HOLON/CADSE: integrating open software standards and formal methods to generate guideline-based decision support agents.
(41/1524)
This paper describes the efforts of a consortium that is trying to develop and validate formal methods and a meta-environment for authoring, checking, and maintaining a large repository of machine executable practice guidelines. The goal is to integrate and extend a number of open software standards so that guidelines in the meta-environment become a resource that any vendor can plug their applications into and run in their proprietary environment provided they conform to the interface standards. (+info)
The dissemination of clinical practice guidelines over an intranet: an evaluation.
(42/1524)
This study compares two clinical practice guideline dissemination systems. It was hypothesized that placing guidelines on an intranet would make this information easier to retrieve. Retrieval time, retrieval accuracy, and ease of use were empirically evaluated. Sixteen clinicians from Kaiser Permanente volunteered to complete tasks that measured these variables. Time values were significantly longer for tasks completed with intranet guidelines (Intranet = 6.7 minutes, Paper = 5.7 minutes). Tasks completed with paper guidelines had a significantly higher percentage of perfect scores than those completed with the intranet (Paper = 85%, Intranet = 59%). There was no significant difference in reported ease of use. Simply placing clinical information on an electronic system does not guarantee that the information will be easier to retrieve. Such information needs to be fully integrated into the clinical decision making process. Computerizing guidelines may provide a necessary initial step toward this goal, but it does not represent the final solution. (+info)
Design of a clinical notification system.
(43/1524)
We describe the requirements and design of an enterprise-wide notification system. From published descriptions of notification schemes, our own experience, and use cases provided by diverse users in our institution, we developed a set of functional requirements. The resulting design supports multiple communication channels, third party mappings (algorithms) from message to recipient and/or channel of delivery, and escalation algorithms. A requirement for multiple message formats is addressed by a document specification. We implemented this system in Java as a CORBA object. This paper describes the design and current implementation of our notification system. (+info)
Questionnaire survey of California consumers' use and rating of sources of health care information including the Internet.
(44/1524)
OBJECTIVE: To understand how Californians use and rate various health information sources, including the Internet. RESEARCH DESIGN: Computer-assisted telephone interviews through which surveys were conducted in English or Spanish. SUBJECTS: A household sample generated by random digit dialing. The sample included 1007 adults (18+), 407 (40%) of whom had access to the Internet. MAIN OUTCOME MEASURES: Past health information sources used, their usefulness and ease of use; future health information sources, which are trusted and distrusted; and concerns about integrating the Internet into future health information seeking and health care behaviors. RESULTS: Physicians and health care providers are more trusted for information than any other source, including the Internet. Among those with Internet access, a minority use it to obtain health information, and a minority is "very likely" to use e-mail to communicate with medical professionals or their own doctors and nurses, to refill prescriptions, or to make doctor appointments. Also, most of those with Internet access are "unlikely" to make their medical records available via the Internet, even if securely protected. CONCLUSIONS: The public, including frequent Internet users, has major concerns about the confidentiality of electronic medical records. Legislation may not assuage these fears and a long-term, open and collaborative process involving consumers and organizations from all the health care sectors may be needed for full public assurance. (+info)
The use of electronic mail in biomedical communication.
(45/1524)
OBJECTIVES: To determine whether there are statistically significant differences in the content of electronic mail (e-mail) and conventional mail sent to authors of papers published in medical journals. DESIGN: Prospective study by postal questionnaire. Over two one-month periods, corresponding authors of papers published in medical journals were asked to record details of the correspondence prompted by their publications. MEASUREMENTS: Conventional and e-mail correspondence received. Reprint requests. Content of correspondence. Quality of correspondence. RESULTS: Eighty-two of 96 authors replied. Fifty received e-mail (mean, 5.7+/-8.8 e-mails per author) and 72 received conventional mail (15.5+/-32.8 letters per author) (p < 0.05). Seventy percent of e-mails and only 53% of correspondence sent by conventional mail (p < 0.05) referred to the content of the paper. CONCLUSIONS: Publication in general medical journals stimulates more conventional than electronic mail. However, the content of e-mail may be of greater scientific relevance. Electronic mail can be encouraged without fear of diminishing the quality of the communications received. (+info)
Electronic reserves: copyright and permissions.
(46/1524)
Electronic reserves present a new service option for libraries to provide needed materials during hours that the library is not open and to user groups located some distance from library collections. Possible changes to current copyright law and publishers permissions policies have delayed the development of electronic reserves in many libraries. This paper reviews the current state of electronic reserves materials in the publishing and library communities and presents the results of a survey of publishers to determine permissions policies for electronic materials. Issues of concern to both libraries and publishers are discussed. (+info)
Electronic network for monitoring travellers' diarrhoea and detection of an outbreak caused by Salmonella enteritidis among overseas travellers.
(47/1524)
The Traveller's Diarrhoea Network, by which the Infectious Disease Surveillance Center is electronically connected with two major airport quarantine stations and three infectious disease hospitals, was launched in February 1988 in Japan. The data on travellers' diarrhoea detected is reported weekly by e-mail. Two clusters of infection among travellers returning from Italy were reported by two airport quarantine stations at the end of September 1998. A total of 12 salmonella isolates from 2 clusters were examined. All were identified as Salmonella enteritidis, phage type 4 and showed identical banding patterns on pulsed-field gel electrophoresis. A case-control study showed that the scrambled eggs served at the hotel restaurant in Rome were the likely source of this outbreak. This outbreak could not have been detected promptly and investigated easily without the e-mail network. International exchange of data on travellers' diarrhoea is important for preventing and controlling food-borne illnesses infected abroad. (+info)
To what extent are practices 'paperless' and what are the constraints to them becoming more so?
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A questionnaire was sent to all practice managers in Wessex in June 1997 to assess to what extent practices had stopped relying on paper records in the consultation. Practices that solely used computer records in the consultation ('noteless') did not necessarily consider themselves 'paperless'. Following a recent declaration that all practices should be using an Electronic Health Record by March 2005, the obstacles to this move were investigated and some differences in the way the 'noteless' and 'paperless' groups used computers were identified. (+info)