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PubMed1986

Self-help computer conferencing.

Computer conferencing has become popular as an alternative to face-to-face conferencing in many kinds of organizations. Since users can participate at any time, from any terminal, computer conferencing makes communication very convenient, though many find the medium to be impersonal. This paper discusses the potential of computer conferencing to increase the number of people who participate in self-help groups, such as groups to help people lose weight or stop smoking. The kinds of interactions that make for successful self-help groups might be encouraged by a computer-conferencing format, even though there is no direct, face-to-face contact. The results of a trial smoking-cessation program which employed computer conferencing suggest that computer conferencing could play a useful role in health promotion.

Computer-Assisted Instruction↗

PubMed1977

[Formative evaluation of education].

The formative evaluation tries to obtain, analyze and furnish information over the planning and development of a course, which is brought about through a continuous performance of the students during the course. This method allows for the adoption of corrective measures with reference to the course (presentation of other learning opportunities, preparation of instructive materials, revision of curriculum, etc.) and with reference to the student (studies prescribed). The formative evaluation may be fulfilled by means of repeated tests which the student himself will correct and, subsequently, will discuss with the professor; it can also be processed by means of the students self-evaluation, interacting with computer terminals. CLATES/Rio presents its experience employing minicomputers to allow for self-evaluation in bioscience courses.

Computers↗

PubMedDate not supplied

Computer-based support for clinical decision making.

Although computers are now commonly used for financial purposes in hospitals and physicians' offices, most physicians do not routinely use them in patient care. And in hospitals where laboratory data are provided on computer terminals, the displays are often difficult to use and programs that offer assistance in interpreting the data are usually unavailable. We have developed decision support programs that are widely used with the clinical computing system at our hospital. This paper describes the programs and how the clinicians use them.

Boston↗

PubMed1978

Computer-assisted instruction in surgery.

Computer-assisted instruction (CAI) is an educational medium which provides a highly interactive, adaptive, and individualized learning experience for the student or physician. A CAI system has benn developed to prepare a curriculum in general surgery. The surgical seminars written on this system have been used enthusiastically by students, residents, and interns for the past 18 months. Using a computer terminal (printer or television screen) connected by telephone to a minicomputer, the user participates in simulated seminars with the authors, viewing information and answering questions based on the material presented. The student responds by typing the answer in his own words, and the computer (author) responds with further information designed specifically for that answer. This response may support or contest what the student said, may branch the student to material covered previously, or instead may lead the student through as much remedial material as he needs. A more sophisticated student will progress rapidly through the seminar. Twenty-five surgeon/authors (at 15 medical schools) are preparing seminars, and it is planned that a complete library in general surgery will be available to departments of surgery nationally by September, 1978, via the Health Education Network.

Computer-Assisted Instruction↗

PubMedDate not supplied

Operating room scheduling by computer.

The surgical operating room schedule has been produced automatically for more than 2 years in our large teaching hospital. In order to apply computer technology to the complex surgical scheduling problem a special programming approach was devised. We discuss this approach under the headings of Expand, Sort, Order and Assign. Consistent, reliable schedules, unaffected by weekends and holidays, are produced by a clerk trained to use a computer terminal. Our program is adapttable to other institutions once the scheduling parameters and operating priorities are delineated.

Anesthesiology↗

PubMed1986

Radiology reporting.

Several different computer methods have been developed to assist in the production of radiology reports. Some systems require the radiologist to interact directly with the computer; in other departments, it is the transcriptionist who types the report into a computer terminal. Automated reporting systems, if they are well designed, offer a significant benefit to most departments, providing an efficient method to produce, store, and distribute radiology reports.

Computers↗

PubMed1978

Readers' forum: experiences with a system. The implementation of a completely operational computer system in a cardio-thoracic department.

Wythenshawe Hospital is a large general district hospital with more than 1000 beds, situated approximately 9 miles south of Manchester. The Cardio-Thoracic department, housed in the new section of the hospital which was completed in 1973, is the major centre for cardiothoracic surgery in the greater Manchester area. It also receives any major accident cases which require treatment within the Intensive Therapy Unit. This paper describes a Patient Data Display System and the methods used to introduce the concept of such a system, to doctors, nurses, laboratory and paramedical staff, and the manner in which these staff were trained in the use of computer terminals. Principles underlying the need for and requirements of such a system are also discussed. Six months after hardware commissioning the system was fully operational throughout the whole department.

Computers↗

PubMed1987

A computer data base for information on cancer treatment.

The Physician Data Query (PDQ) system is a clinically oriented computer data base developed to make recent information on cancer treatment widely available to the medical community. It represents an effort by the National Cancer Institute to promote diffusion of information about the treatment of cancer throughout the country, facilitate access to clinical trials, and accelerate the practical application of advances in research. The computer system provides information about state-of-the-art cancer treatment, which is updated monthly by an editorial board. It also includes a file of active cancer-research protocols and a directory of physicians and organizations providing cancer care to which physicians can gain access by geographic location as well as other features. PDQ was designed for physicians who may not be familiar with computers, to permit them to search for and display information without learning a specialized search language. PDQ uses a computer mainframe, which allows a large amount of data to be stored and made available to physicians rapidly and accurately. Transmission of information about cancer over commercial telecommunication networks gives health professionals access to PDQ by means of a computer terminal and local telephone lines.

Directories as Topic↗

PubMed1985

Drugman--a computerized supplement to a hospital's drug information newsletter.

A computerized supplement to a hospital's drug information newsletter, called Drugman, is described. The pharmacy department of a 452-bed teaching hospital developed Drugman. The program uses the "Converse" software, which was developed by the hospital's computer medicine department. The program provides information on new drugs recently added to the formulary and updated information on current formulary drugs. It also provides information on investigational drugs. A staff pharmacist is responsible for coordinating the writing and review of each new-drug monograph in the system, as well as the computer entry and up-dating of existing monographs. The program is available to all medical, nursing, and pharmacy personnel via computer terminals located on each nursing unit and in the pharmacy department. Survey questions at the end of the program elicit user response to the program and suggestions for additions or changes. In the initial 14-month period, the general response to Drugman has been favorable. Drugman represents a new method of disseminating drug information via computer in an individual hospital. The program complements traditional drug information sources and has been received positively in our hospital.

Boston↗

PubMed1985

The perinatal database: content and collection.

Recent advances in computer technology provide improved means for the collection of information for the perinatal database. They depend principally upon online entry via a computer terminal which allows immediate checking of the data input. The availability of such effective procedures for information gathering demands a careful review of the purposes, content, and structure of a computerized perinatal questionnaire.

Computers↗

PubMed1990

Clinical evaluation of computer-based respiratory care algorithms.

A collection of computer-based respiratory care algorithms were implemented as a prototype computer-based patient advice system (COMPAS) within the existing HELP hospital information system. Detailed medical logic recommended ventilator adjustments for 5 different modes of ventilation: assist/control (A/C), intermittent mandatory ventilation (IMV), continuous positive airway pressure (CPAP), pressure controlled inverted ratio ventilation (PC-IRV), and extracorporeal carbon dioxide removal (ECCO2R). Suggestions for adjusting the mode of ventilation, fraction of inspired oxygen (FiO2), positive end-expiratory pressure (PEEP), peak inspiratory pressure, and several other therapeutic measures related to the treatment of severe arterial hypoxemia in adult respiratory distress syndrome (ARDS) patients were automatically presented to the clinical staff via bedside computer terminals. COMPAS was clinically evaluated for 624 hours of patient care on the first 5 ARDS patients in a randomized clinical trial. The clinical staff carried out 84% (320/379) of the computerized therapy suggestions. In response to a questionnaire distributed to clinical users of the system, 86% judged the system to be potentially valuable. Through implementation of COMPAS, a computer-based ventilatory therapy advice system, we have laid the groundwork for standardization of ventilator management of arterial hypoxemia in critically ill ARDS patients.

Algorithms↗

PubMed1979

Automatic recognition of inter-ictal epileptic activity in prolonged EEG recordings.

A method of automatic recognition and quantification of inter-ictal epileptic activity in the human EEG had previously been developed and tested using short recordings from awake subjects. This paper describes the adaptation of the method for use during overnight recordings in free-moving unattended patients, in combination with the already existing seizure monitoring system. EEG s were recorded from scalp and sphenoidal electrodes, using cable telemetry and a PDP-12 computer. The spike and sharp wave recognition method allowed the on-line analysis of 16 channels. A section of the 16-channel EEG including 1 sec before and 1 sec after each detected spike was saved on digital magnetic tape. Upon completion of the monitoring session, the tape was played back on the EEG machine, giving a discontinuous tracing of spike sections; this constituted a highly concentrated view of the inter-ictal epileptic activity, in traditional paper form. The spike sections were further analyzed by computer to determine and display on the computer terminal the spatial and temporal distributions of the epileptic activity, providing a complete synopsis of the recording. Several examples of the type of information available from this anslysis are discussed in detail. False detection rates are given for 34 six hour recordings, indicating a high vari ability in the performance, mainly because of artefacts. It is concluded that the final computer displays could only be trusted after visual inspection of the EEG sections provided on paper. The variety of morphologies of artefacts appeared to preclude a total automatic elimination.

Electroencephalography↗

PubMed1977

The rubber circle: a technique for analyzing computed tomography scans.

The authors describe a technique for automated analysis of lesions demonstrated by computed tomography. A seed circle may be superimposed on a lesion by an operator controlled program. By selecting density limits, the program will then automatically outline a particular area of abnormal density and calculate the statistics of the pixels within that area. The information may be viewed on the computer terminal or recorded on the printer. The system may be superimposed on first generation EMI scanners without additional hardware. The time for obtaining the information roughly approximates that of systems employing manually operated cursors.

Computers↗

PubMed1990

Computer-critiqued blood ordering using the HELP system.

Recently the medical risk of blood transfusions has emphasized the need to improve the safe use of blood products. For the past 2 1/2 years at LDS Hospital we have used the HELP computer system to assist and critique ordering of blood products "on-line" by physicians and nurses. This report details the computer methods used to order blood products and to critique the appropriateness of those orders. Physicians personally enter the orders for more than 45% of the blood products using computer terminals, whereas 7% are from physician standing orders. Nurses enter the remaining orders from written orders (26%), verbal orders (14%), and phone orders (8%). There were 3396 blood orders for 1043 patients generated by 273 physicians during the fourth quarter of 1989. Each order is justified at the time it is entered by selecting from a menu of physician-approved criteria. The criteria are linked to supportive data in the data base, i.e., laboratory results and clinical data. The computer verified that 82% of these orders met criteria. Quality Assurance nurses verified the remaining 18%. Of these 18% only one in eight required manual chart review. After computer and Quality Assurance review, only eight (0.24%) of the orders were found to be true exceptions to established criteria. Physicians and nurses have accepted the computerized critiquing system. Through use of the computer we provide "on-line" critiquing and improve the use of scarce blood product resources.

Blood Banks↗

PubMed1989

A clinical virology database for a regional virology service.

We describe a laboratory information system employing a virus and chlamydia database developed over seven years which is used by a regional laboratory, performing virus and chlamydia testing. The information system is implemented on a University mainframe computer and accessed by computer terminals in the laboratory. The database is used to identify patients, store patient test results, minimize clerical work and improve accuracy of reported results. The database also serves as a patient registry for use in education and research.

Adolescent↗

PubMed1975

Use of a computer for producing microbiological reports and for data storage and processing.

A simple 'fail-safe' system is described that produces microbiology reports on a computer teleprinter and stores results on the magnetic tapes and discs of a computer for instant retrieval and epidemiological analysis. The system, which has been in operation for over a year, involves the use of a modified conventional NCR request form. The top portion, which is completed manually by the laboratory staff, is coded by writing numbers in hatched boxes. The data thus written on to the bottom portion are transcribed by punch operators on to paper tape and this data input is verified by double punching. The reports are normally produced automatically by the computer terminal telprinter, but in case of mechanical failure the manually completed request forms can be returned to wards and outpatient departments. The system permits a wide choice of options for epidemiological analysis, and six programmes are described, one of which produces a digest of the overall percentage antibiotic sensitivities of organisms from various sites.

Computers↗

PubMedDate not supplied

A survey of medical informatics in Belgium.

The Belgian Society for Medical Informatics (MIM) organized a survey in 1986 in order to assess the present state of development of medical informatics in Belgium. Questionnaires were sent to hospitals, laboratories, private practitioners and pharmacists, as well as to social security organizations and software industries. The response rate was higher in hospitals (93%) than in any other category. Results showed a large number of computerized hospitals (93% of general acute care hospitals and 91% of psychiatric hospitals). There has been a sharp increase (+ 15%) in computerization of the admission, accounting and billing procedures since 1985, most likely in relation with administrative rules issued by the Belgian Government. The same trend (+ 20%) has been observed for computer applications in clinical laboratories, between 1984 and 1985. There is almost one computer terminal for ten beds in the hospitals with more than 200 beds in 1986. This figure exemplifies the present trend to on-line access to data. Computerized instrumental aids to medicine such as text processing, imaging or computerized interpretation of signals have known a rapid extension during recent years, although less comprehensive than administrative applications in hospitals and in social security organizations. The present state of other applications in medicine (general practice, pharmacy, etc.) was more difficult to assess as those information systems remain more pinpointed. In all medical fields, there appears to be a new rise in computer programs offered by software companies.

Belgium↗

PubMed1979

The CASE system for cancer education.

A Computer-Assisted-Self-Evaluation (CASE) program in oncology is described. The program is based on motivation by immediate, informative feedback, and involves the computer-guided interaction of a student with a series of microfiche cards. The computer leads the student through a series of 16 questions and associated explanations and recommendations based on the answer choices. Since all textual materials are placed on microfiche cards, the computer is only required to print simple, prearranged sentences and comments. As a result four students, using different CASE topics, can time-share the same computer terminal. This time-sharing capability, together with the large but compact, low cost information storage afforded by the use of microfiche, makes the cost of this system comparable to that of conventional study aids. The use of the CASE system as an educational aid and self-tutoring mechanism has been well accepted by faculty and students.

Attitude↗