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The authors' laboratory integrated optical mark readers with its existing mainframe computer system to streamline order processing--and improved staff morale as well.
Korean hospitals are experiencing an increasing amount of financial difficulty due to government control of hospital rates since national health insurance has been implemented. The decision support system (DSS) was developed to provide cost and revenue information for the services rendered by each department in an effort to reduce costs. This information may be used to identify the causes of financial loss if cost exceeds revenue and to develop budgets for the next year. The DSS was developed using a micromainframe interface approach where the mainframe computer collects and summarises daily cost data and the micro computer allocates the data to each department.
One hundred seventeen forensic postmortem cases have been studied under controlled conditions. In each case, temperatures of the brain, liver, rectum, and the environment were monitored over a period beginning shortly after death and ending up to 60 h postmortem. The four temperature measurements were recorded every 5 to 10 min using the Microwave Thermography System. Rectal and environmental temperatures were measured by electrical thermocouples while brain and liver temperatures were measured using microwave probes. Data acquisition, analogue-to-digital conversion (ADC), and data processing were provided by a microcomputer. The ADC technique is described and its problems are discussed. The data were then transferred to a mainframe computer for extensive curve-fitting and statistical analysis. The microcomputer-based ADC and data logging and acquisition were found to be accurate, fast, easy to implement, and useful for the field. The postmortem rate of human body cooling was found to be adequately represented by triple-exponential equations.
We talked about using 3 UNIX commands. In UNIX, there are many other options for using them. But for the most part, if you can use them like I have shown, you will be able to do everything you need. If you can learn these few points well, I think you will be better off than if I give you 50 options and leave you totally confused about when to do what. On some UNIX systems, an electronic version of the UNIX manual is on the system. This gives a lot more information about each command. However, it is a bit difficult to understand. If you want more information about any command, you can type man COMMAND, e.g., man ls. This will give you more ways to use the ls command. And remember, the command pwd tells what directory you are in, cd/directory changes to another directory, ls lists the contents of the directory you are in, ls more displays the directory contents 1 page at a time (the space bar gives you the next page), ls-al gives a detailed listing of the contents of the directory you are in, ls-al more displays them 1 page at a time (the space bar gives you the next page).
Replacing a hospital's obsolete mainframe computer system with a modern integrated clinical and administrative information system presents multiple challenges. When the new system is activated in one weekend, in "big bang" fashion, the challenges are magnified. Careful planning is essential to ensure that all hospital staff are fully prepared for this transition, knowing this conversion will involve system downtime, procedural changes, and the resulting stress that naturally accompanies change. Implementation concerns include staff preparation and training, process changes, continuity of patient care, and technical and administrative support. This article outlines how the University of Missouri Health Care addressed these operational concerns during this dramatic information system conversion.
Using miniature cassette tape recorders, measurement of ECG and other physiological measures is possible in industrial or working situations. The development of a semi-automatic high speed processing system for analysis of the tape recorded data is described. This system decodes the signals on the tape, converts ECG to heart rate and presents a listing of the heart rate variation over the recording period, which may be up to 24 hours. A punched paper tape copy of the listing is used for input into a mainframe computer for subsequent analysis. The recorders and processing system have been used extensively for three years on a study of industrial work stress, and have proved reliable, accurate, and of sufficient sensitivity for in-depth analysis. They allow considerable data to be collected, permitting the thorough statistical analysis necessary for the interpretation of complex physiological responses.
Like many hospitals, pneumonia is the number one reason patients are admitted to Richardson Medical Center in Rayville, LA. Most of the treatment costs for those patients involve radiology and pharmacy. But the 49-bed hospital has reduced its drug costs for pneumonia treatment by 26% by harnessing the power of data stored on its mainframe computer.
K (Kell) is one of the most immunogenic of the red blood cell (RBC) antigens. In order to select K- RBC units, we developed K phenotyping on the Olympus PK-7200 equipment to save labor, time, and costs. The Olympus PK-7200 is fully automated equipment used primarily for blood typing and syphilis screening. We tested 3,587 blood donor samples in EDTA using a commercial anti-K serum diluted in HP Hemagen Power Solution(1:40). The equipment was set to prepare a 1.7% RBC suspension in bromelain and to dispense 25 microL of the mixture (diluted serum and HP Hemagen Power Solution) in terraced microplates. After mixing, the microplates were incubated for 1 hour at 30 degrees C. Reading was performed by a C.C.D. camera and the results were automatically transferred to the mainframe computer. We found 185 K+ blood samples and 3,402 K- samples. Four samples, K+ by the PK-7200, were confirmed as K- by tube test. The use of bromelain with the PK-7200 may have caused the falsely positive tests. The Olympus PK-7200, used for K phenotyping, saves labor time and costs. It also reduces handling and thus promotes less contamination risk for laboratory personnel.
This article describes a microcomputer application designed to manage data collected from patients assessed for weaning from mechanical ventilation. The application has menu options for obtaining individual summaries of serial weaning assessments. These summaries provide an overview of patients' progress during the weaning process. Users also have the option of obtaining information about procedures and problems often encountered during weaning. In addition, weaning summary data are easily transferred to mainframe computers for statistical analyses. The application is an efficient data manager and provides information that can be used during the patient care decision process, for staff and student instruction, and for research purposes.
This study aims to develop an electronic nursing and caring system to manage patients' information and provide patients with safe and efficient services. By transmitting data among wireless cards, optical network, and mainframe computer, nursing care will be delivered more systematically and patients' safety centered caring will be delivered more efficiently and effectively. With this system, manual record keeping time was cut down, and relevant nursing and caring information was linked up. With the development of an electronic nursing system, nurses were able to make the best use of the Internet resources, integrate information management systematically and improve quality of nursing and caring service.
Since CDC acquired its first mainframe computer in 1964, the use of information technology in public health practice has grown steadily and, during the past 2 decades, dramatically. Public health informatics (PHI) arrived on the scene during the 1990s after medical informatics (intersecting information technology, medicine, and health care) and bioinformatics (intersecting mathematics, statistics, computer science, and molecular biology). Similarly, PHI merged the disciplines of information science and computer science to public health practice, research, and learning. Using strategies and standards, practitioners employ PHI tools and training to maximize health impacts at local, state, and national levels. They develop and deploy information technology solutions that provide accurate, timely, and secure information to guide public health action.
The Laboratory Services Branch (Epi Lab) of the Epidemiology Division, Brooks AFB, Texas, is designated by regulation to serve as the Air Force's central reference laboratory, providing clinical laboratory testing support to all Air Force medical treatment facilities (MTFs). Epi Lab recognized that it was not offering the MTFs a service comparable to civilian reference laboratories and that, as a result, the Air Force medical system was spending hundreds of thousands of dollars yearly for commercial laboratory support. An in-house laboratory upgrade program was proposed to and approved by the USAF Surgeon General, as a Congressional Efficiencies Add project, to launch a two-phase initiative consisting of a 1-year field trial of 30 MTFs, followed by expansion to another 60 MTFs. Major components of the program include overnight air courier service to deliver patient samples to Epi Lab, a mainframe computer laboratory information system and electronic reporting of results to the MTFs throughout the CONUS. Application of medical marketing concepts and the Total Quality Management (TQM) philosophy allowed Epi to provide dramatically enhanced reference service at a cost savings of about $1 million to the medical system. The Epi Lab upgrade program represents an innovative problem-solving approach, combining technical and managerial improvements, resulting in substantial patient care service and financial dividends. It serves as an example of successful application of TQM and marketing within the military medical system.
The competitors of hospital pathologists are commercial reference laboratories, hospital special function laboratories, pathology groups in neighboring hospitals, hospital mainframe computer personnel, and users of patient proximity testing systems. The laboratory information system can provide a strategic advantage over these competitors by matching, exceeding, or substituting for their capabilities and by creating switching costs for clinics, administrations, and patients. For example, the installation of microcomputers in clinicians' private offices provides them with ready access to the pathology data base, bonds them to the hospital, and capitalizes on the willingness of the hospital to invest in information technology.
A program was written to calculate the probability of patient survival, tabulate the results in the form of a life table and compare two patient groups by the Mantel-Haenszel (logrank) test on a microcomputer. The program reads data in either a text form or the format of data files of the dBASE III/III plus (Ashton-Tate). The program is entirely menu-driven and extremely easy to use. The structure of the data files and the function of the program are described. This program is useful to those without easy access to mainframe computers.
The Maternal and Child Health Information Network--MATCH--was begun in 1984 as a demonstration project with support from the Division of Maternal and Child Health of the Health Resources and Services Administration, Public Health Service. The primary purpose of the project was the development of a system to manage data related to prenatal, child health, family planning, and genetic services that are delivered with State support in clinics in the State of Ohio. The design of MATCH enables the same data base to be used at both the State and local levels. Because it allows all participants, central and district, to manipulate the raw data, it is called an end-user--as opposed to a batch retrieval--system. Data recorded on individual forms during each client's visit to local service clinics are collected and entered into a microcomputer whose software package is a commercial data base. The clinic can then use the data for its purposes: program planning, management, evaluation, client referrals, appointment followup, quality control, and billing. The same data are also uploaded by central office staff to the State's DEC mainframe from data-filled disks mailed in by the clinics. Personnel who staff local projects can access their own data on the mainframe computer to generate reports for local use and send and receive messages electronically. That is, the system is "interactive." The intent is to first link data generated by the primary care and preventive programs of maternal and child health (MCH) in an information system,then link that system to other health data arriving at the State health department (for example, birth and death certificates), and, finally, to use the system as the basis for a State level MCH primary care data system in Ohio for surveillance, planning,management, quality control, accountability,and research purposes.
A controlled trial to determine the effects of introducing a centralised, computerised immunisation register commenced in Northland in May 1985. All infants born since 1 January 1985 have been registered on the Health Department's mainframe computer and assigned to either control or test groups. This birth information has been used to study two interventions aimed at increasing immunisation levels in the experimental group. The first involves sending to general practitioners lists of infants due for immunisation, and the second sending immunisation reminder cards to parents. Results show significant differences in immunisation levels between test group infants and comparable controls: an 18.2% increase for the six week immunisation, a 16.7% increase for the three month immunisation, and a 4.7% increase for the five month immunisation. A user survey has shown a high degree of acceptance by GPs and practice nurses. The pilot scheme will continue through 1986, and will be used over this period to improve acceptability to users and assist in planning a possible national computerised immunisation information system.
Pattern recognition techniques--discriminant analysis and principal component analysis--are utilized in selecting the wavelengths for monitoring, by reflectance spectroscopy, color-generating reactions involving uric acid and cholesterol in serum. The data base we used was accumulated by a rapid-scanning reflectance spectrophotometer that measured reflectance at 16 wavelengths every 5 s after the reaction was initiated. The data were then analyzed in multidimensional space mainframe computer with commercial statistical software packages. The most appropriate wavelengths were those that yielded the largest generalized distance between analyte concentration by discriminant analysis and the largest weighting coefficient by principal component analysis. For uric acid, taking the ratio of reflectance measured at two wavelengths instead of at a single wavelength much better separates the clinically significant concentrations. For cholesterol, the initiated. The data were then analyzed in multidimensional space hemoglobin, can be clearly demonstrated y the "pattern" generated with principal component analysis. generalized distance between analyte generalized distance between analyte concentration by discriminant
A computerized system to maximize inventory performance in a small hospital is described. An inventory control system, which integrates economic order quantity (EOQ) and ABC inventory models was implemented in a 146-bed hospital. The perpetual inventory control data base, supported by the hospital's mainframe computer, generates monthly inventory statistics that are segregated into A, B, and C reports. Using a hand-held computer that interfaces with the perpetual inventory system, a series of inventory management reports were developed. These reports, which are based on the EOQ model, provide the following information for each drug line item: EOQ, EOQ proposed carrying cost, actual inventory carrying costs, safety stock, order point, average inventory, and the "on hand/on order" point. Several supplemental inventory management reports were also developed. While implementing the computerized inventory system, the pharmacy also changed its purchasing strategy from predominantly direct accounts to a progressive prime-vendor wholesaler. From December 1980 to December 1981, the ABC/EOQ system with progressive prime-vendor involvement essentially doubled total aggregate inventory turnover. A 46.5% reduction in standing inventory levels occurred. The drug cost per line item dispersed remained relatively constant over the one-year period, despite price increases. The application of the computerized ABC/EOQ inventory model to an online perpetual inventory control data base effectively reduced the inventory operation costs.