Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2010
Finite element comparison of different growth sparring instrumentation systems for the early treatment of idiopathic scoliosis.
Fusionless growth sparring implants seek to restore spinal alignment through the early intervention of pediatric scoliosis. Amongst a growing number of concepts, the stainless steel (SS) staple, flexible tether and shape memory alloy (SMA) staple have demonstrated their validity by retarding convex vertebral growth while modifying spinal alignment. The purpose of this study was to explore the biomechanics of these devices in a human scoliotic finite element model (FEM) constructed from patient data. ⋯ Initial and long term modifications of coronal spinal alignment following simulated growth was respectfully 28 degrees to 62 degrees in non-instrumented model and patient data, 28 degrees to 31 degrees with SS staple, 23 degrees to 31 degrees with flexible tether, and 27 degrees to 34 degrees with SMA staple. The interpretation of such methods suggests that the long term correction, achieved via growth modulation, would benefit from improved control of asymmetrical stresses within the growth plates. From a biomechanical perspective, fusionless growth sparring techniques for the early treatment of idiopathic scoliosis show promising preliminary results.
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Stud Health Technol Inform · Jan 2010
Patient safety and sociotechnical considerations for electronic handover tools in an Australian ehealth landscape.
The Australian Commission for Safety and Quality in Health Care (ACSQHC) coordinates national improvements in a range of complex health system problems including clinical handover, and has funded a range of handover improvement projects in Australia. One of these, the SafeTECH project in South Australia has developed guidelines for safe use of electronic handover tools. These guidelines were developed using evidence from three hospital case studies into the use of an electronic tool to support different types of shift-to-shift handover. ⋯ The paper then considers these challenges within the broader context of the Australian ehealth landscape. Australia's National eHealth Transition Authority (NEHTA) is actively developing ehealth standards and infrastructure requirements for the electronic collection and secure exchange of health information. The paper argues for flexible standardisation in the design and implementation of electronic handover tools to ensure that all key dimensions of the challenges faced in ensuring patient safety are addressed.
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Stud Health Technol Inform · Jan 2010
Auto-selection of DRG codes from discharge summaries by text mining in several hospitals: analysis of difference of discharge summaries.
Recently, electronic medical record (EMR) systems have become popular in Japan, and number of discharge summaries is stored electronically, though they have not been reutilized yet. We performed text mining with Tf-idf method and morphological analysis in the discharge summaries from three Hospitals (Chiba University Hospital, St. Luke's International Hospital and Saga University Hospital). ⋯ Beyond different styles of the discharge summaries, text mining method could obtain proper extracts of proper DPC codes. Improvement was observed by using integrated model data between the hospitals. It seemed that huge database which contains the data of many hospitals can improve the precision of text mining.
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Stud Health Technol Inform · Jan 2010
The IT-infrastructure of a biobank for an academic medical center.
For high quality research in biomedicine an operable biobank is essential. In order to make optimal use of the material and the huge amount of data a sustainable IT-infrastructure is indispensable. Therefore, we developed a concept for the IT-infrastructure of a biobank for an academic medical center. ⋯ Our results indicate that the IT-infrastructure plays a pivotal role in successfully establishing a biobank. Several aspects of the IT-infrastructure are similarly found in other areas as, e.g. data protection and storage and quality management. Finally, we conclude that although a research database is not required for operating a biobank, the need for it will definitely emerge, especially with regard to personalized medicine and high-throughput gene expression analysis.
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Stud Health Technol Inform · Jan 2010
Discuss now, document later: CIS/CPOE perceived to be a 'shift behind' in the ICU.
Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. ⋯ These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.