Meeting the urgency for document delivery in clinical medicine. (41/46)

A Document Delivery library project was designed to improve delivery of information to health professionals in the Washington DC/Baltimore area. The project goals were to enhance delivery of full text documents and accelerate interlibrary loan services. The aim was to provide direct library services in the clinical arena by facilitating access to the articles needed by practitioners and clinical investigators. The objectives were to (1) design, develop and implement a comprehensive Document Delivery System (DDS) for the Library Information System (LIS) which included interlibrary loan, photocopy services and facsimile transmission capabilities; (2) establish a multi-university Library Knowledge Network for resource sharing; and (3) evaluate the project. The DDS and facsimile service are described and project data and outcomes are reported. Today, the participating libraries can use electronic means to share interlibrary loans. Georgetown users have responded favorably to the DDS and Fax services.  (+info)

Mechanisms for exchange of image data to support distant medical consultation. (42/46)

The VA has developed an integrated infrastructure to support the exchange of medical data, including images and text report data, between medical centers. This capability is expected to support teleconsulting and meet a variety of existing medical staffing and consultation needs. Consultation from distant locations requires at least the same complete integrated patient record available to onsite physicians. Several mechanisms are being explored to support distant medical consultation. Multimedia extensions to the VA's electronic mail system have been developed to allow images and other data objects to be included in electronic mail messages. Another approach that has been prototyped is to extend existing local imaging networks to produce more widely distributed imaging systems. These approaches will be described and discussed.  (+info)

Overcoming the limitations of proprietary computerized billing systems to enhance patient care. (43/46)

Most physician offices have proprietary computerized billing systems, but these are not designed for monitoring utilization or addressing patient care issues, and they are difficult or impossible to modify. These systems do, however, contain valuable diagnosis and demographic information. An open-ended, relational x-base system is described that downloads this billing information and combines it with additional input to provide the practitioner with: current problem lists; medication and allergy lists; health screening reminders that are age, sex and disease specific; and commonly used demographic information. Several popular query/reporting tools are used to generate standard reports and ad hoc inquiries that relate directly to patient care. Two studies, one involving alerting physicians to possible adverse medication effects on specific patients, and one investigating appropriate use and billing of stool occult blood testing are summarized. In the constantly evolving arenas of utilization, outcomes research and cost efficiency, such an open ended, time efficient system has unlimited potential to improve patient care.  (+info)

A randomized trial of the impact of telephone and recorded delivery reminders on the response rate to research questionnaires. (44/46)

BACKGROUND: A range of factors have been shown to affect the response rate to mailed questionnaires, but particular strategies to improve patients' response in trials conducted in general practice require further study. METHODS: Non-responders in a larger trial were randomized to receive a telephone or recorded delivery reminder on the third contact. The cost of administration of each method was estimated. RESULTS: Significantly more patients returned completed questionnaires when sent questionnaires by recorded delivery, although the cost per patient contacted was nearly three times more than for contact by telephone. CONCLUSION: Our study indicates that sending reminders by recorded delivery, although more expensive, is more effective than telephone reminders for recruiting patients to a study in general practice using research questionnaires.  (+info)

Technological stress: psychophysiological aspects of working with modern information technology. (45/46)

There is rapid technological transformation occurring in both work and social life. The results of information technology, such as mobile telephones, computers, and electronic networks, have been looked upon as the key to solving several of the most pressing problems of the Western world. At the same time, numerous studies have shown that the great majority of computerization projects fail to meet their deadlines with the originally specified functionality mainly because human factors are not sufficiently taken into account during the planning and implementation phase of the project. In a study of the bodily, mental, and psychophysiological reactions of employees involved in the design of advanced telecommunications systems and of office employees using regular video display technology, several stress-related psychosomatic disorders have been identified. They include sleep disturbances, psychophysiological stress and somatic complaints. Controlled intervention programs aimed at enhancing organizational structures and individual coping strategies have been proved effective in counteracting the negative effects of working with information technology. The two-way interaction between the external information technology environment and bodily and mental reactions needs to be taken more into account in the design and use of modern information technology. There appears to be an increased awareness of human aspects when the risks and benefits of the rapid spread of information technologies are discussed.  (+info)

Integrating personal computers into family practice: a comparison of practicing physicians and residents. (46/46)

A survey was used to assess levels of experience with personal computers and interest in learning personal computer applications among Alabama family practice physicians and residents in 1994. The study compared responses of 272 physicians and 77 residents as well as responses of physicians and residents in a sample of respondents thirty-eight years old or younger, including 77 physicians and 73 residents. Almost 25% of physicians reported never having used a computer, compared to 7.9% of residents. Respondents had learned computer skills through various combinations of methods, with over half of each group claiming to be self-taught through reading and hands-on experience. More than 86% of both groups expressed interest in learning more; interest increased in the population thirty-eight years or younger. Respondents, especially physicians, reported using professional applications less often than personal applications. Overall, there was a high level of interest in learning various practice-related applications; however, a significantly larger proportion of residents reported interest in each type of application than did physicians.  (+info)