Interactive voice response systems (IVR) have traditionally been used by banking and credit card industries to rapidly process information requests for their customers. Today IVR technology is being used in clinical medicine to randomize patients in clinical studies, to collect patient data, and to follow-up on recently discharged patients. Use ...

One in four actively practicing physicians in the United States is a graduate of an international medical school. International medical graduates (IMGs) account for one-quarter of all visits to office-based physicians in the United States and are more likely than U.S. medical graduates to practice in primary care shortage areas ...

The Brazilian Portuguese language orthographic reform has promoted changes in writing in less than 2% of its lexis. However, these changes have affected medical practice. The authors present in this article the main changes in the orthographic rules and gather a group of words that have had their spelling altered ...

In the early history of Medical Microbiology, investigations into the causes of cholera played an essential role not recognized yet by historians of Medicine. The shocking arrival of the 'nineteenth century plague', which had never appeared in Europe prior to the Second Pandemic in 1830, fuelled the debate on the ...

Objective: To examine the issues surrounding the development and implementation of a behind-the-counter (BTC) category of medications.Data sources: Testimony from organizations submitting comments to the Food and Drug Administration (FDA) panel hearings in November 2007, the 2009 final report of the U. S. General Accounting Office regarding a BTC drug ...

The alleged medical education continuum is interrupted by a number of major transitions. After starting medical school, the first transition students encounter is that from non-clinical to clinical training. The second transition is that of graduated student to junior doctor or specialist trainee, and the third concerns the specialist trainee's ...

The Texas Medical Association regularly collaborates with the Litigation Center of the American Medical Association and State Medical Societies to present a united front in legal cases that might affect the practice of medicine in Texas and even the nation. The Litigation Center has been the medical profession's voice in ...

Athough the 2000-plus page Patient Protection and Affordable Care Act of2010 has not provided a straightforward roadmap of the future of the U.S healthcare system, one fact is clear: the medical reimbursement system is going to change. This paper discusses those changes and the new relationships that stakeholders in healthcare ...

Trainees in undergraduate and postgraduate medical education engage in multiple transitions as part of the educational process, including many transitions that occur on both periodic and daily bases within medical education programmes. The clinical rotation, based on either a medical discipline or clinical care setting and occurring over a predetermined, ...

Purpose The implementation of a telepharmacy service to provide round-the-clock medication order review by pharmacists is described. Summary Seven critical access hospitals (CAHs) worked collaboratively as part of a network of hospitals implementing the same electronic health record (EHR), computerized prescriber-order-entry (CPOE) system, and pharmacy information system to serve as ...

This study aims to alert users of feedback to its dangers, explain some of its complexities and offer the feedforward alternative. We review the damage that feedback may cause to both motivation and performance. We provide an initial solution to the puzzle of the feedback sign (positive versus negative) using ...

Generic medications do not undergo the rigorous approval process required of original medications. Their effectiveness and safety is expected to be equal to that of their more expensive counterparts. However, several case reports and studies describe clinical deterioration and decreased tolerability with generic substitution. Pubmed was searched from January 1, ...

In this paper, we present MedWise, a high level design of a medical information infrastructure, and its architecture. The proposed system offers a comprehensive, modular, robust and extensible infrastructure to be used in public health care systems. The system gathers reliable and evidence based health data, which it then classifies, ...

This conference report presents highlights from the Sixth International Conference on Rapid Response Systems (RRSs) and Medical Emergency Teams.

By 2004, senior leaders at Kaiser Permanente, the largest not-for-profit health plan in the United States, recognizing variations across service areas in quality, safety, service, and efficiency, began developing a performance improvement (PI) system to realizing best-in-class quality performance across all 35 medical centers. MEASURING SYSTEMWIDE PERFORMANCE: In 2005, a ...

The author argues that the well-formulated problem list is essential for both organizing and evaluating diagnostic thinking. He considers evidence of deficiencies in problem lists in the medical record. He observes a trend among medical trainees toward organizing notes in the medical record according to lists of organ systems or ...

BACKGROUND: Resident duty hours have been restricted to 80 per week, a limitation thought to increase patient safety by allowing adequate sleep. Yet decreasing work hours increases the number of patient exchanges (so-called "handoff") at the end of shifts. WHERE ARE WE NOW?: A greater frequency of handoff leads to ...

BACKGROUND: The last mile of the medication use system requires tools to help patients comply with medication administration rules and monitor for side effects. Personal health records (PHR) and emerging user-adopted communication tools promise to change the landscape of medication management; however, no research has been done to demonstrate how ...

This prospective study examined the impact of medication cabinets installed outside patient rooms on nursing and pharmacy workflow. Storing medications and supplies outside patient rooms decreased nursing visits to the automated medication dispensing system, and nurses also reported fewer episodes waiting to access the system when it was busy. Benefits ...

To describe the development, initial application, and evaluation of the Nonverbal Accommodation Analysis System (NAAS). Grounded in Communication Accommodation Theory, this coding system provides a method for analyzing physician and patient nonverbal accommodation behaviors within medical consultations. Video recordings of 45 new visit consultations at a comprehensive cancer center were ...

This study presents a system developed for the 2009 i2b2 Challenge in Natural Language Processing for Clinical Data, whose aim was to automatically extract certain information about medications used by a patient from his/her medical report. The aim was to extract the following information for each medication: name, dosage, mode/route, ...

This paper presents Lancet, a supervised machine-learning system that automatically extracts medication events consisting of medication names and information pertaining to their prescribed use (dosage, mode, frequency, duration and reason) from lists or narrative text in medical discharge summaries. Lancet incorporates three supervised machine-learning models: a conditional random fields model ...

Pharmacotherapy is an integral part of any medical care process and plays an important role in the medical history of most patients. Information on medication is crucial for several tasks such as pharmacovigilance, medical decision or biomedical research. Within a narrative text, medication-related information can be buried within other non-relevant ...

To develop an automated system to extract medications and related information from discharge summaries as part of the 2009 i2b2 natural language processing (NLP) challenge. This task required accurate recognition of medication name, dosage, mode, frequency, duration, and reason for drug administration. We developed an integrated system using several existing ...

The Third i2b2 Workshop on Natural Language Processing Challenges for Clinical Records focused on the identification of medications, their dosages, modes (routes) of administration, frequencies, durations, and reasons for administration in discharge summaries. This challenge is referred to as the medication challenge. For the medication challenge, i2b2 released detailed annotation ...

Medication information comprises a most valuable source of data in clinical records. This paper describes use of a cascade of machine learners that automatically extract medication information from clinical records. Authors developed a novel supervised learning model that incorporates two machine learning algorithms and several rule-based engines. Evaluation of each ...

This article describes a system developed for the 2009 i2b2 Medication Extraction Challenge. The purpose of this challenge is to extract medication information from hospital discharge summaries. The system explored several linguistic natural language processing techniques (eg, term-based and token-based rule matching) to identify medication-related information in the narrative text. ...

OBJECTIVE To describe a new medication information extraction system-Textractor-developed for the 'i2b2 medication extraction challenge'. The development, functionalities, and official evaluation of the system are detailed. Textractor is based on the Apache Unstructured Information Management Architecture (UMIA) framework, and uses methods that are a hybrid between machine learning and pattern ...

Potentially inappropriate medication (PIM) use in hospitalized older patients is common. Our objective was to determine whether a computerized provider order entry (CPOE) drug warning system can decrease orders for PIMs in hospitalized older patients. We used a prospective before-and-after design among patients 65 years or older admitted to a ...

We evaluated the roles of the doctor and the medical system in Israel in the diagnostic delay of childhood malignancies. We investigated the factors affecting the delay in the diagnosis of childhood malignancies in 315 children with solid malignancies, diagnosed and treated in Rambam Medical Center (RMC), between 1993 and ...

Surgeons and clinical staff, theatre circulation and scrub personnel, and anaesthetists, as well as the estates and facilities team at Kent's Maidstone Hospital, have worked with specialist supplier of integrated audio, video, and instrumentation systems for the operating room, Olympus Medical, to develop what is claimed is among the UK's ...

In recent years, the notion of individual responsibility for one's health has been introduced into Swedish medico-political debate. Formerly expressed as a recommendation, it has now taken on the form of expectations. In a Swedish context, this shift from collective to individual responsibility is novel because it implies a break ...

Nowadays, patients usually take more than three drugs for diseases such as hypertension, diabetes, and dyslipidemia. Hence, nuclear medicine physicians should be very careful about the medication history of each patient and ensure that their medication will not cause false positive or false negative imaging results, because either condition will ...

A course in system dynamics has been included in the first year of our university's six-year medical curriculum. System Dynamics is a discipline that facilitates the modelling, simulation and analysis of a wide range of problems in terms of two fundamental concepts viz. rates and levels. Many topics encountered in ...

The objective of this study was to share the experience of building an information security system for a regional collaborative medical platform (RCMP) and discuss the lessons learned from practical projects. Safety measures are analyzed from the perspective of system engineering. We present the essential requirements, critical architectures, and policies ...

The field of healthcare informatics is rapidly evolving. The new models and protocols of medical information system (MIS) are developed. Despite obvious advantages and benefits, practical application of MIS in everyday practice is slow. Much progress has been made around the world in the field of digital imaging and virtual ...

This is the second extract taken from the War Diaries of Brigadier JG Morgan CBE TD MD and is specifically taken from papers he used to prepare a talk for a Civil Defence Audience in the 1950's. Having introduced a system of filtering in Tripoli in 1943 when in command ...

The endogenous cannabinoid system is involved in numerous physiological and neuropsychological functions. Medications that target this system hold promise for the treatment of a wide variety of disorders. However, as reward is one of the most prominent of these functions, medications that activate this system must be evaluated for abuse ...

Recent policy focus on models of the patient-centered medical home raises questions about how medical home practices will relate to the rest of the health-care delivery system. This paper presents a conceptual framework of how patients and clinicians might interact in a medical neighborhood; outlines key features of a neighborhood ...

The 80-h work week has increased discontinuity of patient care resulting in reports of increased medication errors and preventable adverse events. Graduate medical programs are addressing these shortcomings in a number of ways. We have developed a computer simulation platform called the Virtual People Factory (VPF), which allows us to ...

We developed a wireless auto-tracking system for tracking clinical intervention such as drug administrations and blood tests at the patient bedside. The system can not only authenticate patients and nurses, but also confirm medications and provide relevant information, depending on the clinical situation and personnel location. We conducted a feasibility ...

The effective maintenance management of medical technology influences the quality of care delivered and the profitability of healthcare facilities. Medical equipment maintenance in Jordan lacks an objective prioritization system; consequently, the system is not sensitive to the impact of equipment downtime on patient morbidity and mortality. The current work presents ...

BACKGROUND: In July 2006, a 16-year-old patient came to the hospital to deliver her baby. During the process of her care, an infusion intended exclusively for the epidural route was connected to the patient's peripheral intravenous line and infused by pump. The patient experienced cardiovascular collapse. A cesarean section resulted ...

This study aims to evaluate the prevalence of patients with systemic sclerosis (SSc) in Split-Dalmatia County in Southern Croatia. Patients were recruited from the medical records of University Hospital Split. Our Department of Rheumatology and Clinical Immunology is the only tertiary referral center for the Split-Dalmatia County, which has a ...

The Joint Commission mandates that hospitals seeking accreditation have a process to define and address disruptive behavior. Leaders at Maimonides Medical Center, Brooklyn, New York, took the initiative to create a code of mutual respect that not only requires respectful behavior, but also encourages sensitivity and awareness to the causes ...

Informatics and automation are important tools for the reduction of work, errors and costs in a hospital pharmacy. To describe the structuring and function of an informatized system for the dispensing of medications and to assess its effect on nursing and pharmacy services during the period from 1997 to 2003. ...

Hospital medication safety event detection predominantly emphasizes the identification of preventable adverse drug events (ADEs) through self-reports. These relatively rare events only provide insight into patient harm and self-reports identify only a small portion of ADEs. A broader system-focused approach to medication safety event detection that uses an array of ...

Pandemic influenza is considered catastrophic to global health, with severe economic and social effects. Consequently, a strategy for the rapid deployment of essential medical supplies used for the prevention of influenza transmission and to alleviate public panic caused by the expected shortage of such supplies needs to be developed. Therefore, ...

Rapid developments of capability seen in the contemporary operating environment are a constant during any period of conflict. The Second World War is littered with numerous examples of adapting systems developed following the First World War and making them more suitable for a more mobile, modern form of warfare. The ...

This study determines nurses' attitudes toward bar-coding medication administration system use. Some of the factors underlying the successful use of bar-coding medication administration systems that are viewed as a connotative indicator of users' attitudes were used to gather data that describe the attitudinal basis for system adoption and use decisions ...