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 1994
Ethical implications of standardization of ICU care with computerized protocols.
Ethical issues related to the use of computerized protocols to control mechanical ventilation of patients with Acute Respiratory Distress Syndrome (ARDS) are identical to the ethical issues surrounding the use of any therapy or intervention. Four ethical principles must be considered: nonmaleficence, beneficence, autonomy, and distributed justice. The major ethical challenges to computerized protocol use as a specific application of clinical decision support tools are found within the principles of nonmaleficence and of beneficence. ⋯ Clinicians are thus deprived of the knowledge necessary to define benefit and are limited to beneficent intention in clinical decisions. Computerized protocol controlled decision making for the clinical management of mechanical ventilation for ARDS patients is ethically defensible. It is as well supported as most ICU therapy options.
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Proc Annu Symp Comput Appl Med Care · Jan 1994
A simple approach to physician entry of patient problem list.
The patient's problem list is one of the key components of the electronic medical record. Besides the immediate benefits of using the patient problem list for medical records coding and creation of discharge documentation, a coded problem list is a prerequisite of patient management, clinical decision support and research. The ICD9 coding system that is the current standard for coding diagnoses and procedures is not conducive to physician usage. ⋯ Physicians can use their own terminology. ICD9 codes are included where possible, but free text is allowed. The system strikes a balance between capturing a fully coded patient problem list and encouraging usage by a wide physician user group.
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Proc Annu Symp Comput Appl Med Care · Jan 1994
Survey of nurse perceptions regarding the utilization of bedside computers.
In December 1993, Intermountain Health Care (IHC) placed a moratorium on the installation of bedside computers in the acute care setting unless information could be obtained to justify resumption of these installations. A survey was developed and administered to nurses at two IHC hospitals. ⋯ In addition, the acute care nurses estimate that they are using the bedside computers over 75% of the time during the day shift to document vital signs/measurements and intake/output quantities. Based on the results of this survey, IHC has decided to continue installing bedside computers in the acute care setting.
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Proc Annu Symp Comput Appl Med Care · Jan 1994
Advanced clinical monitoring: considerations for real-time hemodynamic diagnostics.
In an effort to ease staffing burdens and potentially improve patient outcome in an intensive care unit (ICU) environment, we are developing a real-time system to accurately and efficiently diagnose cardiopulmonary emergencies. The system is being designed to utilize all relevant routinely-monitored physiological data in order to automatically diagnose potentially fatal events. The initial stage of this project involved formulating the overall system design and appropriate methods for real-time data acquisition, data storage, data trending, waveform analysis, and implementing diagnostic rules. ⋯ As the clinical picture worsened, the fuzzy logic-based system accurately indicated the change in patient condition. Termination of the simulated arrest was rapidly detected by the diagnostic engine. In view of the effectiveness of this fuzzy logic implementation, we plan to develop additional fuzzy logic modules to diagnose other cardiopulmonary emergencies.