Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Jan 1999
Historical ArticleApplications of telemedicine and telecommunications to disaster medicine: historical and future perspectives.
Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. ⋯ This manuscript reviews the history of telemedicine activities in actual disasters and similar scenarios as well as ongoing telemedicine innovations that may be applicable to disaster situations. Emergency care providers must begin to plan effectively to utilize disaster-specific telemedicine applications to improve future outcomes.
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The Patient Education and Activation System (PEAS) project aims to prepare people to take a more active role in their health care decisions. In this paper, the authors describe their work on the Layman Education and Activation Form (LEAF). LEAF is designed to be an interactive, Internet-based system for collecting a patient's medical history. ⋯ It avoids overwhelming the patient, by providing information only when it is likely to relevant. The system avoids asking irrelevant questions or providing irrelevant facts by tailoring the content of the form to the patient's responses. The system also uses the patient's answers to suggest questions that the patient might ask a doctor and provides online resources that the patient can browse.
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J Am Med Inform Assoc · May 1998
Comparative StudyIdentifying adverse drug events: development of a computer-based monitor and comparison with chart review and stimulated voluntary report.
Adverse drug events (ADEs) are both common and costly. Most hospitals identify ADEs using spontaneous reporting, but this approach lacks sensitivity; chart review identifies more events but is expensive. Computer-based approaches to ADE identification appear promising, but they have not been directly compared with chart review and they are not widely used. ⋯ The computer-based monitor identified fewer ADEs than did chart review but many more ADEs than did stimulated voluntary report. The overlap among the ADEs identified using different methods was small, suggesting that the incidence of ADEs may be higher than previously reported and that different detection methods capture different events. The computer-based monitoring system represents an efficient approach for measuring ADE frequency and gauging the effectiveness of ADE prevention programs.
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J Am Med Inform Assoc · May 1998
Infrastructure for reaching disadvantaged consumers: telecommunications in rural and remote nursing in Australia.
Both consumers and health service providers need access to up-to-date information, including patient and practice guidelines, that allows them to make decisions in partnership about individual and public health in line with the primary health care model of health service delivery. Only then is it possible for patient preferences to be considered while the health of the general population is improved. ⋯ It is argued that a suitable telecommunication infrastructure is needed to reach disadvantaged persons in extremely remote areas and that intersectoral support is essential to build this infrastructure. In addition, education will make its utilization possible.
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J Am Med Inform Assoc · Mar 1998
ReviewDevelopment and initial validation of an instrument to measure physicians' use of, knowledge about, and attitudes toward computers.
This paper describes details of four scales of a questionnaire-- "Computers in Medical Care"--measuring attributes of computer use, self-reported computer knowledge, computer feature demand, and computer optimism of academic physicians. The reliability (i.e., precision, or degree to which the scale's result is reproducible) and validity (i.e., accuracy, or degree to which the scale actually measures what it is supposed to measure) of each scale were examined by analysis of the responses of 771 full-time academic physicians across four departments at five academic medical centers in the United States. The objectives of this paper were to define the psychometric properties of the scales as the basis for a future demonstration study and, pending the results of further validity studies, to provide the questionnaire and scales to the medical informatics community as a tool for measuring the attitudes of health care providers. ⋯ The four scales of the questionnaire appear to measure with adequate reliability five attributes of academic physicians' attitudes toward computers in medical care: computer use, self-reported computer knowledge, demand for computer functionality, demand for computer usability, and computer optimism. Results of initial validity studies are positive, but further validation of the scales is needed. The URL of a downloadable HTML copy of the questionnaire is provided.