a medical expert system that provides chemotherapy advice. TNET uses persistent objects to associate observations with intervals of time during which "an event of clinical interest" occurred. A second object-oriented system called the extended temporal network (ETNET), is both an extension and a simplification of TNET. Like TNET, ETNET uses persistent objects to represent relevant intervals; unlike the first system, however, ETNET contains reasoning methods (rules) that can be executed when an event "begins", and that are withdrawn when that event "concludes". TNET and ETNET capture temporal relationships among recorded information that are not represented in TOD-based databases. Although they do not solve all temporal reasoning problems found in medical decision making, these new structures enable patient database systems to encode complex temporal relationships, to store and retrieve patient data based on multiple clinical contexts and, in ETNET, to modify the reasoning methods available to an expert system based on the onset or conclusion of specific clinical events.

Diagnosis, Computer-Assisted↗
PubMed1991

Dual purpose computer aided program for cardiac catheterization laboratory data management.

This communication describes the design criteria used in the early systems analysis activity of the cardiac laboratory. This analysis activity required an understanding of the cardiology laboratory environment, the establishment of needs to be answered by the program, and the goals of the entire system. The rationale for inclusion of various cardiologic, demographic, quality assurance, and personnel safety parameters is discussed. The input forms used, the database structure created, and the information provided by an applications system are described. Since the system is built around a general-purpose computer (the IBM PC or compatible) and widely available powerful general purpose software, the entire system may be used for many other cardiology laboratory data management tasks.

Cardiac Catheterization↗
PubMed1991

VIDEOFAR: an epidemiologic tool for drug utilization studies.

VIDEOFAR is a computerized drug prescription monitoring system oriented to gain an epidemiological insight into the phenomenon of "drug prescription". The set of activities carried out within the VIDEOFAR project were focused to: define methods of analysis of prescription data, which could be transferred to the peripherical operating settings of the National Health Service (Local Health Units, Epidemiologic Observatories, Regional Pharmaceutical Services, etc.); implement a Drug Data Base to allow a flexible utilization of information; implement software systems in different computer environments.

Data Collection↗
PubMed1991

Large database management in clinical dental research.

Previously the management and analysis of large databases for longitudinal clinical dental research has been severely restricted by the costs of custom-made software and access to suitable computing equipment. However, the recent availability of powerful personal computers and the use of the Scientific Information Retrieval Database Management System (SIR/DBMS) in association with BMDP Statistical Software has now created an enormously powerful tool for extensive and fast data manipulation requiring relatively few commands and the capability to easily perform detailed statistical analyses.

Computer Graphics↗
PubMedDate not supplied

The goal of PACS in Nagoya University Hospital.

In Nagoya University Hospital, a Radiology Intelligent Information System (RIIS) is under construction which will be linked with the Hospital Intelligent Information System (HIIS). RIIS is composed of the radiation oncology information system and the diagnostic radiology information system which is named Imaging Diagnosis Intelligent Information System (IDIIS). IDIIS consists of three parts: (a) the Imaging Diagnosis Management System (IDMS); (b) the Picture Archiving and Communication System (PACS); (c) the Report Generation Support System for Imaging Diagnosis (RGSS-ID). Artificial intelligence methodology is applied to RGSS-ID and IDMS which includes the ordering and scheduling system of diagnostic imaging. IDIIS has an important role to improve the quality of patient care and medical education as well as image management and is an essential component for the implementation of HIIS.

Computer Systems↗
PubMed1991

Intelligent management of epidemiologic data.

In the lifecycle of epidemiologic data three steps can be identified: production, interpretation and exploitation for decision. Computerized support can be precious, if not indispensable, at any of the three levels, therefore several epidemiologic data management systems were developed. In this paper we focus on intelligent management of epidemiologic data, where intelligence is needed in order to analyze trends or to compare observed with reference value and possibly detect abnormalities. After having outlined the problems involved in such a task, we show the features of ADAMS, a system realized to manage aggregated data and implemented in a personal computer environment.

Artificial Intelligence↗
PubMedDate not supplied

A clinical information system for foster care in Israel.

It is a source of great concern in Israel that children placed out of home may lose permanence and may drift in the child welfare system. One way to avoid this danger is to improve the monitoring of the children by using modern information technology as a practice aid. A clinical information system is being installed that responds to the information needs of practitioners on all levels of the foster care system. The viability of the system and its possible effects on practice and on clinical judgment are examined.

Child↗
PubMed1992

Automated therapeutic drug monitoring in an ambulatory care endocrine clinic.

OBJECTIVE: To develop and implement an automated therapeutic drug monitoring system for accessing data from endocrine clinic patients who had been prescribed insulin, oral hypoglycemic agents (OHA), or levothyroxine. DATA SOURCES: We designed a computer system to retrieve clinical data from the Medical Information System (MIS), a centralized hospital computer system, and import this information directly into a Macintosh personal computer. Physician entry of prescriptions for insulin, OHA, or levothyroxine into MIS formed the basis for a computer program to retrieve daily diagnostic and prescription information, demographics, and laboratory analyses, including blood glucose and glycosylated hemoglobin for insulin and OHA orders and free and total thyroxine, total triiodothyronine, and thyroid stimulating hormone for levothyroxine orders. The information was imported into a database program (4th Dimension). RESULTS: The system identifies laboratory values outside of predetermined therapeutic ranges, maintains an up-to-date patient profile, and edits and generates reports. Preliminary experience suggests that automation eliminates 75-90 percent of the time required to manually collect the same information, and improves the accuracy, comprehensiveness, and utility of reports. CONCLUSIONS: Automated therapeutic drug monitoring minimizes the time required to collect clinical data, alerts clinicians to potential problems, and provides a means to assess overall therapeutic management. Our methodology can be used to evaluate other medications in a variety of general or specialty clinics.

Ambulatory Care↗
PubMed1991

Computer systems for dental practice management. A new generation of independent dental software.

A new generation of computer programs for dental patient management eliminates total dependence on the vendor for programming support. The software design enables information collected with the dental system to be transferred to popular off-the-shelf programs designed for business. A simplified example is used to illustrate for practitioners the advantages of this type of data structure management. Programs designed on this basis offer optimum performance and expandibility for both present and future needs.

Computer Systems↗
PubMedDate not supplied

New role of a medical documentation system.

Architecture of a new medical documentation system (MDS) is proposed. First, we studied the traditional MDS in terms of organizational structure, main functions, means (resources) and personnel. Special emphasis is given to the information retrieval (IR) system which is the kernel of a MDS. Then, some achievements of information technology is summarized, and concept of a mixed IR system which is the kernel of the new system is presented. New architecture is then presented. Units which compose the entire system are: host documentation centre, local documentation centres, and documentation units. Eventually, objective and features of every part are discussed.

Database Management Systems↗
PubMed1992

CD-ROM source data uploaded to the operating and storage devices of an IBM 3090 mainframe through a PC terminal.

A powerful method of processing MEDLINE and CINAHL source data uploaded to the IBM 3090 mainframe computer through an IBM/PC is described. Data are first downloaded from the CD-ROM's PC devices to floppy disks. These disks then are uploaded to the mainframe computer through an IBM/PC equipped with WordPerfect text editor and computer network connection (SONNGATE). Before downloading, keywords specifying the information to be accessed are typed at the FIND prompt of the CD-ROM station. The resulting abstracts are downloaded into a file called DOWNLOAD.DOC. The floppy disks containing the information are simply carried to an IBM/PC which has a terminal emulation (TELNET) connection to the university-wide computer network (SONNET) at the Ohio State University Academic Computing Services (OSU ACS). The WordPerfect (5.1) processes and saves the text into DOS format. Using the File Transfer Protocol (FTP, 130,000 bytes/s) of SONNET, the entire text containing the information obtained through the MEDLINE and CINAHL search is transferred to the remote mainframe computer for further processing. At this point, abstracts in the specified area are ready for immediate access and multiple retrieval by any PC having network switch or dial-in connection after the USER ID, PASSWORD and ACCOUNT NUMBER are specified by the user. The system provides the user an on-line, very powerful and quick method of searching for words specifying: diseases, agents, experimental methods, animals, authors, and journals in the research area downloaded. The user can also copy the TItles, AUthors and SOurce with optional parts of abstracts into papers under edition. This arrangement serves the special demands of a research laboratory by handling MEDLINE and CINAHL source data resulting after a search is performed with keywords specified for ongoing projects. Since the Ohio State University has a centrally founded mainframe system, the data upload, storage and mainframe operations are free.

CD-ROM↗
PubMed1991

Heterogeneous databases integration in a hospital information systems environment: a bottom-up approach.

The paper describes the problem of heterogeneous databases, discusses the need for an integrated hospital information system and provides a five-step method for integrating heterogeneous databases in the hospital environment. The scope of this method facilitates the integration of medical, administrative and fiscal information elements of a hospital into a unified environment.

Computer Communication Networks↗