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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↗
PubMed1995

[Computer systems in medical practice. I. The aims, difficulties and implementation of computerization in health care organizations].

Several phenomena accompanying the implementation of computer systems in polish health care are discussed. The initiatives of managers of health care organizations or individual hospitals, are directed toward the software supporting their financial and administration activities. On the other hand, the Ministry of Health initiatives deals mainly with registration of manpower (doctors, nurses, etc.), and registration of equipment of health care organizations. Several computer programs elaborated by the polish authors are adjusted to the needs and abilities of health care organizations, hospital and private practices of individual doctors. However, the possibilities of data exchange between different computer software systems are rather limited. Implementation of computer systems are accompanied by the resistance resulting from the fears personnel which uses computers in the health care organizations. The effectiveness of computer systems implementation depends mainly on the user's ability to define precisely his needs, and on approval the computer system by the personnel.

Attitude to Computers↗
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↗
PubMed1995

A multicentre comparative study of 17 experts and an intelligent computer system for managing labour using the cardiotocogram.

OBJECTIVES: To investigate 1. whether an intelligent computer system could obtain a performance in labour management comparable with experts when using cardiotocograms (CTGs), patient information, and fetal blood sampling and 2. whether experts could be consistent and agree in their management of labour. SUBJECTS: An intelligent computer system and 17 clinicians experienced in fetal monitoring from 16 centres in the UK. DESIGN: Fifty cases with complete intrapartum CTGs and clinical data were reviewed by each expert and the system independently on two occasions, at least one month apart. Each CTG was scored in 15 min segments according to a protocol and estimates of the cervical dilatation and fetal scalp blood pH were given when requested. MAIN OUTCOME MEASURES: Consistency and agreement in the recorded scores, agreement and timing of cases recommended for caesarean sections, fetal blood sampling rates, intervention in cases with poor outcome and intervention in cases with good clinical outcome. RESULTS: The system: 1. Agreed with experts well and significantly better than chance (67.33%, kappa = 0.31, P << 0.001). 2. Was highly consistent (99.16%, kappa = 0.98, P << 0.001) when used by two operators independently. 3. Recommended no unnecessary intervention in cases with normal delivery and good condition (cord artery pH > 7.15, vein pH > 7.20, 5 min Apgar > or = 9 and no resuscitation). This was better than all but two of the experts. 4. Recommended delivery by caesarean section in 11 cases; at least 15 of the 17 experts in each review also recommended caesarean section delivery in these cases. The majority did so within 15 min of the system and two-thirds did so within 30 min. 5. Identified as many of the birth asphyxiated cases (cord arterial pH < 7.05 and BDecf > or = 12, and Apgar score at 5 min < or = 7 with neonatal morbidity) as the majority of experts and one more than was acted upon clinically. The experts were found to be consistent and to agree. There was good agreement in the cases and the timing of caesarean section recommendations. The majority of experts did not recommend operative intervention in cases which had a normal delivery and good outcome, but did recommend operative interventions in 10 of 12 cases delivered with cord arterial pH < 7.05. However, in one of the cases delivered with birth asphyxia, 14 of the 17 experts and the system failed to recommend intervention. CONCLUSIONS: The system's performance was found to be indistinguishable from the experts' in the 50 cases examined, but it was more consistent. This demonstrates the potential for an intelligent computer system to improve the interpretation of the CTG and decrease intervention. Furthermore, the good performance of most experts in this study demonstrates the potential effectiveness of the CTG and raises important questions regarding why the CTG has fallen short of expectations in current practice.

Cardiotocography↗
PubMedDate not supplied

Help for house officers: EFCOS--the Ealing Hospital Firm Computer System.

The Ealing Hospital Firm Computer System is a novel database system which has been designed to meet the needs of house physicians in a busy general medical unit. It is maintained exclusively by them and produces instant lists of all patients on their firm, with all relevant information needed to organise their clinical work. It has proved extremely popular, and its value to both junior and senior staff has been documented in an anonymous questionnaire survey. The system is available for distribution on a non-profit basis, and other colleagues are invited to use it.

Medical Records Systems, Computerized↗
PubMed1982

Computer systems planning, development, and impact assessment.

In this final installment of a 12-article series on managing computer systems for the hospital pharmacy department, contemporary issues related to the topic of the series are discussed. Assessment of institutional strategy for acquiring systems and determining the departmental direction is reviewed. The far-reaching impact of computerization on personnel staffing and job functions is discussed. The results of a telephone survey of 23 pharmacy computer system vendors that had at least one installation of a unit dose and i.v. admixture system are also presented. Because of the current and future widespread use of computers, pharmacists must acquire knowledge of computer systems.

Computers↗
PubMed1995

Development of computer systems for endoscopic surgery.

The use of computer technology in endoscopic surgery is a necessity if more advanced and high quality minimal invasive operations are to be performed. Since safety and reliability are a major issue in medical applications, the development of computer systems has to follow a systematic procedure including quality assurance and be supervised by project management as employed in such safety-relevant areas as aerospace and nuclear energy. An overview of the early phases of this development process and of the major tests during the process is presented.

Computer Simulation↗
PubMed1997

Staging prostate cancer with MR imaging: a combined radiologist-computer system.

PURPOSE: To test the accuracy of a combined radiologist-computer system in the diagnosis with magnetic resonance (MR) imaging of cancer of the prostate gland. MATERIALS AND METHODS: The combined system was developed and tested by four specialists in prostate MR imaging and five radiologists expert in body MR imaging. Each group read MR images obtained in 100 proved cases of prostate cancer. The images were obtained from two sources, and all were obtained with an endorectal surface coil. Prostate MR specialists ranked imaging features of cases to develop a checklist for image interpretation. Features with greatest diagnostic value were incorporated in the combined system. Accuracy measures were derived from the area index of the receiver operating characteristic curve for the combined system and compared with those of radiologists working alone. RESULTS: Body MR radiologists had a mean baseline accuracy of 0.67; mean accuracy of their combined system was 0.80. The prostate MR specialists, when they rated the features in each case, had a mean accuracy of 0.81; the accuracy of their combined system was 0.87. CONCLUSIONS: A combined radiologist-computer system substantially improved accuracy of body MR radiologists in the diagnosis of prostate cancer. High levels of accuracy were also achieved by the system with prostate MR specialists.

Diagnosis, Computer-Assisted↗
PubMed1988

Experimental identification of technical and database factors that can affect the success of clinical computer systems.

The entry of clinical data into computer systems is an extremely demanding form of transaction processing. High speed is important, especially if the collection involves real-time data. Clinicians must feel that they intuitively understand a system and that it is responsive. Medical data must be easily accommodated without sacrificing accuracy or completeness. Most systems cannot do this. Clinical systems that involve on-line storage of data from patients should employ data-base technology. Systems that lack any of the following capabilities will not succeed: manual data entry, a data dictionary, a file system, utility functions, ad hoc query, and a statistical report generator. These general capabilities must satisfy a number of specific functional requirements if the entire system is to be a success. A group of such requirements have been experimentally validated. These will be discussed and a more comprehensive list presented.

Computer Systems↗
PubMed1989

Point-of-service computer system and drug-use evaluation: implications for pharmacy practice in ambulatory care.

The point-of-service (POS) computer system and its possible effects on ambulatory-care pharmacy practice are described. The POS system, a key component of the Medicare Catastrophic Coverage Act, is an electronic claims-transmittal device to be installed in community pharmacies. The system transmits information about the patient and the prescribed drug to a claims processor, which verifies the eligibility of the patient for Medicare drug benefits, determines the amount of payment allowed, and sends information back to the POS terminal in less than 30 seconds. Because prescription information can be consolidated into a central data pool, drug-use patterns can be reviewed. The system will also permit automated screening of drug-drug interactions. Problems posed by the POS system relate to (1) the lack of a claims-transmittal device that can communicate with all claims processors, (2) the lack of a direct interface between the POS system and all pharmacy computer systems, (3) the expense of training personnel to operate the POS system, (4) the cost incurred by pharmacies in installing the POS system, and (5) the conflict between protecting the privacy of a patient's drug profile and permitting the monitoring of drug interactions. The catastrophic coverage act proposes that POS data be used to assess the appropriateness of drug use with a focus on outcome and quality-of-care issues; for the full intent of the act to be achieved, the components of an effective drug-use-evaluation program must be employed. Drug-use evaluation should eventually decrease health-care costs and improve quality of care.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care Information Systems↗
PubMed1977

A computer system automatic analysis of vectorcardiograms.

This computer system performs the analysis of orthogonal electrocardiograms for vectorcardiographic (VCG) display and classification. The data acquisition can be performed 'on-line' with the complete analysis in 'real-time', or off-line by processing a magnetic tape. The original computational methods for beat averaging and wave recognition are described. Some features, such as the quality of the visual display of the VCG traces, the availability of a measurement matrix allowing the quantitative analysis of the VCG and the use of a data bank for storage, retrieval and statistical studies make this system very efficient for clinical purposes, introducing the concept of 'Computer Assisted Vectorcardiography'.

Diagnosis, Computer-Assisted↗
PubMed1987

Extending the capabilities of a laboratory computer system through cooperative processing.

The concept of cooperative processing within the context of a hospital or laboratory computer systems environment is introduced. Two examples that produce graphical display of laboratory data are described to illustrate cooperative processing's ability to enhance a system's functionality without placing significant additional burden on system resources.

Clinical Laboratory Information Systems↗
PubMed1989

Computer system and software of POSITOLOGICA II: a whole body positron emission tomograph.

Since a whole body PET-scanner POSITOLOGICA II was installed at the National Institute of Radiological Sciences (NIRS) in 1982, improvements of the computer system and developments of new software have been continuously made to correspond to clinical requirements. As the result, POSITOLOGICA II possesses one of the most powerful systems and sophisticated software in Japan. This report describes the present status of the computer system and software of POSITOLOGICA II. It also discusses problems which still exist and proposes a future computer system for the PET study.

Brain↗