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Fax technology for collecting outcomes data in a computer database.

In this era of cost containment, outcomes research is becoming more prevalent. Therefore, various technologies allowing for flexibility in study design and the capture of specific clinical information need to be examined and used. These technologies include fax data systems, pocket scanners, automated telephone equipment, and hand-held computer devices. Fax data systems convert a fax machine into an automated data-entry system. Data-filled forms are faxed to a computer, the fax is converted, and the data are entered into preset fields in a database. Applications for fax systems include acute care-based and ambulatory care-based drug-use evaluations, drug recall systems, and patient-completed surveys of health status. Pocket scanners are hand-held instruments for rapid data entry and transport. Applications for pocket scanning include patient interview responses, procedure and disease analysis, and procedure coding. Options for automated telephone equipment include surveys with interactive voice-mail responses or keypad data entry, pharmacist-monitored drug information and survey services, fax-back and mail-out services, and patient-generated disease intervention programs. Hand-held computer technology is a source of information on multiple protocols and care pathways. All these technologies improve data collection with respect to accuracy and speed, facilitate data analysis, and promote cost-efficient information sharing. The purpose of this study was to evaluate the use of fax technology in data collection for a prospective, multicenter study of the outcomes and cost-effectiveness of two drugs used in the treatment of cancer. Details for the pharmacoeconomic study can be found elsewhere. Fax technology was selected because of the ease with which those responsible for managing the data collection could be trained to use it, the affordability and efficiency of the technology, the ease with which data could be analyzed, and the accuracy of data collection.

Cost-Benefit Analysis↗

Deaf people communicating via SMS, TTY, relay service, fax, and computers in Australia.

Despite the expansion of Deaf people's use of communication technology little is published about how they use electronic communication in their social and working lives and the implications for their concepts of identity and community. Australia is an ideal research base because the use of a range of technologies is widespread there. To gain access to a wide age range of people who identify as Deaf, members of the national organization, the Australian Association of the Deaf, were surveyed by mail. Results showed that Short Message Service (SMS), telephone typewriters (TTY), voice/TTY relay services, fax, and e-mail were used regularly. Deaf users are discerning of the purposes for which they use each method: SMS for social and personal interactions, TTY for longer communications and (via the relay service) with people and services without TTYs, fax for business and social contact, and computers for personal and business e-mails as well as Web browsing, accessing chat rooms, word processing, games, and study.

Adult↗

Disease reporting from an automated laboratory-based reporting system to a state health department via local county health departments.

OBJECTIVE: The authors assessed the completeness of disease reporting from a managed care organization's automated laboratory-based reporting system to the California Department of Health Services (CDHS) via local public health departments. METHODS: The authors identified all positive laboratory tests for 1997 from the computerized database of Kaiser Permanente Northern California for seven infections for which there are statutory reporting requirements: Campylobacter jejuni, Chlamydia trachomatis, Cryptosporidium parvum, hepatitis A, Neisseria meningitidis, Neisseria gonorrhoeae, and Salmonella (N = 7,331 reports). Cases were then matched by computer query to records of cases reported to CDHS. To determine why cases were not found in CDHS records, a sample of un-matched cases was searched at two county health departments. RESULTS: Overall, 84.5% (95% CI 83.4, 85.6) of the laboratory reports submitted with accompanying demographic information were successfully matched with cases in the CDHS disease surveillance database. Frequency of matching for specific diseases ranged from 79.4% (95% CI 75.6, 83.3) for N. gonorrhoeae to 88.4% (95% CI 85.3, 91.6) for C. jejuni. Reports were more likely to be matched when the county of residence was the same as the county of the health care facility. At the county level, reasons for failure of cases to be forwarded to CDHS included: errors due to manual data entry, failure to forward information from the county of diagnosis to the county of residence, and incorrect disease coding. CONCLUSION: Automated laboratory-based reporting is highly effective, but some data are lost with off-line transfer of information. To optimize surveillance accuracy and completeness, reporting at all levels should be done via direct electronic data transfer.

Animals↗

Faxes, modems, and fax/modems.

Although the use of computers for word processing and spreadsheet analysis is widespread, other less well-known uses can also increase efficiency and productivity. In this bimonthly column, Dr. Nicoll discusses a variety of computer applications to help the nurse executive catch up, keep up, and get ahead.

Communication↗

Personal computer teleradiology interhospital image transmission to facilitate tertiary pediatric telephone consultation and patient transfer: soft-tissue lateral neck and elbow radiographs.

Although teleradiology systems are available commercially, they are expensive ($30,000), and different makes are incompatible with each other, making them unusable for interhospital image transfers. Standard components were added to a personal computer (PC) to build a functional teleradiology unit capable of interhospital image transmission at a low cost ($600 upgrade). This PC teleradiology system was studied to assess its accuracy in the interpretation of soft-tissue lateral neck x-rays with epiglottitis or retropharyngeal abscesses and elbow x-rays with joint effusions, fractures, or both. A radiologist and a pediatric emergency physician were asked to read the PC teleradiology images. Both physicians read 13 of 13 soft-tissue lateral neck x-rays and 15 of 15 elbow x-rays correctly. This study supports the premise that PC teleradiology can be used to facilitate telephone consultation and patient transfers between tertiary pediatric emergency centers by transmitting pertinent radiographic information over a phone line. Although verbal communication can often suffice in a telephone consultation or transfer, there are many instances when visualizing a radiographic image such as an x-ray or computed tomography scan can provide important information that cannot be optimally described verbally. Rural hospitals can form interhospital image transmission links with tertiary center resources. Tertiary centers may elect to organize interhospital image transmission and referral networks with their rural hospital sources.

Adolescent↗

The Army's Community-Based Health Care Initiative: an innovative military case management program.

As more Army National Guard and U.S. Army Reserve soldiers are called to active duty, there has been a rise in injuries sustained or aggravated by deployment. This increase caused an overwhelming explosion in the number of soldiers requiring prolonged medical care. The U.S. Army developed a program to address Army National Guard and U.S. Army Reserve soldiers requiring extended recuperation periods. This article addresses the Army's Community-Based Health Care Initiative. This initiative entails case management through the use of technology involving fax, phone, and e-mail and focuses on reduction in the number of medical holdover soldiers at military treatment facilities. Community-based healthcare organizations allow Army National Guard and Army Reserve soldiers to receive medical care in their hometown while living at home, working for the military, and continuing to receive full benefits as an active duty soldier.

Adult↗

A decade of rare donor services in the United States. Report of the American Red Cross Rare Donor Registry (1981-1990).

Between 1981 and 1990, the American Red Cross Rare Donor Registry supplied 9,872 units of red cell components with rare phenotypes to blood centers in the United States and abroad. Approximately 51% were from donors with high-frequency antigen-negative phenotypes and 49% were from donors with multiple antigen-negative phenotypes. Since 1989, the disease category requiring the largest number of units has been sickle cell disease. Strategies to ensure that the Registry will have adequate resources to meet future requirements include testing selected donors for rare phenotypes and blood conservation programs, such as intraoperative salvage and the treatment of anemia of chronic renal failure with recombinant erythropoietin.

Anemia, Sickle Cell↗

Using a facsimile (fax) as an aid for communication in maxillectomy planning between the prosthodontist and surgeon.

Preoperative communication between the prosthodontist and surgeon is required for properly planning the surgical prostheses that are often indicated for maxillectomy patients. When geography or long distances preclude face-to-face consultation, electronic means of correspondence are necessary to minimize delays in the fabrication of surgical prostheses. This article presents a time-efficient procedure for facilitation of the necessary communication between the prosthodontist and surgeon before maxillectomy surgical procedures.

Communication↗