International journal of medical informatics
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Children with acute abdominal pain (AP) are frequently assessed in the Emergency Department (ED). Though the majority of patients have benign causes, uncertainty during the physician's initial assessment may result in unnecessary tests and prolonged observation before a definitive disposition decision can be made. A rule-based mobile clinical decision support system, Mobile Emergency Triage-Abdominal Pain (MET-AP), has been developed to recommend an appropriate triage plan (discharge, consult surgery or observe/investigate) early in the ED visit, with the goal of promoting ED efficiencies and improved patient outcomes. ⋯ MET-AP shows promise in recommending the correct triage plan with similar overall accuracy to experienced pediatric EPs, but requires further research to improve accuracy and safety. MET-AP can be used on all pediatric ED patients with AP and is capable of producing a triage plan recommendation without requiring a complete set of patient information.
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Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. ⋯ Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care will provide accurate and timely information for the management of resources during disaster response.
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The purpose of this paper is to analyse the feasibility and usefulness of expressing clinical data sets (CDSs) as openEHR archetypes. For this, we present an approach to transform CDS into archetypes, and outline typical problems with CDS and analyse whether some of these problems can be overcome by the use of archetypes. ⋯ While openEHR cannot overcome all barriers to Ubiquitous Computing, it can provide the common basis for ubiquitous presence of meaningful and computer-processable knowledge and information, which we believe is a basic requirement for Ubiquitous Computing. Expressing CDSs as openEHR archetypes is feasible and advantageous as it fosters semantic interoperability, supports ubiquitous computing, and helps to develop archetypes that are arguably of better quality than the original CDS.
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Introduction of teledermatology in general practice changes responsibilities and workloads of general practitioners (GPs) and dermatologists. We investigated the time investment of GPs as well as the relative share of the separate teledermatology activities during a store-and-forward teledermatology consultation. ⋯ Usage of store-and-forward teledermatology increases the average duration of a GP consultation with at least three and a half minutes. Further integration of teledermatology applications and electronic patients' records may reduce the total duration of a consultation and increase acceptance of teledermatology in general practice.
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Clinical practice guidelines (CPGs) are common tools for clinicians in daily practice. In order to use CPGs effectively at the point of care, representing CPGs into computer-interpretable format is essential. Since computer-interpretable guidelines (CIGs) have been reported to increase clinicians' usage of guidelines and improve patient's outcomes, it is critical to assess health care knowledge translated from CPGs into CIGs. The overall goal of this study was to illustrate the steps involved in encoding a guideline in guideline interchange format-3 (GLIF3) through a case study of a depression screening and management CPG for a nursing decision support system (DSS). ⋯ This study contributes to the body of knowledge regarding creation of CIGs and the use of GLEE as an evaluation tool for the encoded CIG in GLIF format for a depression CPG. CPG representation using GLIF3 and its evaluation by GLEE are useful methods to prepare nursing CPGs for implementation in a DSS.