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PubMed1992

Continuous quality improvement and medical informatics: the convergent synergy.

Continuous quality improvement (CQI) and medical informatics specialists need to converge their efforts to create synergy for improving health care. Health care CQI needs medical informatics' expertise and technology to build the information systems needed to manage health care organizations according to quality improvement principles. Medical informatics needs CQI's philosophy and methods to build health care information systems that can evolve to meet the changing needs of clinicians and other stakeholders. This paper explores the philosophical basis for convergence of CQI and medical informatics efforts, and then examines a clinical computer workstation development project that is applying a combined approach.

Computer Security↗
PubMed1992

A clinical and research database management system for a geriatric nursing outreach program to rural elderly: purpose and general structure.

The need to systematically and comprehensively manage data to support nursing services asserts itself in all areas and contexts where nursing services are delivered to patients and families. While most applications have targeted inpatient nursing services, several systems to sustain ambulatory nursing care have been proposed as well. In this paper, we outline the purpose and general structure of a custom-designed computerized database management system to support the clinical, administrative, and research operations of a geriatric nursing outreach program in rural Virginia.

Aged↗
PubMed1992

Computerized patient information under the Privacy Act: a regulatory effectiveness analysis.

Regulatory Effectiveness Analysis is a new technique for measuring compliance with a technological regulatory system. By examining the public policies, legal structures and technical tools involved in the regulatory system, it is possible to discover discontinuities which may result in non compliance with the regulatory system. This technique can be used to analyze the Veterans Health Administration's (VHA) actions under the Privacy Act.

Civil Rights↗
PubMed1985

[Value of computer tomography and lymphography for staging of malignant testicular tumors].

Findings of computer tomographic and lymphographic examinations of 74 patients were evaluated concerning their evidence in the pretherapeutic staging compared with the histological results of lymphonodectomy. The security of the computer tomography was about 82.4%, the specifity about 95.12%, the sensitivity about 66.66%. Lymphographically, a security of 85.14%, a specifity of 95.12% and a sensitivity of 66.66% was achieved. The combination of the methods achieved a security of 91.7%, a specifity of 100% and a sensitivity of 71.72% was achieved. Metastases of lymphatic nodes less than 0.5 cm diameter were not recognized by means of the two methods. In 2 cases no metastases, which were not covered by means of computer tomography, could not be recognized lymphographically in slightly enlarged lymphatic nodes. In contrast to this in 11 out of 74 patients (14.8%) in the computer tomography an enlargement of the findings was the result in comparison to lymphography. Since none of the two methods is absolutely reliable for the proof or the exclusion of smaller metastases, in a secure evidence of the computer tomography before a lymphonodectomy the lymphography can be omitted.

Adult↗
PubMedDate not supplied

Computers in nursing practice. A comparison of the attitudes of nurses and nursing students.

This study was undertaken to compare the attitudes of nurses and nursing students toward computer use in nursing practice and to clarify factors that influence these attitudes. Three factors within the student sample were examined: changes over time, prior experience with computers, and attitudes toward technology in general. Second, the attitudes of the nursing students were compared with those of a sample of practicing nurses. Finally, the multidimensional structure of Stronge's attitude scale was analyzed. A total of 353 sophomore nursing students and 358 staff nurses participated in the study. The analysis produced a refined 17-item attitude scale composed of three identifiable subscales: computers and patient care, computers and personal security, and general attitude. It was found that students had less experience with computers than the investigators had anticipated, and there was little change over three successive cohorts of students. However, in general, students' attitudes toward computer use in nursing were positive, and the more computer experience students had, the more positive their attitudes. The attitudes of the practicing nurses also were generally positive, but differences between students and nurses were observed.

Attitude to Computers↗
PubMedDate not supplied

Security screening.

Explore the source record for details and available documents.

Computers↗
PubMed1988

Treated blood pressure, rather than pretreatment, predicts survival in hypertensive patients. A report from the DHSS Hypertension Care Computing Project (DHCCP).

A group of hypertensive patients (n = 2855) with an untreated diastolic blood pressure greater than or equal to 90 mmHg were followed in the Department of Health and Social Security (DHSS) Hypertension Care Computing Project (DHCCP) for periods of up to 10 years. During this period 191 of these patients died. Survival was assessed in relation to pretreatment blood pressure levels and blood pressure achieved during treatment. The blood pressure during treatment was a useful predictor of mortality, but the pretreatment pressure was not. After adjusting for age, mortality was particularly related to the height of the systolic and diastolic blood pressure during the second and third years of treatment. In men, age-standardized 5-year mortality was greater than 10% in those with a first year treated systolic pressure greater than 150 mmHg or a diastolic pressure greater than 95 mmHg. In women, age standardized 5-year mortality was greater than 5% with the same levels of treated blood pressure. The longest survival occurred with the lowest bands of treated pressure, i.e. systolic pressure less than 140 and diastolic pressure less than 90 mmHg; the 5-year mortality being less than 7% in men and less than 3% in women. Treated systolic and diastolic pressures were useful in predicting death from ischaemic heart disease (IHD).

Blood Pressure↗
PubMed1985

[Computer tomography in the diagnosis of space-occupying gynecologic processes. 3: Use of computer tomography in the diagnosis of recurrence of uterine cancers].

150 patients were evaluated because of suspicion of recurrencies with computed tomography, lymphography and urography after treatment of carcinomas of the cervix respectively endometrial carcinomas. Size and localisation of recurrencies can be diagnosed with high security by application of computed tomography. Retroperitoneal lymphoma and distant metastasis can be demonstrated in many cases.

Combined Modality Therapy↗
PubMed1975

[Blood stock management by computers in a transfusion center].

In large blood Transfusion Centers, blood stock management is quite difficult because of the numerous daily movements, the short storage time of blood products, the multiplicity of sample types, and, indeed, of blood antigens, etc. A data processing system has been established in the Blood Transfusion Center ofLille (170 000 bottles a year). From information codified in collection and in distribution departments, the computer is able to give to the authorities essential daily decision elements such as the knowledge of :--the exact profile of each collection (1 119 in 1974),--statistics of blood distributions,--available stock, classified by storage time, volume, blood group, etc. The computer contribution from the security point of view, as well as its utilization in phenotyped blood research is described here.

Blood Banks↗
PubMed1990

Mortality associated with captopril and enalapril: a report from the DHSS Hypertension Care Computing Project.

In 1986, the Committee on Safety of Medicines published a report suggesting that enalapril may have an adverse effect on renal function. The prescription event monitoring scheme subsequently published figures on adverse drug reactions and mortality for patients treated with enalapril. They concluded that enalapril did not have an adverse effect on renal function and survival. Similar data were not available for captopril, as the drug was marketed before prescription event monitoring had been developed. In the Department of Health and Social Security (DHSS) Hypertension Care Computing Project (DHCCP), 368 hypertensive patients treated with captopril and 371 treated with enalapril were followed for an average of 3.1 and 1.6 years, respectively. Thirty-two patients died; none had renal failure as an underlying cause of death. The death rate was similar in both drug groups, at 17.5 (enalapril) and 24.0 (captopril) per 1000 patient-years. The present report shows that, for patients treated for high blood pressure, the relative risk of mortality with captopril compared with enalapril was 1.37, an insignificant difference (95% confidence interval 0.63, 2.98).

Acute Kidney Injury↗
PubMed1990

[Use of computers for patient data and billing].

The security and speed with which data can be handled in a medical software context depends on the kind of filing and sorting codes used. Thus software producers can be classified by how good the follow-up program is, as well by the quality of the filing and sorting codes applied. Using a sorting code that is composed of patients' initials, partially enlarged by their data of birth, is not sufficient to fulfill the demand for user comfort and input-security. An alternative often used, a patient number, demands a highly cooperative patient, who keeps his special number in mind and presents it when visiting the doctor's office. When used as a unique filing code, if that number is missing at the patient check-in counter in the office, an additional search must be made in a book listing patients. Besides wasting a lot of time, this kind of filing system is too insecure and unreliable. The best searching and filing code in medical software should be composed of parts of a patient's name, family name and date of birth. Large and small numbers should be accepted by the input window. The amount of matching codes should be minimized and selecting the patient in question should be done by clicking the mouse. A definite advantage in using a computer in the office is to manage routine data. Addresses, telephone numbers, insurance companies, drugs, therapy, mailing addresses, etc. must be made exclusively the computer's tasks. In this way, the speed of handling and data security can be improved. The benefits from an office computer will grow.(ABSTRACT TRUNCATED AT 250 WORDS)

Confidentiality↗
PubMed2026

Secure bioinformatics: privacy-preserving federated analytics using homomorphic encryption.

MOTIVATION: Large-scale bioinformatics analyses increasingly require collaboration across multiple cohorts and institutions, yet existing workflows often rely on data co-localization, which is slow, difficult to scale, and raises privacy concerns. We present a privacy-preserving federated analytics framework that enables secure statistical analysis across distributed datasets without transferring raw data, by performing all computations on encrypted data via cryptographic methods. RESULTS: We evaluate the framework by validating polygenic risk scores and conducting meta-analyses on two real-world cohorts. The proposed solution achieves over 99.9% accuracy relative to plaintext analyses, while maintaining scalable runtime performance with increasing data size and number of participating sites. These results demonstrate the feasibility of secure federated analytics for practical bioinformatics applications involving sensitive data.

Computational Biology↗