BACKGROUND: The member boards of the American Board of Medical Specialties have agreed to expand the scope of certification to include assessment of medical knowledge, practice-based learning and improvement, patient care, interpersonal and communication skills, systems-based practice, and professionalism. Multiple-choice examinations provide limited ability to assess these dimensions. METHODS: The ...

Bar coding for the medication administration step of the drug-use process is discussed. FDA will propose a rule in 2003 that would require bar-code labels on all human drugs and biologicals. Even with an FDA mandate, manufacturer procrastination and possible shifts in product availability are likely to slow progress. Such ...

During orthodontic tooth movement with the preadjusted edgewise system, friction generated at the bracket/archwire interface tends to impede the desired movement. The method of ligation is an important contributor to this frictional force. This in vitro study investigated the effect of ligation method on friction and evaluated the efficacy of ...

Health level 7 (HL7) is the standard of electronic data interchange in the health domain. We have developed a web-based message generation and validation system for testing the message format of the data exchange among hospitals and health organizations. Compared with other existing ones, this system has incorporated several novel ...

Hippocrates, Galienni, Maimonides, and their contemporaries used to reveal the illness by conversing with the patient, by observing, palpating and even smelling him. The tools available to the ancient doctors were very simple. Today there is a complete arsenal of laboratory and X-ray equipment available for diagnostic purposes. This is ...

Even though Mexico is considered internationally as a pacifist country, its economic, social, and geopolitical characteristics during the last half of the 20th century have resulted in internal events that can be considered acts of terrorism. Most of the acts of terrorism during the last 15 years have had to ...

One of the most recent innovations coalescing computer technology and medical care is the further development of integrated medical component technology coupled with a computer subsystem. One such example is the self-contained patient transport system known as the Life Support for Trauma and Transport (LSTAT(tm)). The LSTAT creates a new ...

This is the third in a series of papers describing the evolution of the British casualty evacuation chain during the 20th century. This period was dominated by the threat of war between NATO and the Warsaw Pact in Central Europe. The Suez Crisis in 1956, the Falklands War in 1982, ...

This paper describes an evaluation methodology designed for the IMSA (Interactive Multimedia System for Auto-medication) system. IMSA stands in the multidisciplinary field of medical informatics and aims at providing a health care Internet tool for the general public. As far as a medical information system is patient-oriented, issues in understanding ...

We developed a low cost, user-friendly multimedia delivery system, to provide medical lectures saved as multimedia contents to persons engaged in medicine. This system was created using the RealSystem package with the TCP/IP network. Users can review lectures and medical meeting presentations with video and audio through the Internet, whenever ...

The control of the right application of medical protocols is a key issue in hospital environments. For the automated monitoring of medical protocols, we need a domain-independent language for their representation and a fully, or semi, autonomous system that understands the protocols and supervises their application. In this paper we ...

Physiological monitoring of humans for medical applications is well established and ready to be adapted to the Internet. This paper describes the implementation of a Medical Information System (MIS-ECG system) incorporating an Internet based ECG acquisition device. Traditionally clinical monitoring of ECG is largely a labour intensive process with data ...

Providers investing in a clinical information technology (IT) system should consider their organization's specific needs and those of the surrounding community. Assessments of clinical IT value should take into account factors beyond cost savings. Providers should be aware of related tangible benefits, such as reductions in length of stay and ...

This paper discusses the integration of soft systems methodology (SSM) within an ecosystem approach in research to support rehabilitation and management of the Cooum River and environs in Chennai, India. The Cooum is an extremely polluted urban stream. Its management is complicated by high rates of population growth, poverty, uncontrolled ...

In this paper, we use the theory of distributed cognition to understand work practices in terms of the behavior of an activity system. We do so by detailing the roles that local representations of information play in the social, cognitive, organizational, and technological processes that accomplish task work. Specifically, we ...

Provider charge entry systems offer many benefits to users and organizations. At Vanderbilt University Medical Center, a web-based provider charge entry system promises to deliver benefits in reducing days in accounts receivable, reducing labor required for claims and edit processing, and implementing business rules that deliver both strategic and financial ...

The optimal treatment of pyoderma gangrenosum includes a combination of local wound care and systemic medications. Oral and pulse intravenous corticosteroids have traditionally been the most commonly recommended first-line systemic therapies. Cyclosporine, with or without corticosteroids, has more recently emerged as a first-line systemic treatment. A multitude of immunosuppressive and ...

OBJECTIVE: The aim of this paper is to analyse telemedicine as a new means to improve health care accessibility. METHOD: A case study design was used to understand how medical specialists perceived, made sense of, and appropriated a teleconsultation system. RESULTS AND CONCLUSIONS: The technology was used neither in the ...

The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much ...

INTRODUCTION: Every year many disasters cause thousands of injuries, deaths, refugees. Depending on the kind of disaster (train/plane accident, flood, earthquake) not only an acute emergency medicine treatment but also general and family medicine and hospital treatment have to be safeguarded over a longer time-period in the disaster area. PROBLEM: ...

To help curb constantly rising costs of medical services, healthcare providers in Israel have been busy incorporating computerized patient record systems (CPR) into their organizations since the early 1990s. Our CPR based integrated system solutions (named Clicks) now serve over 90% of primary and secondary medical care professionals throughout the ...

This paper describes the implementation of the Web Based Pneumonia Chemotherapeutics (WPCh) a Web-based expert system for chemotherapeutic assistantship for nosocomial and community-acquired pneumonia based on different types of data. WPCh can be accessed through World Wide Web or a mobile phone using the relevant script languages. The core of ...

The Arden Syntax standard has been utilized in the medical informatics community in several countries during the past decade. It is never used in nursing in Taiwan. We try to develop a system that acquire medical expert knowledge in Chinese and translates data and logic slot into TSQL Language. The ...

Prior attempts to interface ICU Clinical Information Systems (CIS) to Pharmacy systems have been less than successful. The major problem is that in ICUs, medications frequently have to be administered and charted in the CIS Medication Administration Record (MAR) before pharmacists can enter them into the Pharmacy system. When the ...

The transition from conventional film based to filmless operation at the Baltimore VA Medical Center in 1993 was successful and has resulted in a number of clinical and economic benefits. The subsequent integration of the Department of VA hospitals in Maryland into a single network, the VA Maryland Health Care ...

Chinese acupuncture is a traditional medical treatment in Chinese history. Recent evidence shows that this treatment is effective. However, acupuncture students can only practice on either real patients or mannequin. In this project, we propose a virtual reality training system for acupuncture. The system not just provides 3D stereo display, ...

Advances in technology can have direct and indirect benefits to clinical practice. The challenge that clinicians face is to properly match resources and outcomes, along with patient preferences. This article explores the use of an innovative interactive voice response system to increase patient compliance with antidepressant medication prescribed in primary ...

This paper focuses on the Organ Transplant Management (OTM) process defined as the set of activities that need to be coordinated before the surgery operation itself can take place. The main goal is to understand how the different OTM tasks are interrelated, in order to build an innovative software system ...

It is well recognized that controlled medical terminologies play a critical role in Health Information Systems and Clinical Patient Record systems, but the creation and management of customized lists of terms ("picklists") remains a potential obstacle. We have been developing a sophisticated authoring tool that is fully integrated with our ...

The title of this contribution involves two consecutive questions: have the effects of medication in autism indeed been disappointing? And if so, why? The answer to the first question depends on whether one focuses on the core social and communicative deficits of autism, or on various complicating behaviour problems. Attempts ...

Concept relationships are traditionally defined in human-generated vocabulary lists such as the Medical Subject Headings (MeSH). This poster describes a prototype system that automatically generates concept relationships from the medical literature. The system is directly connected to the PUBMED search engine. For any given medical concept, the system will generate ...

A fundamental goal of space medicine is to maintain the health and fitness of spacecrews. Meeting this goal requires reliable, effective, up-to-date medical support systems for use in microgravity. This article describes some of the factors considered in the design and assembly of Russian and U.S. in-flight medical care systems. ...

The aim of this paper is to introduce the main software module of the DIABCARD Chip Card Medical Information System (DIABCARD CCMIS) that provides an online, portable diabetes medical record information system based on a high performance object-oriented rapid application development language such as Borland Delphi. A chip card based ...

Physicians are familiar with conventional nebulizers, which deliver aerosols in a relatively uncontrolled manner. As aerosol medications evolve beyond bronchodilators, the need for control of dose variability, the possibility of overdose, and the need for efficient delivery have provoked the industry to redesign aerosol delivery systems. The need to target ...

In this paper, the current published knowledge about smart and adaptive engineering systems in medicine is reviewed. The achievements of frontier research in this particular field within medical engineering are described. A multi-disciplinary approach to the applications of adaptive systems is observed from the literature surveyed. The three modalities of ...

The author describes five critical elements for reducing and, ultimately, preventing harm to patients-from a systems perspective. In the element called leadership and culture, leaders must advocate patient safety as a primary goal and foster an institutional culture where change that promote patient safety can occur. In internal surveillance, systems ...

Laser vibrometry was used to measure the vibration velocity at different points on the ossicular apparatus of the bullfrog Rana catesbeiana in response to free-field sound. The ascending process of the extrastapes, neglected in most accounts of frog middle ear mechanics, supports a rocking motion of the extrastapes and is ...

Xtrack is a web-based database-backed crystallographic notebook system that allows groups of workers to keep track of crystallographic project data from the crystallization stage through to data bank deposition. A working demonstration version is available from http://xray.bmc.uu.se/xtrack and the code is available for those who wish to set up their ...

The PREPaRe system is a patient-oriented internet-based information system that is able to store, combine, process and visualize all types of medical data that are part of a "personal electronic medical record". This paper describes the visualization and interaction aspects of the PREPaRe system which is designed with respect to ...

To clarify the real cause of death of sudden infant death syndrome (SIDS), it is the most urgent and important subject to increase the autopsy rate of SIDS. So, we make following three proposals. (1) SIDS must be reported to the police. (2) Autopsy of SIDS must be performed in ...

A remote medical monitoring system is described, which continuously monitors patients' state of health. The system uses the services provided by intranets and the Internet to allow remote supervision of patients, who may be domiciled in their own home. A hardware/software prototype system has been constructed to demonstrate the use ...

Previous investigation has suggested that the use of airflow-based gastrointestinal intraluminal PCO2 (GI PiCO2) monitoring systems may affect the local tissue microenvironment, making it not representative of the organ system as a whole. Therefore, we investigated the effects of using an airflow-based PCO2 monitoring system in a sealed environment. A ...

Starting with the air handling unit, new features concerning energy efficient air treatment in combination with optimisation of required space were presented. Strategic concepts for the supply of one or more operating suites with a modular based air handling system were discussed. The operating theatre ceiling itself, as a major ...

The Arden Syntax was introduced more than 10 years ago, but it is still not in widespread use. One reason might be that for each particular architecture and information system, a different Arden Syntax compiler must be written as well as a program for the runtime execution of the medical ...

The Japanese have enjoyed the longest average life span in the world for these ten years. The universal health insurance system with free access and low cost seems to play the most important role among the proposed causes. We didn't need to worry about the charges at hospitals when we ...

Flexible endoscopes are complex medical instruments that are easily damaged. In order to maintain the flexible endoscope in optimum working condition, the user must have a thorough understanding of the structure and function of the instrument. This is the fourth in a series of articles presenting an in-depth look at ...

This is a discussion of a collaborative approach between psychologists, physicians, patients, and others in the administration of psychotropic medication. It is based on a systems point of view. In that perspective, not only are the people indicated above a system, but also the patient is considered from a holistic-systems ...

Clinical trials constitute a key source of medical research and are therefore conducted on a regular basis at university hospitals. The professional execution of trials requires, among other things, a repertoire of tools that support efficient data management. Tasks that are essential for efficient data management in clinical trials include ...

Previous evaluation of HWP1 in systemic candidiasis in CBA/J mice was done with Candida albicans strains with differing genetic locations of URA3 as a result of Ura-blaster mutagenesis. In this study, the presence of HWP1 and the location of URA3 contributed to the severity of murine systemic candidiasis in BALB/c ...

For selected diagnoses of public health interest during the 1996 Olympic Games, the authors compared data concurrently obtained on the same patient population by two separate surveillance systems: (1) an existing hospital electronic medical billing records system and (2) a system based on manual record abstraction. Counts of total patient ...