Proceedings / AMIA ... Annual Symposium. AMIA Symposium
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A critical mass of Internet users is leading to a wide diffusion of electronic communications within medical practice. Unless implemented with substantial forethought, these new technological linkages could disturb delicate balances in the doctor-patient relationship, threaten the privacy of medical information, widen social disparity in health outcomes, and even function as barriers to access. ⋯ This paper describes the motivations for and the design of HealthConnect, a web-based patient-doctor communications tool currently in use at Children's Hospital, Boston. Structural and process-oriented features of HealthConnect, as they relate to promotion of adherence with the Guidelines, are discussed.
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The increasing volume of information available on the Internet today is a problem for health care professionals who want to access rapidly data of high quality. Usual search engines and directories are not sufficient to satisfy their needs. Moreover, the information published by Web sites is not always guaranteed. ⋯ We base our current work on the technologies we developed previously in order to integrate sources of information of various kinds using the "Unified Medical Language System" knowledge bases. This paper focuses on quality criteria and access characteristics Web sites should satisfy to be registered in a "Health Internet Directory". The design of such a system is proposed and discussed.
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Comparative Study
Making ICU alarms meaningful: a comparison of traditional vs. trend-based algorithms.
Much of the work in the ICU revolves around information that is recorded by electronic devices. Such devices typically incorporate simple alarm functions that trigger when a value exceeds predefined limits. Depending on the parameter followed, these "boundary based" alarms tend to produce vast numbers of false alarms. ⋯ Results show a ten-fold increase in positive predictive value of alarms from 3% using monitor alarms to 32% using the module. The module's overall sensitivity was 82%, failing to detect 18% of significant alarms as defined by the ICU staff. The results suggests that implementation of such methodology may assist in filtering false and insignificant alarms in the ICU setting.
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A limiting factor in realizing the full potential of electronic medical records (EMR) is physician reluctance to use these applications. There have been very few formal usability studies of experienced physician users of EMRs in routine clinical use. ⋯ Overall user satisfaction was most highly correlated with screen design and layout, and surprisingly not with system response time. Human-computer interaction studies can help focus our design efforts as we strive to increase clinician usage of information technology.
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Artifacts in clinical intensive care monitoring lead to false alarms and complicate data analysis. They must be identified and processed to obtain true information. In this paper, we present a method for detecting artifacts in heart-rate (HR) and mean blood-pressure (BP) data from a physiological monitoring system used in preterm infants. ⋯ In a huge space of CVDetector instances, we have successfully discovered an optimal CVDetector instance, denoted by CVDetector. The sensitivity and specificity of CVDetector for HR artifacts is 94.8% (SD = 7.6%) and 90.6% (SD = 6.9%), respectively. The sensitivity and specificity of CVDetector for BP artifacts is 94.2% (SD = 5.3%) and 80.0% (SD = 12.4%), respectively.