Real-time automated interfacing of a dedicated departmental computer to a mainframe computer.
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The hospital mainframe computer pharmacist intervention documentation system described has successfully facilitated the recording, communication, analysis, and reporting of interventions at our hospital. It has proven to be time efficient, accessible, and user-friendly from the standpoint of both the pharmacist and administrator. The advantages of this system greatly outweigh manual documentation and justify the initial time investment in its design and development. In the future, it is hoped that the system can have even broader impact. Intervention/recommendations documented can be made accessible to medical and nursing staff, and as such further increase interdepartmental communication. As pharmacists embrace the pharmaceutical care mandate, documenting interventions in patient care will continue to grow in importance. Complete documentation is essential if pharmacists are to assume responsibility for patient outcomes. With time being an ever-increasing premium, and with economic and human resources dwindling, an efficient and effective means of recording and tracking pharmacist interventions will become imperative for survival in the fiscally challenged health care arena. Documentation of pharmacist intervention using a hospital mainframe computer at UIH has proven both efficient and effective.
The translation of mainframe-stored information in ASCII into spreadsheet format for use in Lotus 1-2-3 is explained. Details are presented on how to use the Data Parse command to create a translation template that tells Lotus 1-2-3 how to interpret a file written in ASCII. Lotus 1-2-3 can also translate some files in formats other than ASCII. It can translate files in the Data Interchange Format directly into its own format. Translating mainframe computer data into spreadsheet format is relatively simple and obviates the rekeying of those data.
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This paper describes a computer based method that was developed to prepare a profile of the patient care experiences of a cohort in a three-year, university based family practice residency. Sample pages from the report produced by this method and a description of the computer program are presented. This method of presenting patient encounter information may be particularly useful for program-level evaluation and for monitoring resident training.
The development and implementation of a code that enables pharmacists to document their clinical interventions in the hospital's computerized patient records is described. To allow data to be entered in patient records from terminals throughout the hospital that are linked to the mainframe computer, a code was developed to summarize each pharmacist recommendation. The coded information is added to the computer entry for the specific drug requiring intervention. A computer program was developed inhouse for generating daily reports of the pharmacist interventions. During an initial 25-day study period, 300 interventions were documented; house staff physicians accepted the pharmacists' recommendations in 257 (85.7%) of these interventions. An additional 17 (6%) of the interventions resulted from physicians' requests for pharmacists' recommendations. In addition to review of all pharmacist clinical interventions, this system allows review of a specific target drug to determine compliance with institutional drug-use guidelines. Through use of the computer program developed at this hospital, information that documents pharmacists' clinical services can be entered directly into patients' records on the hospital's mainframe computer system and retrieved as useful reports.
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Critical, intertwined objectives for consultation psychiatry include 1) the development of data-based clinical practices, and 2) heightening the effectiveness of consultation. Toward these ends, the Consultation Psychiatry Service at the University of Minnesota has previously conducted systematic studies of consultation and established an ongoing data collection system for consultations. Both steps have relied extensively upon mainframe computer capability. This primary application of computer capability to the field of psychiatric consultation is reviewed by the authors.
The minicomputer-based information system in the Department of Radiology at the Medical College of Georgia Hospital and Clinics was placed in service in February, 1982. This system represents a sizable investment in minicomputer hardware in addition to more than 6 years of software customization. One serious deficiency in the original system was the lack of a radiology results reporting facility. Several options were considered to provide the department with this capability. The most obvious option was retiring the existing system and replacing it with one of a number of commercial products already offering results reporting. In-house development of a reporting facility lent itself more readily to microcomputers than to the existing minicomputer system. Due to system customization, economic and time constraints, it was decided to merge an in-house developed microcomputer-based report module into our existing minicomputer system. The minicomputer was able to communicate with and transfer files to and from both micro and mainframe systems. Combining technologies allowed us to continue taking advantage of our sizable investment in money, time, and customization while providing a microcomputer-based report module. Radiology reports are now typed on microcomputer word processors and bulk transferred to the minicomputer. The minicomputer provides access to both unapproved and approved reports on system terminals throughout the department. It also enhances reports by merging patient demographics and registration information. Using existing communications facilities to the hospital mainframe system, reports are provided throughout the institution.
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A unique computerized management system has been used to control the anticoagulation of over 400 patients at a large teaching hospital for the last eighteen months. The system is located on the main pathology computer which can be interfaced with the patient administration system (PAS). This enables files in the anticoagulant program to be linked with files in the PAS and files in the haematology database. This system has many advantages over a stand-alone microcomputer system and will form the basis for the next generation of computerized anticoagulant management systems.
We constructed a micro-mainframe-link clinical research system for personal use (Personal Clinical Research System). This system was developed with both a mainframe computer and a personal computer (PC). The prepared programs included a database manager (on the mainframe computer), a user interface program (on the PC), and a communication control program that connected the mainframe computer with the PC. The database on the mainframe computer was constructed by two methods. The first method was to transmit data from the PC to the mainframe computer. The second method was to extract data from the patient information database. Using this system, a physician is able to construct a personal research database that contains interesting data for the physician. In addition, the physician is able to accumulate data on a special field using this system. A discharge summary system is now in operation as an example of this system.
If mainframe computing is like driving a reliable sedan, some experts say client-server computing is like driving a fast, maneuverable sports car. But until you understand and fine-tune a client-server system, performance can be disappointing.
We describe a laboratory information system employing a virus and chlamydia database developed over seven years which is used by a regional laboratory, performing virus and chlamydia testing. The information system is implemented on a University mainframe computer and accessed by computer terminals in the laboratory. The database is used to identify patients, store patient test results, minimize clerical work and improve accuracy of reported results. The database also serves as a patient registry for use in education and research.
1 The methodology and interim results of a post marketing surveillance of captopril, the first orally active angiotensin converting enzyme inhibitor are presented. 2 Utilising viewdata technology, details of hypertensive patients were entered directly into a mainframe computer. This allowed day to day monitoring of events; a facility not available with paper-based methods. 3 The design of the study allowed analysis of results including some details of efficacy, concomitant therapy, any disease symptoms and reasons for withdrawal. These factors could be categorised according to sex and age. 4 This preliminary report is based on the first 13,295 patients entered from July 1983 with follow-up until January 1985. The results of the study confirm the safety of captopril in the patients studied.
As a company changes in scope and character, so must its information systems. Here is a case of a multitude of risks and gains by a large hospital supplier that was spun off from its parent and decided to convert from the world of a large mainframe computer to networked personal computers.