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At least 127 records · Page 7Linked to original sources
PubMed1992

[Management of personal health examination data for a population by use of a portable computer].

A new system was developed for processing annual personal health examination data with a portable microcomputer utilizing commercial software by converting the IBM formatted data file of the law mandated health examination for adults into an MS-DOS file. The sequential data file was further transferred into a random access data file by a simple program and software was developed for the presentation of annual personal data by table and graphs. Printout of data and selected comments filed on disc by the public health nurse or physician could become retrievable. This system is easily operated by a beginner in micro-computers from conversion of the original data to actual demonstration. This system was utilized for a small village of about 700 adults. By using part of the main memory as a RAM disc, presentation of 5 years' data was possible. File capacity was dependent on population size and also on the type of software for Japanese language input. In the case of a larger population, use of hard disc or expansion of memory may be recommended to shorten computer start-up time. Once necessary data has been placed into the field buffer's memory, retrieval of data requires less than one second. The results of health examination were usually provided by hard copies to village. But by use of this system, a more effective transfer of data between computerized systems by using a floppy disc is possible.

Humans↗
PubMedDate not supplied

Reading the medical record. I. Analysis of physicians' ways of reading the medical record.

Physicians were interviewed about their routines in everyday use of the medical record. From the interviews, we conclude that the medical record is a well functioning working instrument for the experienced physician. Using the medical record as a basis for decision making involves interpretation of format, layout and other textural features of the type-written data. Interpretation of these features provides effective guidance in the process of searching, reading and assessing the relevance of different items of information in the record. It seems that this is a skill which is an integrated part of diagnostic expertise. This skill plays an important role in decision making based on the large amount of information about a patient, which is exhibited to the reader in the medical record. This finding has implications for the design of user interfaces for reading computerized medical records.

Decision Support Techniques↗
PubMed1991

Dissemination, standardization and user-flexibility in implementing TOMRs for cardiology.

A great many clinics are interested in using software programs in daily practice. We report on the construction of a time oriented medical record unit (TOMRU). It runs on MS-DOS personal computers. TOMRU handles the follow-up data of ambulatory patients. Of the possible database customizations allowed by TOMRU, the cardiology patient database (TOMRU/C) and hypertensive patient database (TOMRU/H) were developed and are described here. Customizing TOMRU should in any case be left to an expert user, in charge of database management. The clinical information to be included in the customizations was obtained by discussing the needs of and obtaining the consensus of clinical practitioners. TOMRU/C was handed over to some hundreds of clinical centres during the computerized itinerant courses held to train users.

Ambulatory Care Information Systems↗
PubMed1992

MS2/Cardio: towards a multi-service medical software for cardiology.

Many clinics are interested to use software packages in daily practice, but lack of integration of such packages seriously limits their scope. In practice this often entails switching between programs and interrupting the run of an individual program. A multi-task approach would not solve this problem as it would not eliminate the need to input the same data many times, as often occurs when using separate packages. The construction of a Multi-Service Medical Software package (MSx2) is described, which was also developed as an example of practical integration of some clinically relevant functions. The package runs on a personal computer in an MS-DOS environment and integrates a time-oriented medical record management unit (TOMRU) for data of ambulatory patients, and a drug information management unit (DIMU) concerning posology, content, effects, and possible interactions. Of the possible database configurations allowed by MSx2, the cardiology patient database (MSx2/C) and hypertensive patient database (MSx2/H) were developed and described here. Clinical information to be included in the configurations was obtained after discussion and consensus of clinical practitioners. MSx2/C was distributed to several hundred clinical centers during computerized courses to train future users. MSx2 can easily transfer patient data to statistical processing packages.

Ambulatory Care Information Systems↗
PubMed1992

PADS (Patient Archiving and Documentation System): a computerized patient record with educational aspects.

Rapid acquisition and analysis of information in an Intensive Care Unit (ICU) setting is essential, even more so the documentation of the decision making process which has vital consequences for the lives of ICU patients. We describe an Ethernet based local area network (LAN) with clinical workstations (Macintosh fx, ci). Our Patient Archiving and Documentation System (PADS) represents a computerized patient record presently used in a university hospitals' ICU. Taking full advantage of the Macintosh based graphical user interface (GUI) our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent and complete automatic encoding of diagnoses following the International Classification of Disease (ICD; WHO, [1]). For educational purposes the user can also view disease entities or complications related to the diagnoses she/he encoded. The system has links to other educational programs such as cardiac auscultation. A MEDLINE literature search through a CD-ROM based system can be performed without exiting the system; also, CD-ROM based medical textbooks can be accessed as well. Commercially available Macintosh programs can be integrated in the system without existing the main program thus enabling users to customize their working environment. Additional options include automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological and health care related problems. Furthermore, we are in the process of integrating sound and digital video in our system. This system represents one in a line of modular departmental models which will eventually be integrated to form a decentralized Hospital Information System (HIS).

Computer User Training↗
PubMed1991

Introducing a computerized record and verify system: its impact on the reduction of treatment errors.

A survey of treatment errors has been conducted over a period of several months before and after the introduction of a CMS computerized record and verify system for radiation treatments administered on a Varian CL-1800 accelerator. It was found that treatment errors could be reduced considerably. However, some errors were also caused by wrong data entry into the system. In two instances, errors were detected only through the record and verify system; they had escaped all previous chart checks and would never have been found otherwise. The impact of the computerized record and verify system is analyzed with regard to improved treatment delivery, reception by technologists, and treatment documentation.

Humans↗
PubMed1992

Computers in medicine: enhancing medical care for children with developmental disabilities.

Caring for children with developmental disabilities and their families requires the close monitoring and management of a multitude of complex medical and psychosocial issues. The need for an interdisciplinary team approach to address these concerns presents special logistical problems on how to organize and present the information obtained during a clinic visit, and how to expedite the dissemination of this information to the team members. I am currently utilizing a computerized medical record database in the Developmental Disabilities Clinic at Children's Hospital-Columbus, Ohio and at The Nisonger Center a university affiliated program (UAP). The hardware required for the operation of this system includes a Macintosh PowerBook 170 and FilemakerPro software by Claris. The flexibility of use and the potential future applications of this program provides a practical clinical approach to caring for children with developmental disabilities.

Child, Preschool↗
PubMed1992

Eight year's experience with automated anesthesia record keeping: lessons learned--new directions taken.

For the past eight years, an automated anesthesia record keeping system, COMANDAS (COMputerized ANesthesia Data Acquisition System) has been used in the cardiovascular operating rooms at Mayo Clinic. The automated anesthesia record is designed to match the traditional hand-written record and becomes part of the official medical record. COMANDAS is interfaced with the physiologic monitor and mass spectrometer in each OR, and a number of other computers within the Mayo Medical Center. Since the introduction of COMANDAS over 24,000 surgical procedures have been charted. The anesthesia record is more complete, consistent in organization, and legible when compared to a hand-written record. Recently, it was determined that the computers and peripherals that make up COMANDAS were wearing out and that the vendors would no longer support or replace the equipment. A process to find a replacement for COMANDAS was then begun. Although the cardiovascular anesthesia group was satisfied with the automated anesthesia record, there were a number of areas in which improvement was desired. A systematic evaluation of the system was begun with a survey of the users. The majority of those surveyed felt that COMANDAS was a useful system which made parts of their job easier. The user interface, method of manual data entry, time to produce the record and difficulty learning the system were the source of the greatest dissatisfaction. Artifacts, networking, interfacing with other devices and computers were also issues for the replacement system. Most commercial systems were found wanting in one or more areas of significance. The most practical solution appeared to be the modification of a currently available intensive care unit patient data management system.

Anesthesiology↗
PubMedDate not supplied

Computerized medical records: defining a standard without the computer.

The inevitable computerization of medical records may be a boon or a hindrance to the practice of medicine. A comprehensive view of the project is essential for its success. Definite goals for the computerized medical record are stated to this end. An argument is presented for keeping the structure of the medical record separate from any specific requirements of technology. An elegant structure for medical records is proposed, independent of any computer system and requiring a minimum of definitions or special characters. The roles of clinical specialists (such as physicians and nurses), medical records specialists, administrators, accountants, and computer architects (hardware and software) are defined. In particular, the tasks of lexicon and template creation are defined and emphasized as urgent and ongoing challenges for specialty organizations.

Forecasting↗
PubMed1991

Information management in ambulatory care: the nurse and computerized records.

The ambulatory office setting is increasingly becoming a central focus of patient care. The nursing staff are integral to patient care management in this environment. They are frequently the heaviest users of medical records and are generally early advocates of well designed computer records systems. As our implementation of a Computer Stored Ambulatory Record (COSTAR V) has grown in complexity and utility, reorganization of the record and development of new features to support nursing has become critical. This demonstration will show how nursing information management has changed using a variety of computer record tools, including features of exam room data entry, specialized nursing displays and problem based patient summaries. Specific items for demonstration will include: nursing check-in module, rule driven nursing history program, prescription refill functions, documentation and billing for nursing procedures, nursing telephone management functions, a module for management of anticoagulation and document retrieval and display utilities.

Ambulatory Care Information Systems↗
PubMed1991

Surveillance of occupational risks using job-exposure matrices.

This article deals with the problem of surveillance of occupational risks of workers. Computer-assisted elaboration of the job history (JH) for each worker was achieved by means of a job-exposure matrix (JEM) for each company. The final aim of the project is to find correlations between the exposure data of JHs and the health data of corresponding medical records. As a first experiment, some JEMs were computed using rectangular arrays even though it was realized that this simple structure was not really adequate. Later on, the structure of the computerized JEM included the following questions: (1) what types of information are involved; (2) how can the job-exposure correspondence be represented in the computer; (3) what characteristics of a company should be used for the elaboration of a JEM; (4) who is to construct each JEM, and how? This article shows the inadequacy of some occupational names for evoking the appropriate risks, a drawback which can be surmounted if the company organization is included in the JEM. Based on our analysis, several specifications useful for JEM computerization have been suggested.

Data Collection↗