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PubMed1987

Carola, a computer system for automatic documentation in anesthesia.

A computer system has been designed for documentation and data acquisition during open heart surgery. This computer system (called 'Carola') processes all patient data during cardiac surgery. More than 50 analogue or digital signals are scanned. These are derived from a monitoring rack, a Siemens Servo 900B ventilator with its accessory devices and a heart lung machine. All these values are plotted as well as offline data, such as medications, fluids, laboratory results and user comments, on an A3 format anesthetic record using an eight pen flat bed plotter. Simultaneously all data is written onto a cassette tape. These tapes are then transferred to a database for storage and statistical processing. The sampling frequency is every 10 seconds, averages being calculated over one minute periods. The chart is updated once a minute normally or every 15 minutes for slowly changing signals e.g. temperatures. Hardware and software of the computer have modular design. The hardware consists of two Motorola 6809 based microprocessor systems. The software is entirely written in Pascal. The user interface is implemented on a menu driven basis. A terminal with a keyboard is used for the communication with the users, namely anesthetic nurses and anesthesiologists. The system was readily accepted by the users. The menu structure proved to be easy to learn and allowed fast entries, even when the users were not previously accustomed to the use of a keyboard. The clear and detailed presentation of the data on the plotted chart helped to detect trends early and facilitated therapeutic decisions. From december 1983 the first prototype was used on a routine basis, followed by a second unit in June 1984 and a third in December 1985. Up to now more than 12.500 anesthetic hours have been recorded. Since then almost 100% of all anesthetics performed in our cardiothoracic unit have been documented by the computers, including all short procedures without invasive monitoring and all emergencies.

Anesthesiology↗
PubMed1990

Computer system for equipment management.

A computer system has been developed to meet the requirements of equipment management. The system was originally developed to run on personal computers, but has been upgraded to provide true multiuser facilities and more advanced program capabilities. This has been achieved using improved hardware and a relational database. The manner in which the software operates is described, with some examples examined in more detail. The system provides a wide range of information, including inventory data, repair costs and time as well as service records and worksheets. In addition it meets the other basic requirements of the department, including wordprocessing, budgetary control and stock control. The system also provides an immediate and rapid overview of the repair state of all equipment whilst reducing administration time for many aspects of the service. Emphasis has been placed on the integrity of the data and ease of entry of additional data.

Computer Systems↗
PubMed1995

[Computer system of the electronystagmographic examination. Part III. Comparative results obtained by computer and traditional technology in the examination of the vestibular organ].

The study presents a comparison of the research into results of vestibular organ stimulated with caloric tests which had been simultaneously registered with the help of a computer system of electronystagmographic examination, as well as the traditional electronystagmographic technic. In the case of 32 healthy persons there had been counted by hand average angular velocity of the slow phase caloric nystagmus average level of reduced excitability of labyrinth and direction predominance. It had been defined that those values are comparable to the ones given by the computer. That points to the right chose of the space of time in the climax of nystagmus reaction and a good identification of the phase both slow and fast by the computer system.

Adult↗
PubMed1978

Computer system for unit dose drug distribution.

A computerized unit dose drug distribution system, part of an online hospital information system, is described. Differences between manual and computerized pharmacy distribution, and the advantages and deficiencies of the automated system are discussed. The system seems to improve pharmacy's efficiency, accuracy, control of drugs and capabilities for patient monitoring and drug use review. If mechanical failure occurs, back-up procedures keep the distribution system operational. The computer system is believed to decrease the time spent by pharmacists on routine distribution tasks, leaving time for other necessary pharmacy functions.

Computers↗
PubMed1982

Managing the implementation of a pharmacy computer system.

The process of managing the implementation of a pharmacy computer system is described. The three major phases of an implementation plan are (1) orientation and testing, (2) training of personnel, and (3) operation and expansion. Testing procedures described include those for entering new medication orders, profile maintenance, printouts for unit dose cart dispensing, label and report generation, i.v. system orders, back-up system, special edit features, charge generation, and admission, discharge, and transfer status. Personnel training components described are orientation, formal and practical sessions, program development, and training manual development. Implementation programs described include parallel operations of manual and computer systems, limited independent operation, and expansion. Successful implementation of a pharmacy computer system depends on careful planning and coordination.

Computers↗
PubMed1995

Computer systems in dysmorphology.

A number of computer systems have been dedicated to some aspect of dysmorphology. These systems have generally been developed in isolation and demonstrate much variation in their design. Some systems are purely database applications designed to take advantage of computer technology in order to provide up to date syndrome compendia. Conversely, a number of research projects have endeavoured to build an intelligent system that can formulate a diagnosis, either through its own knowledge-base, or through interaction with an expert user. This report reviews computer systems in dysmorphology with reference to these two alternative design methodologies. The London Dysmorphology Database and POSSUM provide case studies in a standard database approach. The Skeletal Dysplasia Diagnostician (SDD) is described in order to demonstrate how an expert system might operate in dysmorphology. Other work in the field is reviewed in terms of the common and distinctive aspects of their design with respect to the three aforenamed systems.

Databases, Factual↗
PubMed1978

A ten-year follow-up study on measles vaccination in Japan: evaluation of the efficacy analyzed on a computer system.

A long-term surveillance system using a computer system was established for the follow-up study on the protective effect of measles vaccination. More than 3,000 children, 3 to 6 years of age, who were immunized with measles vaccines by various methods have been registered in the system since 1971, and their outcomes with regard to measles have been followed up every year. The subjects were divided into three groups by the vaccination method: live vaccine alone (L), further attenuated live vaccine alone (FL), and the combined use of live and killed vaccines (KL). From comparative studies with these groups, the following results were obtained: (1) Annual measles incidence rates were found to be the lowest in L group followed by FL and KL. (2) Accumulated incidence rates of measles for 10 years in L, FL and KL groups calculated were 1.90, 2.49 and 17.84%, respectively. A linear regression was observed only from 0 to 3 years after vaccination in L and FL groups, and from 0 to 9 years in KL group. KL group showed a significantly larger regression coefficient than did the former two groups. (3) Protection rates against close contact with measles in families calculated were 97% in L and FL and 80% in KL group, respectively. (4) Low but detectable levels of antibody titers were observed in the sera for at least 4--6 years after vaccination.

Antibodies, Viral↗
PubMed1983

Work-sampling evaluation of an upgraded outpatient pharmacy computer system.

The effect of an upgraded outpatient pharmacy computer system on routine dispensing activities was studied. A computer system that previously generated patient bills, prescription labels, and management reports was upgraded to provide patient profiles, allergy and drug-drug interaction monitoring, auxiliary-label notification, and prescription prices. Four months after the upgraded system was implemented, dispensing activities were analyzed using a work-sampling technique. The percent of time spent in prescription processing, inventory maintenance, problem solving, or miscellaneous activities was determined. These data were compared with data obtained in a study of the old system. A total of 5897 observations of the upgraded system was compared with 5632 observations in the previous study. There were significantly different changes among the four activity groups for the total staff and for pharmacists, technicians, and the data-entry operator. Under the modified system, pharmacists spent more time in prescription coding and less time on patient counseling. The data-entry operator had less computer-entry time. It could not be stated conclusively that overall efficiency was improved by the new system.

Computers↗
PubMed1980

Data integrity in a general practice computer system (CLINICS).

The accuracy of computer held medical information may be of critical importance in patient care, therefore it is important not only to know the error rate in the stored data but also to know the effectiveness of error checking and detection programmes. This paper reports on the errors which were detected in the University of Southampton Primary Medical Care computer system (CLINICS) by checking the consistency between stored data and incoming data. Seven per cent of incoming data had important errors of kinds not normally detected by many medical record systems. The majority were traced either to the registration of new patients or to the doctors failing to pay adequate attention to detail in their record keeping (or to their legibility). They have been subsequently corrected, and it is calculated that the stored data contains less than 1% errors. We suggest ways of improving this; and conclude that certain items are essential to general practice information systems.

Computers↗
PubMed1989

LABKA. A real-time computer system for the clinical laboratory.

This paper provides an introduction to the real-time clinical laboratory information system (LABKA), which is implemented on a Hewlett-Packard 1000 system. The system is optimized for fast data handling combined with easy control of on-line results, data flow, and linking of related information. The design of LABKA is based on the principle of having a short reporting time together with simplified working procedures. The system can be adjusted to small as well as very large laboratories. Data control is achieved by status information being returned to the operator in real-time, thus avoiding having to use matching lists. This information is presented immediately in response to the procedure which has caused the error. This method of early error detection simplifies working procedures, inhibits accumulation of errors, and increases the flexibility and speed of data reporting. As a result, the number of requested stat analyses has been reduced by 50 percent. Working lists are not generally used. Instead, requisition information is transferred on-line to the instruments on request. A fourth-generation program system for entry, calculation, and test of manually entered data, called RUCAT (1), has been developed. This system enables the user to define forms on vdu-terminals, specify calculations, and test all manually entered data. The LABKA system can also produce cumulative reporting as standard reporting, in real time, fast and in a very high print quality. The real-time demands have strongly influenced the design and layout of the lab files and system design.

Clinical Laboratory Information Systems↗
PubMed1991

Acquiring a laboratory computer system. Vendor selection and contracting.

The steps involved in acquiring a computer system, from writing the request for a proposal to signing the contract, are discussed. Guidelines for selecting a system include information on the merits of different hardware and software available for use in the laboratory.

Clinical Laboratory Information Systems↗
PubMed1994

[The uses of computer systems in daily medical care].

This paper describes the use of computer systems for daily primary medical care. They are two computer systems for selection of the sets of suitable clinical laboratory tests to diagnose the diseases. One of them is a system which has an electronic medical textbook and another is a system using an IC card. This paper also describes a plan for the use of clinical laboratory tests to diagnose the respiratory diseases. Several problems are suggested for management of the clinical laboratory data of respiratory diseases by computer.

Clinical Laboratory Information Systems↗
PubMed1983

Computer assisted patient evaluation (CAPE): a multi-purpose computer system for an anesthesia service.

We have designed and built a database management system, the computer assisted patient evaluation (CAPE) system, for use in patient management, research, and administration in our anesthesia practice. An important part of the system is the use of specially designed forms on which anesthesiologists record patient histories and management information during the course of patient care. The forms provide means for convenient and complete record keeping, as well as for direct computerization. We demonstrate the flexibility and utility of the CAPE system by presenting a series of examples of its use. These include development and implementation of a preoperative screening program to identify patients at high risk of postoperative respiratory complications; a study of anesthesia technique and outcome; auditing for quality of care; and utilization review of respiratory therapy.

Anesthesia Department, Hospital↗
PubMed1979

Comprehensive analysis of a Radiology Operations Management computer system.

The Radiology Operations Management computer system at the Hospital of the University of Pennsylvania is discussed. The scheduling and file room modules are based on the system at Massachusetts General Hospital. Patient delays are indicated by the patient tracking module. A reporting module allows CRT/keyboard entry by transcriptionists, entry of standard reports by radiologists using bar code labels, and entry by radiologists using a specialty designed diagnostic reporting terminal. Time-flow analyses demonstrate a significant improvement in scheduling, patient waiting, retrieval of radiographs, and report delivery. Recovery of previously lost billing contributes to the proved cost effectiveness of this system.

Appointments and Schedules↗
PubMedDate not supplied

Digital radiography: utilization of a nuclear medicine computer system.

A standard nuclear medicine computer system was modified to accept video input and utilized to perform digital intravenous and intra-arterial angiography, substration of CT images and enhance ultrasound images as well as to read video and magnetic tape. This system provides greater versatility and adaptability than presently conceptualized and produced digital systems and deserves further evaluation as a multipurpose imaging device.

Angiography↗
PubMed1986

Implementing a mainframe packaged pharmacy computer system in a 190-bed hospital.

The implementation of a pharmacy computer system in a 190-bed institution is described. A computer system was instituted in the pharmacy department as part of a hospitalwide conversion to an online information system. Planning for implementation began nine months before the actual live date (date of full computerization). Problems in the existing distribution and record-keeping systems that might be eliminated by computerization were identified, and changes in the layout of the pharmacy and department procedures were initiated to prepare for computerization. The events leading to computerization are presented in chronological order, and the advantages and shortcomings of the system are discussed. Because of careful planning, the cooperation of all pharmacy staff members, and frequent assistance from the computer vender, the nine-month conversion to a computerized system proceeded smoothly.

Computers↗
PubMedDate not supplied

Specialized PC software package for creation of computer systems supporting partial diagnostics based on numerical results of medical examinations.

Computer scientists creating computer systems supporting partial diagnostics based on numerical results of medical examinations always follow a similar method. Why not algorithmize this procedure? This was the main reason for preparation of the specialized PC software presented in the paper. The software is addressed to clinicians-scientists and enables such users to create by themselves (with no need of programming) practically useful computer systems for differential diagnosis of chosen diseases. These generated systems are assigned to an end-user, i.e. any physician interested in a partial diagnosis of the considered type. They perform classification of patients on the basis of numerical results of the examinations selected for the training databases. The software is based on a statistical approach; multi-dimensional variance analysis and discriminant analysis methods have been used. The pilot version of the software (experimentally implemented in a Warsaw clinic) and an outline of planned work are presented.

Algorithms↗