Can computer autoacquisition of medical information meet the needs of the future? A feasibility study in direct computation of the fine grained electronic medical record.
(57/7649)
The project describes feasibility testing of a two-year clinical deployment of an electronic record keeping system for primary care medicine that allowed financial medical management and clinical disease study without the encumbrance of human encoding. The software used an expert system for acquisition of historical information and automatic database encoding of each independent fact. The historical acquisition system was combined with a screen-based physician data entry system to create a fine-grained medical record. Fine-grained data allowed direct computer processing to mimic the ends that presently require human encoding--gatekeeping, disease characterization and remote disease surveillance. The project demonstrated the possibility of real time gatekeeping through direct analysis of data. Detection and characterization of disease states using statistical methods within the database was possible, however, limited in this study because of the large numbers of patient interviews required. The possibilities for remote disease monitoring and clinical studies are also discussed. (+info)
Intelligent split menus for data entry: a simulation study in general practice medicine.
(58/7649)
A compelling notion in menu design is that a few of the most frequently selected items should be placed as a hot list at the top of the menu. A few researchers have explored this type of interface control, known as a split menu, and have investigated the identification of the hot-list items by statistical analysis of past data. We extend the technique to automated development of dynamic hot-lists for entry of medication data in a General Practice setting. Using clinical data from 113,000 visits, a statistical model is developed and evaluated by simulated data entry of cases held back from training. Simulated SOAP note entry shows 12-item hot lists to hold over 70% of desired drug and diagnosis selections. Intelligent split menus should improve user efficiency if current selection methods require 3 seconds or more per item. A demonstration prototype can be downloaded over the Web. (+info)
Perceptions of house officers who use physician order entry.
(59/7649)
OBJECTIVE: Describe the perceptions of housestaff physicians about their experience using computerized physician order entry (POE) in hospitals. METHODS: Qualitative study using data from participant observation, focus groups, and both formal and informal interviews. Data were analyzed by three researchers using a grounded approach to identify patterns and themes in the texts. RESULTS: Six themes were identified, including housestaff education, benefits of POE, problems with POE, feelings about POE, implementation strategies, and the future of POE. CONCLUSION: House officers felt that POE assists patient care but may undermine education. They found that POE works best when tailored to fit local and individual workflow. Implementation strategies should include mechanisms for engaging housestaff in the decision process. (+info)
Implementation and evaluation of a virtual learning center for distributed education.
(60/7649)
A number of tools are required to support a distributed education program. This paper will relate experiences in the development and implementation of a web-based Virtual Learning Center. Initial evaluation offers direction for further development, necessary university support, and faculty and student preparation. (+info)
Bringing a virtual library to a small group classroom.
(61/7649)
A small group case discussion class would seem to be the ideal setting for a virtual library. Two courses at the Albert Einstein College of Medicine were observed. One hour of observation was of groups with no computer available, one hour of groups with a computer available "incidentally", and two hours of groups with computer integrated case material. Across all groups, at least one student was using a reference source (paper or computer) 55% of the time. In a room with no computer, paper references were used 59% of the time. In a room with a computer, references were used 53% of the time (18% computer only, 13% paper only, 22% both). While the amount of data is insufficient for detecting statistically significant difference, this study does provide important baseline data not previously available concerning reference use behavior for electronic and paper sources. (+info)
MediSign: using a web-based SignOut System to improve provider identification.
(62/7649)
Continuity of care necessitates communication between the primary providers of inpatient and outpatient care. Communication requires identification of providers in addition to clinical information. We have constructed a web-based SignOut System to improve provider identification. The web-based SignOut System correctly identified the provider for 100% (34/34) of patients in 1997 and 93% (37/40) of patients in 1998. The hospital bed census correctly identified the attending provider for 50% (17/34) of patients in 1997 and 73% (29/40) in 1998. When analyzed by attending type (i.e., service and private,) the SignOut System correctly identified 86% of service providers in contrast to the hospital bed census that correctly identified 57% of service providers. Both the SignOut System (100%) and the hospital bed census (95%) had superior results in identifying private attendings. The web-based technology provides a familiar user interface and ubiquitous workstation access. (+info)
The transition to automated practitioner order entry in a teaching hospital: the VA Puget Sound experience.
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We recently installed an automated practitioner order entry system on our busiest inpatient wards and critical care units. The installation followed 20 months preparation in which we created the workstation, network, and host infrastructure, developed requisite policies, recruited personnel to support the system, and installed the software in areas where the pace of order entry was less intense. Since implementing automated order entry, we have experienced problems such as an increase in time required for practitioners to enter orders, workflow changes on inpatient units, difficulties with patient transfers, and others. Our user support system has been heavily used during the transition period. Software tailoring and enhancements designed to address these problems are planned, as is installation of the order entry system in remaining clinical units in our medical centers. (+info)
The accessibility of information systems for patients: use of touchscreen information systems by 345 patients with cancer in Scotland.
(64/7649)
AIM: To examine cancer patients' use, and satisfaction with touchscreen information systems. By examining the experience of subgroups, to address issues of equality of access. PATIENTS: 345 patients starting radiotherapy at the Beatson Oncology Centre (BOC), Glasgow. METHODS: Patients were invited to use a touchscreen computer at the start of treatment. They were sent a printout of what they saw on screen. Patients had open access to the system. Data were collected at recruitment, intervention, 3 weeks and 3 months. Predictor variables included: patients' demographics, information preferences, technology use, and psychological state. Outcome variables included: use and views of the computer and printout. RESULTS: Younger, broadsheet readers with previous computer use were more likely to find the system easy to use. Older, tabloid readers were more likely to find the content new and relevant. DISCUSSION: We need to make systems adapt to users' different needs. More effort should be made to provide affordable information for older, generally less literate and technologically less literate groups in suitable locations. (+info)