To observe how electronic messaging between a hospital consultant and general practitioners (GPs) in 15 practices about patients suffering from diabetes evolved over a 3-year period after an initial 1-year study. Case report. Electronic messages between a hospital consultant and GPs were counted. The authors determined whether a message sent ...

PURPOSE: To create a software application that automates a significant portion of a clinical radiologist's work. METHODS: The daily workflow of clinical radiologists in a university-based department was analyzed, specifically looking for manual tasks that could be implemented in software. An application that a practicing radiologist would use in his ...

BACKGROUND: Approximately 80% of GPs use a GP information system (GIS) and an electronic medical record (EMR) in their daily practice. To reap the full benefits of an EMR for patient care, post-graduate education and research, the data input must be well structured and accurately coded. OBJECTIVES: The quality and ...

Taiwan is a heavily populated country, with a small land area and many mountains and isolated islands. Because medical resources are unequally distributed, high quality accessible medical care is a major problem in rural areas. Medical personnel are unwilling to practice in rural areas because of fear of isolation from ...

AAPM Task Group 58 was created to provide materials to help the medical physicist and colleagues succeed in the clinical implementation of electronic portal imaging devices (EPIDs) in radiation oncology. This complex technology has matured over the past decade and is capable of being integrated into routine practice. However, the ...

OBJECTIVES: To give a brief overview of issues pertinent to selecting an ophthalmic electronic medical record (EMR) program and to outline the company demographics and software capabilities of the major vendors in this area. METHODS: Software companies shipping an EMR package were contacted to obtain information on their software and ...

BACKGROUND AND PURPOSE: The European Council Directive on health protection 97/43/EURATOM requires radiotherapy quality assurance programmes for performance and safety characteristics including acceptance and repeated tests. For Boron Neutron Capture therapy (BNCT) at the High Flux Reactor (HFR) in Petten/NL such a programme has been developed on the basis of ...

INTRODUCTION: In inpatients, computer monitors have been used to improve the detection of adverse drug events (ADEs). However, similar programs have not been available in outpatients. OBJECTIVE: To describe an approach for detecting incidents suggesting that an ADE may have occurred in outpatients by adapting methods from inpatient computer monitoring ...

A computerised general medical practice using electronic medical records is described. Issues including security, confidentiality, shared access to records, use of knowledge bases and decision support are discussed. The practice has electronic data interchange links with local hospitals and health authorities. The practice has demonstrated increased clinical effectiveness, improved primary ...

In this series of articles, the author discusses the potential risks, benefits, and liabilities associated with using electronic communications and computer-based records to manage a patient's medical information. This second article in the series considers the role and responsibility of the healthcare professional in collecting and sharing a patient's private ...

CONTEXT: The primary prevention of coronary artery disease in patients with diabetes could have a large impact on health care costs and outcomes. Guidelines for improving diabetic health indices are common, but significant challenges exist in implementing them. GENERAL QUESTION: How does integrating an evidence-based guideline into an electronic medical ...

The ever-increasing complexity of medical device therapy and installation of public electronic security systems demands vigilance in discerning interactions that may be harmful to patients during typical activities of daily living. Premature pacemaker stimulation, isolated skipped beats, or reversion to backup asynchronous pacing have been observed during in vitro and ...

A major obstacle in deploying computer-based clinical guidelines at the point of care is the variability of electronic medical records and the consequent need to adapt guideline modeling languages, guideline knowledge bases, and execution engines to idiosyncratic data models in the deployment environment. This paper reports an approach, developed jointly ...

BACKGROUND: The University of Alabama at Birmingham School of Optometry and the Alabama Institute for Deaf and Blind have collaborated in development of electronic medical records, digital slit-lamp medical imaging, and ocular telemedicine between their two sites. METHODS: The telemedicine link uses the electronic medical record system (EMRS) called PEARL, ...

Doctor Global Ltd began online consulting in April 1999. It was one of the first online medical consulting services in the world. Doctor Global does not derive a significant portion of its income from providing or supervising online consultations via its Website, although experience with enabling them has been important ...

Computerization of physician practices is increasing. Stakeholders are demanding demonstrated value for their Electronic Medical Record (EMR) implementations. We developed survey tools to measure medical office processes, including administrative and physician tasks pre- and post-EMR implementation. We included variables that were expected to improve with EMR implementation and those that ...

A multileaf collimator (MLC)-based intensity-modulated radiation therapy (IMRT) program was implemented successfully at Monmouth Medical Center, a community hospital at Long Branch, New Jersey. Our clinical experience gained in the treatment of over 80 patients using IMRT for prostate, head and neck, and brain is reviewed, and some of the ...

Direct electronic acquisition of data from patients possesses accuracy and diagnostic value. The mechanics of how best to capture historical information from patients using electronic interfaces are not well studied. We undertook an iterative usability experiment to answer 2 questions: 1) How can maximal electronic data input from a patient ...

Communication between different institutions which are responsible for the treatment of the same patient is of outstanding significance, especially in the field of tumor diseases. Regional electronic patient records could support the co-operation of different institutions by providing ac-cess to all necessary information whether it belongs to the own institution ...

Medical record should enable doctors to comprehend the patient's history and select suitable medical treatment. In paper based medical records, medical events (examination, treatment etc.) are recorded successively, and problem oriented recording is difficult to be applied to patients with much information and a long history. Consequently it is not ...

Electronic medical consultation is available worldwide through access to the World Wide Web (WWW). This article outlines a research study on the adoption of electronic medical consultation as a means of health delivery. It focuses on the delivery of healthcare specifically for New Zealanders, by New Zealanders. It is acknowledged ...

The Internet is dramatically changing the structure of the industry. For the first time, direct communication between all suppliers and all hospitals is available. The Internet-based electronic market place not only provides the ability to choose products from a standardized catalogue, but also to send orders direct to suppliers' enterprise ...

In this series of articles, the author discusses the potential risks, benefits, and liabilities in using electronic communications and computer-based record keeping for patients' medical data. Article #1 in this series reviews the foundations of privacy for personal information and the current practices of collecting disaggregated private personal and medical ...

OBJECTIVE: To establish and prospectively collect data for a minimum dataset in urology by agreeing a dataset amongst a group of urologists, designing structured forms around the data items and implementing them in clinical practice. METHODS: Consultant urologists decided the initial dataset. Structured forms, which incorporated the dataset items, were ...

The development of integrated health care systems, the building of distributed computer networks throughout them, and the advent of easy-to-use electronic medical records for ambulatory practices combine to create a powerful argument for an enterprise electronic medical record. Potential customers need to learn from both successes and failures. Although the ...

BACKGROUND: It is critical for providers caring for HIV-positive methadone recipients to have accurate information on pharmacologic interactions between methadone and antiretroviral therapy. If providers do not have these data, symptoms of narcotic withdrawal or excess due to medication interactions may be mismanaged, and antiretroviral regimens may be suboptimal in ...

This paper presents the authors' experience with the development and use of a document-centered electronic patient record (EPR) in a large teaching hospital. The development of the document-centered EPR began with the formulation of a set of critical hypotheses to facilitate both the continuation of the best medical practice and ...

This article presents an electronic patient record (EPR) for stroke patients. At the neurology department of the Maastricht University Hospital, coordination and communication of the multidisciplinary team for stroke patients is intended to be supported by an EPR. Existing, structured, paper nursing and medical records served as a starting point ...

An ongoing concern for physicians and their patients is protecting the confidentiality of medical records. The proliferation of electronic methods for collecting and storing medical information, along with the growing complexity of the health-care system, has created the need for new means to protect confidentiality. Currently, a patchwork of protections ...

The continuously increased mobility of patients and doctors, in conjunction with the existence of medical groups consisting of private doctors, general practitioners, hospitals, medical centers, and insurance companies, pose significant difficulties on the management of patients' medical data. Inevitably this affects the quality of the health care services provided. The ...

BACKGROUND: Unsolicited electronic mail (e-mail) is e-mail sent to a physician from a person unknown to the physician, who is seeking professional help. The purpose of this project was to analyze unsolicited e-mails sent to a digital textbook author to: 1) characterize the e-mails, 2) determine what resources would be ...

A new online publishing effort, eMedicine Otolaryngology-Facial Plastic Surgery (FPS), is a comprehensive textbook now being developed on the Internet (www.emedicine.com). This book is one of a series of 15 electronic textbooks written by a worldwide panel of authors and editors, and it is distributed free of charge to anyone ...

STUDY OBJECTIVES: We assessed the validity and completeness of data in the past medical history (PMH) obtained electronically from parents and examined effects of the human-computer interface and sociodemographic variables on electronic parental report. METHODS: We compared parents' electronic report of PMH data with a criterion standard, structured face-to-face interview ...

The Internet promises to touch every aspect of a physician's professional life, from patient relations to access to clinical studies, from billing to patient records, from marketing to e-mail. To help you make sense of what may be the most profound force in medical practice today, we're kicking off a ...

Recent advances in the development of automated speech recognition (ASR) have made routine applications for medical documentation possible. To achieve this, ASR has to be optimally integrated into the specific documentation scenario. The classification presented in this paper allows the definition of specification requirements. For two different documentation scenarios the ...

The need of an electronic patient record with a process view on medical care is widely acknowledged. Characteristics of DEMO (Dynamic Essential Modeling of Organizations) suggest that with this methodology an adequate process view of medical practice can be obtained. In applying DEMO to the care process of the emergency ...

This work concerns the management of electronic medical records. Classical systems based on databases do not satisfy end users, as the provided capture forms are never completely adapted to the patient case and to the physician's way of working. Electronic documents proved to be a better user interface paradigm, but ...

OBJECTIVES: To determine if published figures on the proportion of articles included in systematic reviews and identified in electronic databases are applicable to an example from medical imaging. METHODS: A systematic review was performed. Additionally, sensitivity and precision of a MEDLINE search were compared with values from three published searches, ...

The number of general practitioners in Denmark with electronic patient record systems is rising. More than 80% of all GP practices now have computerised patient record systems. These medical practices communicate electronically with hospitals, laboratories, pharmacies and county councils. With the procurement of electronic patient record systems and connection to ...

This article presents baseline work sampling data from an outpatient oncology clinic prior to an electronic medical record implementation. The physicians and medical office assistants spent 29% and 39% of their time, respectively, entering and retrieving information from medical records. The physicians and medical office assistants spent 43% and 17% ...

Hospital librarians in Naval Medical Centers and Naval Hospitals provide information to support the physicians, nurses, psychologists, chaplains, dentists, and corpsmen on ships and on Navy bases worldwide. The concept of "operational readiness" refers to the training required by Navy personnel during peacetime to perform war-time missons. Navy medical librarians ...

Careful attention must be paid when designing the following components of a hospital-wide electronic patient record (EPR) system: the common medical controlled terminology, the semantic data model for a standardized representation of patient data and the normalized database. Requirements are detailed. Problems encountered when coordinating the development of a medical ...

Functional gastrointestinal disorders are poorly understood. The lack of clear classification and definition of these disturbances interferes with unsatisfying treatment. The possible explanation has been recently looked up in the changes of brain-gut axis interactions. Simultaneously microelectronics has been made tremendous progress in the cooperation with medical sciences lately. Electronic ...

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 ...

When considering electronic patient files some conditions have to be respected. They are, in particular, confidentiality and informed consent by the patient. Furthermore, undue access to data can be prevented by PET, access authorization and the like. Patients should be allowed to exert control over their medical data. National and ...

This article presents an overview of a research project concerning the consultation of medical narratives in the electronic medical record (EMR). It describes an analysis of user needs, the design and implementation of a prototype EMR system, and the evaluation of the ease of consultation of medical narratives when using ...

OBJECTIVE: The purpose of the study was to determine the impact of filmless operation on the relative frequency of in-person consultations in the radiology department between radiologists and clinicians. CONCLUSION: The transition to filmless operation at the Baltimore Veterans Affairs Medical Center was associated with an 82% reduction in the ...

With advances in technology and the wider acceptance of computerization in physicians' offices, electronic medical records (EMRs) are now coming of age. This article describes the evolution of EMR systems during the last decade and their emergence as truly useful tools to increase practice efficiency and enhance medical care. The ...

HL7 is an organization with a short history and more activity now than ever before. Opportunities abound within HL& to assist in the development of the automation of healthcare and the deployment of information systems that create and support the electronic medical record. Finally, the continual advances in information systems ...

Washington Primary Care Physicians, Washington, D.C. PROBLEM: Keeping up with 15,000 patients, 20 percent of whom were covered under Medicare and Medicaid, was proving impossible with WPCP's paper-based record system. SOLUTION: Implementing an electronic medical record. RESULTS: Fewer problems associated with lost or missing paper documents, lower medical records costs ...