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PubMed1992

The MEDLINE Retriever.

Baylor College of Medicine has developed the MEDLINE Retriever, a tool to query MEDLINE, the data-base of medical literature at the National Library of Medicine. The MEDLINE Retriever communicates via the Internet to achieve excellent response time for MEDLINE queries. It uses the X Window System and the Motif toolkit, and employs the Knowbot Operating Environment developed by the Corporation for National Research Initiatives. We discuss the architecture of the MEDLINE Retriever, focusing on the graphical user interface that we have developed, as well as our experiences in developing and deploying the MEDLINE Retriever at Baylor. The MEDLINE Retriever is an extension of Baylor's IAIMS design concept that brought forth the Virtual Notebook System, and fits well with Baylor's aims with regard to the High Performance Computing Initiative.

Computer Communication Networks↗
PubMed1992

An interactive graphics information system for familial data.

GRIFFIN, an interactive graphics system for studying familial information, facilitates viewing of complex databases and introduces graphical representations of multivariate scalar data into a conventional pedigree display format.

Computer Graphics↗
PubMed1992

The organization engine: virtual data integration.

The Organization Engine is an early example of Virtual Data Integration--providing the appearance of integration at the desktop without modifying existing infrastructure. Starting with the Organization Engine, eight programming days were needed to provide uniform desktop access to a CODASYL-compliant hospital information system and to a MUMPS-based radiology information system (the technique is equally effective for relational and other data bases). The resulting tool provides a seamless integration of these two systems, image storage, pre-recorded audio, and document storage. In addition to providing uniform access, the tool allows healthcare providers to organize the data to suit their individual needs. The ease of this integration lies in two simple techniques: the transformation of data from all sources into a single, homogeneous representation, and the use of simple customization files to describe new object types and formats. The approach is sufficiently general to allow the integration of applications which present external interfaces of radically different forms. Two such forms are discussed here: data map publication and transactions.

Computer Communication Networks↗
PubMed1992

Collaboration between unlikely disciplines in the creation of a conceptual framework for nurse-computer interactions.

A unique conceptual framework for the study of nurse-computer interaction was created through the collaboration of two researchers in seemingly diverse fields: nursing informatics and developmental psychology. The framework depicts nurses and computers interacting in a system of mutual influences, exchanging information during a particular task, and proceeding on a developmental trajectory. The conceptual framework can help guide research within nursing informatics and help build a cohesive body of knowledge for the future.

Medical Informatics↗
PubMed1992

DentLE. The dental learning environment: a prototype.

The State University of New York at Buffalo School of Dental Medicine was awarded a 'Model Curriculum' grant through the USPHS Bureau of Health Professions Education. The award was provided in support of the School's ongoing effort to design a 'model electronic curriculum' for the health professions. The project's development is described from its grounding in critical thinking and problem solving to a discussion of its features including the organization of its knowledge base, the layout of its computer-based oral health record, and its navigation features.

Computer-Assisted Instruction↗
PubMed1992

Real problems: a layered approach to constructing a patient simulation.

We propose and have implemented a program, called "Real Problems", for the authoring of simulated patient encounters. This program uses a layered database approach to separate the unchanging sections of the program from the more patient-specific sections, so as to increase the speed of authoring. The user's interest is maintained through the use of graphics, sound and extensive feedback.

Computer Graphics↗
PubMed1992

Decision support system and medical liability.

Expert systems, which are going to be an essential tool in Medicine, are evolving in terms of sophistication of both knowledge representation and types of reasoning models used. The more efficient they are, the more often they will be used and professional liability will be involved. So after giving a short survey of configuration and working of expert systems, the authors will study the liabilities of people building and the using expert systems regarding some various dysfunctions. Of course the expert systems have to be considered only for human support and they should not possess any authority themselves, therefore the doctors must keep in mind that it is their own responsibility and as such keep their judgment and criticism. However other professionals could be involved, if they have participated in the building of expert systems. The different liabilities and the burden of proof are discussed according to some possible dysfunctions. In any case the final proof is inside the expert system by itself through re-computation of data.

Expert Systems↗
PubMed1992

A history-taking system that uses continuous speech recognition.

Q-MED is an automated history-taking system that uses speaker-independent continuous speech as its main interface modality. Q-MED is designed to allow a patient to enter her basic symptoms by engaging in a dialog with the program. Error-recovery mechanisms help to eliminate findings resulting from misrecognitions or incorrect parses. An evaluation of the natural language parser that Q-MED uses to map user utterances to findings showed an overall semantic accuracy of 87 percent; Q-MED asks more specific questions to capture findings that were not volunteered, or that were unable to be parsed in their initial, open-ended form.

Back Pain↗
PubMed1992

The integration of a continuous-speech-recognition system with the QMR diagnostic program.

We describe a continuous-speech interface for Quick Medical Reference (QMR), which allows physicians to input spoken descriptions of physical-examination findings, or observations. We analyze the difficulties in designing a continuous-speech interface for systems that use medical terminology. We present a method for matching spoken findings names expressed in natural language to QMR terms. The method is based on a semantic representation of findings that both minimize the effect of misrecognition and derive grammars that are necessary for supporting the recognition process.

Diagnosis, Computer-Assisted↗
PubMed1992

Improving the quality of emergency department documentation using the voice-activated word processor: interim results.

We examined whether voice-activated word processors provide an acceptable means for emergency physicians to create medical records. Our study addressed three areas of inquiry: whether physicians can be induced to try this new technology, whether they will continue to use it after outside technical support is withdrawn, and the factors contributing to adoption and substantial use of voice-activated computers by practicing emergency physicians. This paper presents findings from the first half of the study, reflecting physicians' reported experiences while receiving onsite training followed by technical support for three months after system installation. Based on preliminary assessments, the keys to successful use appear to include physician and group commitment, acceptance of a steep learning curve, and flexibility in adapting the computer software and/or practice habits.

Demography↗
PubMed1992

Direct physician entry of injury information and automated coding via a graphical user interface.

Injury data in the paper medical record are often inaccurate or lack adequate specificity to evaluate trauma patient care. To improve the quality of recorded injury data, we are testing a graphical, anatomic-based interface for quick collection of detailed injury information directly from the trauma physician. Navigation and data collection throughout the interface are facilitated by anatomic illustrations, menus, lists, and "dialog boxes". Using a "point and click" method, the user selects a specific anatomic structure (i.e., the spleen) from drawings. Detailed injury information, specific to the selected structure, is then collected from the user in an "intelligent" modal dialog box. The software uses SNOMED III nomenclature to create and store ICD, AIS, and trauma registry codes for each injury. Users can review and print abbreviated and detailed injury information for each patient. This demonstration will walk viewers through the injury collection and review process for injuries to the abdomen. We plan to evaluate the interface for accuracy, speed, user satisfaction and resources expended by comparing it with current methods of data collection and injury coding at our level I trauma facility.

Computer Graphics↗
PubMed1992

VA's Integrated Imaging System on three platforms.

The DHCP Integrated Imaging System provides users with integrated patient data including text, image and graphics data. This system has been transferred from its original two screen DOS-based MUMPS platform to an X window workstation and a Microsoft Windows-based workstation. There are differences between these various platforms that impact on software design and on software development strategy. Data structures and conventions were used to isolate hardware, operating system, imaging software, and user-interface differences between platforms in the implementation of functionality for text and image display and interaction. The use of an object-oriented approach greatly increased system portability.

Computer Graphics↗
PubMed1992

PC CLIN-SIM: a toolbook based clinical simulation environment.

The Departments of Computer Medicine, Health Care Sciences, Medicine, and Electrical Engineering & Computer Science at the George Washington University have joined forces to create a clinical simulation program. The purpose of this program is to provide experience in the management of complex patient populations (eg geriatrics). A number of simulation programs are available commercially, however none provide adequate geriatric content, or were deemed to lack functionality important to the developers. The immediate goal of this effort was to create a computer-based, core curriculum in geriatric medicine for medical and allied health students. The curriculum includes case simulations linked to a comprehensive reference database. The development objectives were to create an intuitive, friendly, consistent user interface which could serve as a shell for additional content areas. In order to increase fidelity, free text entry and time simulation were included.

Computer Graphics↗
PubMed1992

Testing spatial understanding of anatomy.

A system was designed to test the medical student's ability to recognize and locate anatomical cross-sections. The computer was used to prepare the data, present the test and track the user's responses. The nature of the test was such that it could be prepared, presented and used much more easily on the computer than on paper. The system was used successfully by anatomists and medical students.

Anatomy↗
PubMed1992

MailMinder: taming DHCP's mailman interface.

While the Department of Veteran's Affairs Decentralized Hospital Computer Program (DHCP) is one of the most widely disseminated and successful hospital information systems in existence, it currently is accessed through a user interface which is not as mature as the rest of the system. This interface is a VT-100 compatible, character oriented interface using menus accessed by typed commands for feature access. This project demonstrated that a mature graphical user interface (MailMinder) can be successfully used as a "front-end" to DHCP. MailMinder is completely compatible with the existing unmodified DHCP electronic mail program, Mailman. MailMinder allows the user to be more efficient than the current interface and offers additional features over the current mail system. The program has undergone evaluation and limited deployment at five separate sites. The feature set of this program and its operation will be shown at this demonstration. The demonstration has implications for all current hospital information systems.

Computer Graphics↗
PubMed1992

M NET: a statewide referring physician computer network.

M NET, the Referring Physician Computer Network, is a joint project between the University of Michigan Medical Center (UMMC) and IBM. A graphical user interface was developed to allow referring physicians easy access to a variety of patient, clinical, and institutional data. File transfer mechanisms were created and current clinical database files and programs were enhanced and restructured to facilitate remote data transmission. M NET is currently installed in referring physician office sites across the state, with additional physician sites identified and program enhancements under development.

Computer Communication Networks↗