AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
-
AMIA Annu Symp Proc · Jan 2003
Feasibility and patients' acceptance of Home Automated Telemanagement of oral anticoagulation therapy.
We developed the Home Automated Telemanagement (HAT) system for patients on oral anticoagulation therapy. It consists of a home unit, HAT server, and clinician unit. Patients at home use a palmtop or a laptop connected with a prothrombin time (PT) monitor. ⋯ Compared to baseline, patients completing the home study showed statistically significant improvement in disease-specific quality of life dimensions of general satisfaction, self-efficacy, daily hassles, and distress. The Client Satisfaction Questionnaire demonstrated significant improvement in patient satisfaction with the treatment process. Our results demonstrated high acceptance of the HAT system by patients receiving long term anticoagulation therapy regardless of their previous computer experience or socioeconomic background.
-
AMIA Annu Symp Proc · Jan 2003
Assessment of a computer-aided instructional program for the pediatric emergency department.
Computer aided instruction (CAI) software is becoming commonplace in medical education. Our experience with CAI programs in our pediatric ED raised concerns about the time commitment some of these programs require. We developed a just-in-time learning program, the Virtual Preceptor (VP) and evaluated this program for use in a busy clinical environment. ⋯ Content was rated as appropriate by 72% of users. 95% of residents would use the program again. Although no resident felt the program itself took too long to use, 51% said they were too busy to use the VP. Time of use and level of training may be important factors in CAI use in the pediatric ED environment.
-
AMIA Annu Symp Proc · Jan 2003
Information needs of residents during inpatient and outpatient rotations: identifying effective personal digital assistant applications.
Last year, we reported (2002 AMIA Proceedings, p 971) on how medical school residents report on their use of personal digital assistants (PDA) or hand held devices. We first surveyed 88 residents in six residency programs representing both generalist and specialist practices (Family Medicine, Internal Medicine, Neurology, Pediatrics, Radiology, and Surgery. Following our survey, we contacted some of these same residents for follow-up advantages and disadvantages of specific software applications, and what information residents would like to have on their PDAs. ⋯ Interviews with the residents using these checksheets should provide additional details of how utility of the resource, disadvantages of the resource, etc. Specific Goals The goals of our current study include: (1) direct observations of residents PDA usage to determine how this compares to our previous results (above), ts (above), (2) determine if PDA usage varies between outpatient and inpatient clinics, (3) determine how different information sources are used in these clinics. Our long range goal includes considering how PDAs might improve the information gathering processes by identifying useful PDA applications, along with user interfaces residents find intuitive.
-
AMIA Annu Symp Proc · Jan 2003
Adapting current Arden Syntax knowledge for an object oriented event monitor.
Arden Syntax for Medical Logic Module (MLM)1 was designed for writing and sharing task-specific health knowledge in 1989. Several researchers have developed frameworks to improve the sharability and adaptability of Arden Syntax MLMs, an issue known as "curly braces" problem. Karadimas et al proposed an Arden Syntax MLM-based decision support system that uses an object oriented model and the dynamic linking features of the Java platform.2 Peleg et al proposed creating a Guideline Expression Language (GEL) based on Arden Syntax's logic grammar.3 The New York Presbyterian Hospital (NYPH) has a collection of about 200 MLMs. In a process of adapting the current MLMs for an object-oriented event monitor, we identified two problems that may influence the "curly braces" one: (1) the query expressions within the curly braces of Arden Syntax used in our institution are cryptic to the physicians, institutional dependent and written ineffectively (unpublished results), and (2) the events are coded individually within a curly braces, resulting sometimes in a large number of events - up to 200.
-
AMIA Annu Symp Proc · Jan 2003
Discharge communiqué: use of a workflow byproduct to generate an interim discharge summary.
Medical problems left unresolved during hospitalizations (along with recommended outpatient evaluations, test results pending at discharge, and discharge medication regimens) are often documented in patients' discharge summaries. However, studies have demonstrated that discharge summaries are frequently unavailable or inaccessible at post discharge visit(s). Interim discharge summaries have been shown to improve the flow of information between inpatient and outpatient physicians. ⋯ The New SignOut System captures signout information and generates discharge communiqués immediately upon discharge. From June 2002-January 2003 7926 discharge communiqués were made available on 7926 patients and there were 12,920 look-ups of communiqués. Studies concur that 40-50% of patients will not have an available discharge summary making communiqués the primary source of clinical information on prior hospitalization for outpatient physicians.