Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2001
Ranking of information in the computerized problem-oriented patient record.
We propose a framework for a problem-oriented patient record for general practice 1 and defend that the problem-oriented medical record represents an intuitive way to organize the patient record. By adding a layer of knowledge to the electronic patient record the record system is able to better utilize the information stored in the record. If a record system is process aware, having knowledge of work processes and is able to distinguish between different contexts in use, the system can provide relevant and useful information during the handling of patients' medical problems. ⋯ Traces give valuable indications of what is going on during the process of patient care. Decision frames represents relevant contexts based on the information in the record. Both decision frames and traces provide an environment in which more optimal medical decisions can be made.
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Stud Health Technol Inform · Jan 2001
Structured data entry of clinical information for documentation and data collection.
Routine databases containing large amounts of clinical data represent a tremendous opportunity for the evaluation of health care practices and outcomes. However, data collected for administrative purposes has limitations in content, accuracy and completeness. ⋯ We developed a structured data entry method, the Clinical Data Framework (CDF), which has been used to support the capture of clinical information by clinicians in the normal process of care delivery. A study of the CDF over a two month period showed that it improved the accuracy of completeness of data collection over a coding method which was based on selection of ICD-9-CM codes.
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Stud Health Technol Inform · Jan 2001
Measurement of in-vivo local shear modulus by combining multiple phase offsets mr elastography.
To provide realistic surgical simulation, haptic feedback is important. In the existing surgical simulators, the fidelity of the deformation and haptic feedback is limited because they are based on the subjective evaluation of the expert-user and not on an objective model-based evaluation. To obtain elastic modulus of in-vivo human tissues, magnetic resonance elastography (MRE) was developed. ⋯ To confirm the reliability of this method, a computer simulation and phantom study were performed. The shear modulus measured with various elastic objects was well consistent with the value obtained by MRE and the mechanical method. The shear moduli of excised porcine liver and in-vivo human calf muscle were also analyzed by this method. on the subjective evaluation of an expert-user and not on objective model-based methods.
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Training medics, medical students, nurses, and residents to perform trauma care skills presents many obstacles. These include: emergent nature of the procedures, instructor time, availability of clinical material, and anatomic knowledge. Virtual Reality simulators address each of these obstacles. ⋯ Commercial VR simulators to teach trauma skills include: CathSim Intravenous Simulator (HT Medical), UltraSim Ultrasound Simulator (MedSim), Limb Trauma Simulator (Musculographics/BDI), and the Human Patient Simulator (MedSim). Additionally, we have developed two additional simulators based on the HT CathSim; these are the pericardiocentesis simulator and the diagnostic peritoneal lavage simulator. Future applications include virtual environment triage simulation and surgical airway simulators.
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Implementing telehealth applications represents a substantial investment of resources, which is one reason why success is of great interest. Many research and evaluation studies have investigated measures of successful telehealth systems. However, the term "telehealth" represents a wide range of variables including clinical application, characteristics of the information being transmitted, temporal relationships of data transfer and the organizational context. ⋯ Less is known about the relationship among these variables and whether the findings around one variable are generalizable to other settings or applications. For example, organizational support may be essential for successful provider-patient interactions via videoconference, which result in higher quality of life. A conceptual framework would assist in accumulating this type of evidence and supporting more advanced research efforts.