Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Review Comparative Study
See one, do one, teach one: advanced technology in medical education.
The concept of "learning by doing" has become less acceptable, particularly when invasive procedures and high-risk care are required. Restrictions on medical educators have prompted them to seek alternative methods to teach medical knowledge and gain procedural experience. Fortunately, the last decade has seen an explosion of the number of tools available to enhance medical education: web-based education, virtual reality, and high fidelity patient simulation. This paper presents some of the consensus statements in regard to these tools agreed upon by members of the Educational Technology Section of the 2004 AEM Consensus Conference for Informatics and Technology in Emergency Department Health Care, held in Orlando, Florida. ⋯ Across specialties, patient simulation, virtual reality, and the Web will soon enable medical students and residents to... see one, simulate many, do one competently, and teach everyone.
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Review Comparative Study
Using online analytical processing to manage emergency department operations.
The emergency department (ED) is a unique setting in which to explore and evaluate the utility of information technology to improve health care operations. A potentially useful software tool in managing this complex environment is online analytical processing (OLAP). An OLAP system has the ability to provide managers, providers, and researchers with the necessary information to make decisions quickly and effectively by allowing them to examine patterns and trends in operations and patient flow. ⋯ It allows the user to form a comprehensive picture of the ED from both system-wide and patient-specific perspectives and to interactively view the data using an approach that meets his or her needs. This article describes OLAP software tools and provides examples of potential OLAP applications for care improvement projects, primarily from the perspective of the ED. While OLAP is clearly a helpful tool in the ED, it is far more useful when integrated into the larger continuum of health information systems across a hospital or health care delivery system.
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Review Comparative Study
Information technology and emergency medical care during disasters.
Disaster response to mass-casualty incidents represents one of the greatest challenges to a community's emergency response system. Rescuers, field medical personnel, and regional emergency departments and hospitals must often provide care to large numbers of casualties in a setting of limited resources, inadequate communication, misinformation, damaged infrastructure, and great personal risk. ⋯ In particular, next-generation wireless Internet and geopositioning technologies may have the greatest impact on improving communications, information management, and overall disaster response and emergency medical care. These technologies have applications in terms of enhancing mass-casualty field care, provider safety, field incident command, resource management, informatics support, and regional emergency department and hospital care of disaster victims.
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Comparative Study
Discrete event simulation of emergency department activity: a platform for system-level operations research.
This article explores the potential of discrete event simulation (DES) methods to advance system-level investigation of emergency department (ED) operations. To this end, the authors describe the development and operation of Emergency Department SIMulation (EDSIM), a new platform for computer simulation of ED activity at a Level 1 trauma center. The authors also demonstrate one potential application of EDSIM by using simulated ED activity to compare two patient triage methods. ⋯ The EDSIM model provides a flexible platform for studying ED operations as they relate to average treatment times for ED patients, but the model will require further refinement to predict individual patient times. A comparative study of triage methods suggests that ART provides a mix of benefits and drawbacks, but further investigation will be required to substantiate these preliminary findings.
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Review Comparative Study
Computerized physician order entry and online decision support.
Computerized physician order entry (CPOE) and decision support systems (DSS) can reduce certain types of error but often slow clinicians and may increase other types of error. The net effect of these systems on an emergency department (ED) is unknown. The consensus participants combined published evidence with expert opinion to outline recommendations for success. ⋯ Additional CPOE and DSS research is needed quickly, and this research should receive funding priority. DSS and CPOE hold great promise to improve patient care, but not all systems are equal. Evidence must guide these efforts, and the measured outcomes must consider the many factors of quality care.