Proceedings / the ... Annual Symposium on Computer Application [sic] in Medical Care. Symposium on Computer Applications in Medical Care
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Proc Annu Symp Comput Appl Med Care · Jan 1995
Comparative StudyThe impact of a guideline-driven computer charting system on the emergency care of patients with acute low back pain.
Federal guidelines for the treatment of acute low back pain were locally modified and made more specific. These guidelines were then programmed into a rule-based computer charting system which provides real-time advice regarding documentation, testing, treatment, and disposition of emergency department patients with this condition. ⋯ These findings contrast with our previous experiment using a similar program for the care of health care workers exposed to body fluids. In that study both the appropriateness of care and the cost-effectiveness of care were substantially improved.
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Proc Annu Symp Comput Appl Med Care · Jan 1995
Converting a legacy system database into relational format to enhance query efficiency.
The analysis of clinical data collected over time can provide important insight into the health care process. Unfortunately, much of the electronic clinical data that exists today is stored in legacy systems, making it difficult to access and share the information. ⋯ In this study, a legacy database is converted into a relational format in the personal computer environment. The impact of such a conversion on query performance is evaluated, and issues that need to be considered when converting a legacy system database are identified.
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Proc Annu Symp Comput Appl Med Care · Jan 1995
Medical decision support: experience with implementing the Arden Syntax at the Columbia-Presbyterian Medical Center.
We began implementation of a medical decision support system (MDSS) at the Columbia-Presbyterian Medical Center (CPMC) using the Arden Syntax in 1992. The Clinical Event Monitor which executes the Medical Logic Modules (MLMs) runs on a mainframe computer. Data are stored in a relational database and accessed via PL/I programs known as Data Access Modules (DAMs). ⋯ Most simple interpretations are not read at all. A significant problem of MLMs is maintenance, and changes in laboratory testing and message output can impair MLM execution significantly. We are now using relational database technology and coded MLM output to study the process outcome of our MDSS.
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Proc Annu Symp Comput Appl Med Care · Jan 1995
Analysis of medical decision making: a cognitive perspective on medical informatics.
The improved support of complex medical decision making will require a greater understanding of the cognitive processes of physicians. Decision making in medicine often involves the careful weighing of uncertain and ill-structured information from various sources. In this paper a cognitive approach to analyzing complex intensive care decision making is outlined. ⋯ The audiotaped protocols were then analyzed for the use of decision strategies and for key aspects of decision making. It was found that expert subjects tended to focus on developing a more refined situational analysis of the decision problem. The study results are being used in the design of a system for aiding physicians in making complex decisions in intensive care medicine.
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Proc Annu Symp Comput Appl Med Care · Jan 1995
A method for interactive medical instruction utilizing the World Wide Web.
We describe the implementation of interactive medical teaching programs in radiology and histology which utilize the Internet's World Wide Web (WWW). The WWW standard hypertext interface allows for simple navigation between related documents but does not provide a method for student tracking or question queries. ⋯ The approach allows multiple simultaneous, yet asynchronous interactions by geographically dispersed students upon the same instructional database and is scalable, providing the capability for multiple image/document servers. The security of the database is assured given that it is not accessible through the Internet.