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PubMed1986

A case for system security.

Mainframe security measures provided by the manufacturer, are adequate for normal security needs. However, a truly competent MIS security and/or hospital administration strategy must try to take advantage of the latest technological advancements as they become available. The integration of intelligent "dial-back" modems that "hang up" and then re-establish their communications link with a CRT terminal is now a requirement. However, finding a terminal with adequate stand-alone security devices is a different matter.

Computers↗

PubMed1988

PaperChase: computerized bibliographical retrieval for the physician.

PaperChase is a computer program that permits any physician or scientist to search the National Library of Medicine's MEDLINE data base of references to the biomedical literature. Written for the clinician rather than for the search librarian, PaperChase permits the user to search the entire MEDLINE collection of over 5,000,000 references published in 4,000 biomedical journals dating back to 1966. PaperChase is now available throughout the world to anyone who has a computer terminal or personal computer, and a modem. No special training is needed for a successful search. There is no user's manual. Users can search by title word, Medical Subject Heading, author's name, journal title, year of publication, language of publication, or any combination of the above. Users can read abstracts online, and they can request that a photocopy of the full text of any article be mailed to them.

Abstracting and Indexing↗

PubMed1989

Computers for the continuing education of practicing physicians.

Computer-based medical education became practical with the wide-spread availability of personal computers and the ease of dialing in to a central computer via standard telephone lines with a modem. Continuing education credits can now be earned from the privacy and convenience of the physician's home or office via the computer. A variety of courses are available from national medical organizations, medical schools, and medical publishers. While examples can give a flavor of the type of courseware available, only hands-on use can help you decide if this style of education fits yours.

Computer-Assisted Instruction↗

PubMed1998

[Delivery with epidural analgesia (a preliminary report)].

UNLABELLED: In the last decade delivery by continuous epidural analgesia (CEA) has become a golden standard in most modem perinatal centers. The aim of this study is to find the effect of CEA on the quality of labor, mode of delivery and the condition of mother and fetus after delivery. The study is prospective and includes 15 parturients. CEA was delivered with 0.25% solution of Marcaine. RESULTS: The average age of the parthers was 23 +/- 5.05 years and their body weights 63 +/- 9.82 kg. 13 of the women were nulliparous and 2 multiparous. All were delivered vaginally normally. The average length of the first period of labor was 4 Hours (+/- 3.18 h) and of the second period 20 minutes (+/- 11.06) q which is different from data from current literature. Labor was estimated in the cases with i.v. infusion of oxytocin. Apgar scores of the newborns was 8-10 points. We can conclude that deliveries with CEA are eutocic, shorter and promote and excellent psychoemotional state of the parturients.

Adult↗

PubMed1998

Psychological interventions in general hospitals: background, current status and clinical guidelines.

PURPOSE: To promote the systematic development, interests, practice, research and clinical applications of health psychology in general hospitals in Hong Kong and the mainland of China. DATA SOURCES: The targets and aims of therapeutic work with patients in pain, cancer patients, child and adolescent patients, patients with chronic illnesses, the elderly, and patients requiring organ transplantation are highlighted. STUDY SELECTION: The psychological interventions described are experiences derived from routine clinical services carried out in the Clinical Health Psychology Unit where the authors are affiliated, and can be seen as an example of a more comprehensive psychological intervention program for physically ill patients in Hong Kong. RESULTS: Psychological interventions have intrinsic values in reducing patients' distress and sufferings. The services are also an integral part of modem day comprehensive patient care with positive effects on treatment effectiveness and eventual illness outcome. CONCLUSIONS: Physical illnesses affect a person physically as well as psychologically. Psychological care in general hospitals is cost effective and beneficial in reducing undue psychological complications precipitated by physical afflictions as well as in promoting better overall outcomes.

Chronic Disease↗

PubMed1998

Telematic system for monitoring of asthma severity in patients' homes.

Despite advances in the treatment of asthma the morbidity and mortality of this disease has increased significantly in the past several years. Recent studies have shown that monitoring of asthma severity in the patient home especially combined with patient education can reduce incidence of asthma exacerbation and subsequent hospitalization. The existing methods for home asthma monitoring are limited by four factors; they completely rely on a patient's ability to document and to evaluate test results; there is no easy way for a physician to review data in a timely manner; they use imprecise tools for evaluation of asthma severity and they don't provide clinical decision support tools. The goal of this study is to develop and to evaluate a telematic system for asthma severity monitoring which will minimize patients' efforts in performing self-testing at their homes and allow prompt reciprocal exchange of all relevant information between patients and health care providers. In our setting, patients use portable spirometer and pocket-sized palmtop computer for data exchange. Our system allows daily serial monitoring of asthma severity at patients' homes using Forced Vital Capacity test and symptom diary. The results of the tests become available for physicians review immediately after completion of self-testing procedures via Web browser. The results can be transmitted from patients' homes (or any other remote location) to the medical records database via landline or wireless networks in several minutes. Each time the remote server receives patient's results, it invokes the application which tests the validity of data, analyzes parameters trends and dispatches corresponding messages for the patient and, if necessary, for physicians. Such an approach provides constant feedback loop between asthma patient and physician. The system has been tested in 10 healthy volunteers and asthma patients. Patients participated in the study from two to 21 days. The test results showed that the system provides reliable reciprocal exchange of all relevant information between a physician and asthma patient in home settings. Average transmission time from the patient's palmtop to the remote central data repository was about 1 minute for 14.4 Kbps landline modem, 6 minutes for cellular network and 8 minutes for RAM Mobile network. After transmission, the test results were immediately available for review at our web site.

Asthma↗

PubMed1999

Remote microscopy through the internet.

A fully robotic microscope Axioplan2 (Zeiss) and CCD camera (RGB-Sony) mounted on this microscope have been connected to a computer dedicated as an Internet server. This server is available by means of an Internet browser with an interpreter of the Java programming language. We have used Java technology for remote control this full-motorized telemicroscope. The Java program for microscope control is automatically downloaded and started when the user selects the Web site of the corresponding microscope server with his Internet browser. At the client's side, there is no need for any additional software except for what is included in Netscape Navigator 3.0, Microsoft Explorer 3.0 or its later versions. Our remote microscope can be remotely controlled from any place in the world through the Internet. The user can move the microscope stage, change the magnification or can execute any other microscope operations by pressing the related buttons of the downloaded telemicroscopy client program. The microscope server receives the commands from the client program, executes the operation on the microscope and after every new command distributes the next microscope image to the connected telemicroscopy clients. There are also software modules which allow marking a field of interest in the image and discuss. Every Internet user can control the remote microscope and discuss the images with others who have direct access to the Internet on-line, or are connected by modem or ISDN. The quality of the transferred microscopic images and response time is sufficient for practical use. No complicated installation processes are necessary and the system is easy to use. The system design makes every pathologist, who is the Internet user, to be a possible consultant.

Internet↗

PubMed1999

Data compression methods for EEG.

Modem brain research experiments require the recording of large amounts of high-accuracy EEG data. Sampling frequency, bit resolution and number of channels are significantly larger than in routine clinical measurements. Because of this, the need of efficient signal compression has emerged. This paper presents a survey of available methods and explores some techniques, both lossy and lossless, for compressing EEG signals.

Algorithms↗

PubMed1992

Increases in knowledge and use of information technology by entering medical students at McMaster University in successive annual surveys.

OBJECTIVE: To determine self-reported microcomputer and information technology competency, access, and usage by entering medical students and their perceptions of the need for training in additional applications. DESIGN: Cross-sectional surveys of successive classes. SETTING: McMaster University Faculty of Health Sciences Medical Undergraduate Program, which has a 33-month, problem-based, self-directed learning curriculum and a high applicant-to-student ratio. PARTICIPANTS: Medical school classes entering in 1987, 1988, and 1989. Response rates were 80%, 90%, and 86% respectively. MEASURES: A self-report questionnaire was sent to each student, with up to two follow-up letters to prompt a response. RESULTS: There was a progressive rise in reported information technology access and use for the three years. For the classes starting in 1987, '88, and '89 respectively, computer access was 29%, 49%, and 49% (P < 0.002 for linear trend), and, among those with computer access, modem access was 17%, 29% and 50% (P = 0.012). Self-service MEDLINE use on CD-ROM at the Health Sciences Library was 65%, 75%, and 89% respectively (P < 0.001) for all respondents within the first few months of starting medical school. Over 50% of each class stated they would take courses, if available, on clinical applications software, office management, online searching, filing, and CD-ROM searching. CONCLUSIONS: Half of the most recent entering students already had access to a personal computer and most wished to learn computer applications that would assist them with patient management, and with information access and organization. Medical schools need to address which applications they will teach or make available and how to bring all students to acceptable competency in their use.

Computer Literacy↗

PubMed1992

Can teledialysis help in the clinical management of patients on remote hemodialysis?

This study investigated whether transmission of the parameters monitored from a remote center to the main center could improve the control of a dialysis session. The parameters of the computer connection module Monitral SC in remote and main centers, were transmitted by means of the Hospal data collection software (Demoplus) by modem, to the host computer. Each remote center can be temporarily disconnected, if necessary, from the telephone line and linked directly to a local computer. We checked 101 hemodialyses. The dialysis was monitored from filter washing to disconnection of the patients and the following parameters were selected: backfiltration during washing and hemodialysis: ultrafiltration, conductivity and temperature. From the sessions recorded (93%) we observed that backfiltration during the filter preparation phase was high (30%) in 28 sessions. Backfiltration during the preparatory phase is the major problem for correct management of dialysis sessions. The high percentage in which ultrafiltration had to be stopped shows that control of this parameter is still not ideal. Finally, the collection of monitor parameters and the comparative analysis of clinical data is useful for improving dialytic management.

Adult↗

PubMed1992

CAD/CAM in dentistry: a historical perspective and view of the future.

What can we look forward too? Lots of fun with new CAD/CAM systems that will enhance dentistry, providing quality restorations quickly. The evolution of an array of new versions of already available systems as well as altogether new systems will provide improved quality, expanded capabilities, and increasing user friendliness. And new materials will be more esthetic, wear more nearly like enamel, and strong enough for full crowns and bridges. We can also look forward to lots of change. Because of the cost of CAD/CAM systems, many clinicians are likely to collaborate by sharing a single system. Laboratories and clinicians may collaborate as well, with data being gathered in the operatory and sent to a laboratory via modem. The fabrication would then be done by the laboratory. Other changes that we cannot even predict are likely to occur in dentistry. Exciting times are here. Automation through dental CAD/CAM systems will, most certainly, change the profession. The impact of that change will only be known in the future. But as the future approaches, the systems and materials available to us will continue to evolve, improve, and enhance dentistry.

Artificial Intelligence↗

PubMed1992

[Computer-assisted ENT medical literature search and literature management--a report of experiences].

The increasing number of medical articles calls for a computer-aided system for literature database programs, literature retrieval and bibliography systems. We report an assessment of a dedicated modem line to DIMDI of Cologne (an institute offering a variety of biomedical, psychological and other literature databases), Medline on Silverplatter, Current Contents on disk and the Papyrus bibliography system. The databases with retrieval software are installed on a IBM-compatible PC (386 with an 80MB hard disc) and 4 CD-ROM players. Medline contains bibliographic citations and abstracts of biomedical literature; Current Contents on disk with its weekly update provides citations of articles published very recently; and the Papyrus bibliography system maintains a permanent collection of reference citations. When linked to a word processor, Papyrus can automatically read the manuscript, create a bibliography and produce a new copy of the manuscript in which the citations have been appropriately edited, and the references can be printed in any desired format. Although not without drawbacks, the configuration described here proved to be a valuable, time-saving tool to access citations precisely.

Computer Systems↗

PubMed1991

Personal computer access to MEDLINE: an introduction.

Physicians can personally search MEDLINE to answer clinical questions or to update their knowledge base. The components required, each of which is discussed in the text, are a personal computer, a communications software program, a modem, the literature database, and an information vendor. Physicians can assemble and use these components with a minimum of expense and computer knowledge. For the novice searcher who does not want to make a large initial investment, obtaining a low-cost personal computer and using an information vendor such as GRATEFUL MED or PaperChase may be the most suitable alternative. For searchers without access to a medical library or for more experienced searchers, an information vendor such as BRS, MEDIS, or DIALOG may be more appropriate.

Computers↗

PubMed1990

PaperChase: a user-friendly program for searching the biomedical literature.

PaperChase is a computer program which provides an efficient interface to the National Library of Medicine's MEDLINE database of references to the biomedical literature. The database includes references (citations) and abstracts compiled from Index Medicus, the International Nursing Index and the Index to Dental Literature. PaperChase may be accessed using any computer terminal or personal computer with modem. No special knowledge of computers or biomedical terms is necessary. Simple menus enable the novice to search the biomedical literature without training. A command language speeds searching for the experienced user. PaperChase does not require the user to know the database's indexing terminology, called Medical Subject Headings. Everyday language may be used and PaperChase will translate, or "map", the user's search term into the required Medical Subject Heading. PaperChase monitors a search in progress and suggests additional Medical Subject Headings which can be used to broaden or narrow a search. The searcher can order a full-text photocopy of any reference found in PaperChase. Support documentation and a subscriber newsletter are provided at no charge. Trained search specialists are available to offer assistance and to answer questions.

MEDLARS↗

PubMedDate not supplied

Communicating in the 1990s: a technology update.

With the variety of available technologies, choosing among them will be difficult at best. Waiting for integration and standardization among technologies may effectively eliminate a competitive edge and productivity improvements for health care organizations. Also, selecting which one communication technology is needed may not be the issue since several technologies likely are needed to solve different communication needs in organizations. One might begin to sort out options by performing an assessment of current communication patterns and deficiencies. Ideally, the assessment should be completed by someone who is able to assess needs over an entire organization, not just one service or one organizational level. The assessment should focus at least on some of the following questions. Are three major problems with staff or client communications? If staff-related, are primary needs interactive with routine communication needs? If they are interactive, time-sensitive, and inter-organizational then a form of video-conferencing may help. Short-term interactive needs might be met by leasing video-conferencing rooms. Long-term, time sensitive interactive needs might require PC-based video-conferencing, Non-time-sensitive, interactive, inter-organizational needs might be met with voice mail or e-mail, which allow some time-delayed but single-mode interactions. If communication needs are routine, one might examine how e-mail, or fax could help. If text-based paper traffic through the mail room is enormous or slow, e-mail may help. If communication among persons at any level of geographically separate organizations is needed, modem-based or public e-mail may be the answer.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗

PubMed1990

Improving access to computer-based library and drug information services in patient-care areas.

A project to increase access to drug and biomedical information through electronic linkage of drug information and library services to three patient-care areas is described. In February 1987, microcomputer work stations were installed in the Bexar County Hospital District's hospital emergency department, medical residents' office, and ambulatory-care clinic, as well as in The University of Texas Health Science Center's library reference area and drug information service office. Drug information was available on compact disk through the Micromedex Computerized Clinical Information System (CCIS) database, which includes DRUGDEX, POISINDEX, EMERGINDEX, and IDENTIDEX. Each work station was also connected to the library's computer via modem, allowing access to the Library Information System, books, journals, audiovisual materials, miniMEDLINE, and an electronic mail system. During the six-month project, the system was used 5487 times by 702 people. The system was successful in providing drug and other information in clinical settings and in introducing clinical staff members to new information technology. To increase access to the system after the project ended, the CD-ROM version was discontinued, and the distributed tape version of CCIS for VAX computers was added to the library's online information system, making drug information more available throughout the campus and teaching hospitals. In 1988-89 an average of 200 people accessed the tape version of CCIS each month. Although it is difficult to replace the convenience of an onsite library, at least some drug and biomedical information needs in the clinical setting can be met through computer networking.

Computer Communication Networks↗

PubMedDate not supplied

MEDLINE, cancer-CD, SCI-CD addition on CD-ROM.

Compact Disc Read-Only-Memory, CD-ROM, is a powerful resource which combines the best features of both online and print access to the literature: multiple access points and leisurely browsing (online accessibility without a modem or without its cost). Applied to the MEDLINE database, this technology has created a brand new market, one which is increasingly competitive and therefore evolving rapidly. Five MEDLINE and two non-MEDLINE products are reviewed. The MEDLINE products include: BRS/COLLEAGUE DISC, Compact Cambridge, Ebsco's Core MEDLINE, Online Research System's Compact Med-Base, and SilverPlatter's MEDLINE on CD-ROM. The two other products include: Institute for Scientific Information's SCI CD Edition and SilverPlatter's CANCER-CD. The market is still wide open and the buyer is wise to try before he buys. However, there are great differences between the various packagings of a rather familiar product. In our view, in terms of ease of use, SilverPlatter was the clear winner. Ebsco's product is attractive because of its containment on one CD. Med-Base is the most original and offers special features not found elsewhere. Finally, personal preference is a strong consideration and should not be overlooked.

MEDLARS↗

PubMed1989

Accessing the biomedical literature: the South Dakota Med-Fax Network.

Librarians developed a plan for a medical information network based upon the needs of South Dakota physicians as revealed in a 1984 survey. The South Dakota Med-Fax Network received private funding in 1987 and became operational in 1988. The Network incorporates interactive simultaneous remote on-line database searching (ISRS) and telefacsimile transmission to expedite the identification and delivery of medical literature to South Dakota physicians. At present, the Network is composed of sixteen institutional sites. Individual physicians may establish their own sites if they provide an IBM compatible personal computer with a modem and purchase a telecommunications software package. The Network will provide training and follow-up support. Use patterns to date demonstrate that telefacsimile transmission is instrumental in reducing significantly the time necessary to deliver journal literature and that ISRS searching is the method of choice in the Network's remote sites.

Humans↗