Analysis of internet use behaviors among clinical medical students in China

PubMed Central

2014-01-01

Background The availability of internet-based information resources is increasing and the appropriate use of such resources is an important subject for clinical medical students. The aims of this study were to investigate the behaviors of clinical medical students regarding the use of internet-based activities, to analyze the behavior and characteristics of the students’ information demands, and to discuss the behaviors and time preferences related to internet use of students with different levels of education. Methods Librarians obtained real-time feedback from 999 clinical medical students to record online activities. The data was recorded in a standard form and then analyzed statistically. Results There were significant differences in the use of the internet for learning activities among the different groups of clinical medical students (P < 0.0001). Learning accounted for 73.5% of all internet use for doctoral candidates, 47.6% of internet use for master’s candidates, 28.7% of internet use for seven-year undergraduate students, and 14.1% of use for five-year undergraduate students. There was also a significant difference in the proportions of leisure and e-commerce activities among the student groups (P < 0.0001), with five-year students displaying the highest total proportion of these activities (59.4% and 18.8%). Internet use for entertainment activities was the same for all groups of clinical medical students. Time of day of internet use was consistent across all student groups, but internet use differed by day of the week (P < 0.01). There was no difference among the time of day of internet use for learning, leisure and entertainment activities during a single day (P > 0.05), but e-commerce activities varied according to time of day (P < 0.05). Learning and e-commerce activities by clinical medical students did not vary by day of the week (P > 0.05), but the distributions of leisure and entertainment activities were different

Analysis of internet use behaviors among clinical medical students in China.

PubMed

Yang, Hua; Chen, Yunxiang; Zheng, Liqiang; Xu, Xin; Cao, Xia

2014-04-02

The availability of internet-based information resources is increasing and the appropriate use of such resources is an important subject for clinical medical students. The aims of this study were to investigate the behaviors of clinical medical students regarding the use of internet-based activities, to analyze the behavior and characteristics of the students' information demands, and to discuss the behaviors and time preferences related to internet use of students with different levels of education. Librarians obtained real-time feedback from 999 clinical medical students to record online activities. The data was recorded in a standard form and then analyzed statistically. There were significant differences in the use of the internet for learning activities among the different groups of clinical medical students (P < 0.0001). Learning accounted for 73.5% of all internet use for doctoral candidates, 47.6% of internet use for master's candidates, 28.7% of internet use for seven-year undergraduate students, and 14.1% of use for five-year undergraduate students. There was also a significant difference in the proportions of leisure and e-commerce activities among the student groups (P < 0.0001), with five-year students displaying the highest total proportion of these activities (59.4% and 18.8%). Internet use for entertainment activities was the same for all groups of clinical medical students. Time of day of internet use was consistent across all student groups, but internet use differed by day of the week (P < 0.01). There was no difference among the time of day of internet use for learning, leisure and entertainment activities during a single day (P > 0.05), but e-commerce activities varied according to time of day (P < 0.05). Learning and e-commerce activities by clinical medical students did not vary by day of the week (P > 0.05), but the distributions of leisure and entertainment activities were different according to day of the week (P < 0.05). A stronger demand

Evaluation of internet access and utilization by medical students in Lahore, Pakistan.

PubMed

Jadoon, Nauman A; Zahid, Muhammad F; Mansoorulhaq, Hafiz; Ullah, Sami; Jadoon, Bilal A; Raza, Ali; Hussain, Mansoor; Yaqoob, Rehan; Shahzad, Mohammad A

2011-05-30

The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan. A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution. A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from staff were cited as the most

Evaluation of internet access and utilization by medical students in Lahore, Pakistan

PubMed Central

2011-01-01

Background The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan. Methods A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution. Results A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from

Quality of Life in Medical Students With Internet Addiction.

PubMed

Fatehi, Farzad; Monajemi, Alireza; Sadeghi, Anahita; Mojtahedzadeh, Rita; Mirzazadeh, Azim

2016-10-01

The widespread use of internet has caused new psychological, social, and educational problems for the students. The aim of this study was to examine the quality of life in medical students who suffer from internet addiction. This cross-sectional survey was carried out in Tehran University of Medical Sciences, and a total of 174 fourth-to seventh-year undergraduate medical students were enrolled. The quality of life was assessed by WHOQOL-BREF questionnaire which covers four domains of physical health, psychological, social relationships, and the environment. For assessing internet addiction, we used Internet Addiction Test (IAT) of Young. The students with IAT score higher than 50 were considered as addicted. For evaluating academic performance, the students were requested to report their grade point average (GPA). The mean IA score (±SD) was 34.13±12.76. Twenty-eight students (16.90%) had IAT score above 50. The mean quality of life score in internet addicted group was 54.97±11.38 versus 61.65±11.21 in normal group (P=0.005). Furthermore, there was a negative correlation between IA score and physical domain (r=-0.18, P=0.02); psychological domain (r=-0.35, P=0.000); and social relation domain (r=-0.26, P=0.001). Mean GPA was significantly lower in the addicted group. It seems that quality of life is lower in the internet addicted medical students; moreover, such students academically perform poorer in comparison with non-addicts. Since internet addiction is increasing at a rapid pace which may provoke considerable academic, psychological and social implications; as a result, it may require screening programs to the immediate finding of such problem to give consultations to prevent unwanted complications.

Internet use and addiction among medical students of Universiti Sultan Zainal Abidin, Malaysia

PubMed Central

Haque, Mainul; Rahman, Nor Azlina A; Majumder, Md Anwarul Azim; Haque, Seraj Zohurul; Kamal, Zubair M; Islam, Zakirul; Haque, ATM Emdadul; Rahman, Nor Iza A; Alattraqchi, Ahmed Ghazi

2016-01-01

Background The use of Internet has now become indispensable, and the technology has revolutionized the medical education and practice worldwide. Currently, medical students and professionals have an enormous opportunity to keep them always updated with the exponential growth of knowledge because of potential progression of Internet throughout the world that enables them to become a lifelong learner. Internet addiction is a widespread phenomenon among students and academicians at universities in Malaysia. Students use the Internet for recreational purpose and personal and professional development. The Internet has become an integral part of day-to-day life of the university students, including medical students. The aim of the present study was to examine the Internet use and addiction among students of Universiti Sultan Zainal Abidin, Malaysia. Methods This was a cross-sectional study in which a questionnaire, Internet Addiction Diagnostic Questionnaire, developed by the Center for Internet Addiction, USA, was used. One hundred forty-nine medical students of Universiti Sultan Zainal Abidin participated in this study. Data were analyzed using Statistical Package for the Social Sciences software. Results The mean scores were 44.9±14.05 and 41.4±13.05 for male and female participants, respectively, which indicated that both the genders were suffering from mild Internet addiction. Conclusion This study shows almost similar level of Internet usage among medical students irrespective of their socioeconomic background, with no statistically significant (p>0.05) differences, except among the years of study (p=0.007). Overall, from the research data and having worked with this cohort very closely, Universiti Sultan Zainal Abidin medical students can be labeled as wonted and recurring users of the Internet. Nevertheless, it is very difficult to define as Internet addicts or pathological users of the Internet because of small sample size and cross-sectional study. PMID

Internet use and addiction among medical students of Universiti Sultan Zainal Abidin, Malaysia.

PubMed

Haque, Mainul; Rahman, Nor Azlina A; Majumder, Md Anwarul Azim; Haque, Seraj Zohurul; Kamal, Zubair M; Islam, Zakirul; Haque, Atm Emdadul; Rahman, Nor Iza A; Alattraqchi, Ahmed Ghazi

2016-01-01

The use of Internet has now become indispensable, and the technology has revolutionized the medical education and practice worldwide. Currently, medical students and professionals have an enormous opportunity to keep them always updated with the exponential growth of knowledge because of potential progression of Internet throughout the world that enables them to become a lifelong learner. Internet addiction is a widespread phenomenon among students and academicians at universities in Malaysia. Students use the Internet for recreational purpose and personal and professional development. The Internet has become an integral part of day-to-day life of the university students, including medical students. The aim of the present study was to examine the Internet use and addiction among students of Universiti Sultan Zainal Abidin, Malaysia. This was a cross-sectional study in which a questionnaire, Internet Addiction Diagnostic Questionnaire, developed by the Center for Internet Addiction, USA, was used. One hundred forty-nine medical students of Universiti Sultan Zainal Abidin participated in this study. Data were analyzed using Statistical Package for the Social Sciences software. The mean scores were 44.9±14.05 and 41.4±13.05 for male and female participants, respectively, which indicated that both the genders were suffering from mild Internet addiction. This study shows almost similar level of Internet usage among medical students irrespective of their socioeconomic background, with no statistically significant ( p >0.05) differences, except among the years of study ( p =0.007). Overall, from the research data and having worked with this cohort very closely, Universiti Sultan Zainal Abidin medical students can be labeled as wonted and recurring users of the Internet. Nevertheless, it is very difficult to define as Internet addicts or pathological users of the Internet because of small sample size and cross-sectional study.

An automatic indexing method for medical documents.

PubMed Central

Wagner, M. M.

1991-01-01

This paper describes MetaIndex, an automatic indexing program that creates symbolic representations of documents for the purpose of document retrieval. MetaIndex uses a simple transition network parser to recognize a language that is derived from the set of main concepts in the Unified Medical Language System Metathesaurus (Meta-1). MetaIndex uses a hierarchy of medical concepts, also derived from Meta-1, to represent the content of documents. The goal of this approach is to improve document retrieval performance by better representation of documents. An evaluation method is described, and the performance of MetaIndex on the task of indexing the Slice of Life medical image collection is reported. PMID:1807564

Medication communication through documentation in medical wards: knowledge and power relations.

PubMed

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

2014-09-01

Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals. © 2013 John Wiley & Sons Ltd.

Local CD-ROM in interaction with HTML documents over the Internet.

PubMed

Mattheos, N; Nattestad, A; Attström, R

2000-08-01

The internet and computer assisted learning have enhanced the possibilities of providing quality distance learning in dentistry. The use of multimedia material is an essential part of such distance learning courses. However the Internet technology available has limitations regarding transmission of large multimedia files. Therefore especially when addressing undergraduate students or geographically isolated professionals, large download times make distance learning unattractive. This problem was technically solved in a distance learning course for undergraduate students from all over Europe. The present communication describes a method to bypass the problem of transmitting large multimedia files by the use of a specially designed CD-ROM. This CD-ROM was run locally on the students' PC interacting with HTML documents sent over the Internet.

Intelligent retrieval of medical images from the Internet

NASA Astrophysics Data System (ADS)

Tang, Yau-Kuo; Chiang, Ted T.

1996-05-01

The object of this study is using Internet resources to provide a cost-effective, user-friendly method to access the medical image archive system and to provide an easy method for the user to identify the images required. This paper describes the prototype system architecture, the implementation, and results. In the study, we prototype the Intelligent Medical Image Retrieval (IMIR) system as a Hypertext Transport Prototype server and provide Hypertext Markup Language forms for user, as an Internet client, using browser to enter image retrieval criteria for review. We are developing the intelligent retrieval engine, with the capability to map the free text search criteria to the standard terminology used for medical image identification. We evaluate retrieved records based on the number of the free text entries matched and their relevance level to the standard terminology. We are in the integration and testing phase. We have collected only a few different types of images for testing and have trained a few phrases to map the free text to the standard medical terminology. Nevertheless, we are able to demonstrate the IMIR's ability to search, retrieve, and review medical images from the archives using general Internet browser. The prototype also uncovered potential problems in performance, security, and accuracy. Additional studies and enhancements will make the system clinically operational.

Documentation of clinical care in hospital patients' medical records: A qualitative study of medical students' perspectives on clinical documentation education.

PubMed

Rowlands, Stella; Coverdale, Steven; Callen, Joanne

2016-12-01

Clinical documentation is essential for communication between health professionals and the provision of quality care to patients. To examine medical students' perspectives of their education in documentation of clinical care in hospital patients' medical records. A qualitative design using semi-structured interviews with fourth-year medical students was undertaken at a hospital-based clinical school in an Australian university. Several themes reflecting medical students' clinical documentation education emerged from the data: formal clinical documentation education using lectures and tutorials was minimal; most education occurred on the job by junior doctors and student's expressed concerns regarding variation in education between teams and receiving limited feedback on performance. Respondents reported on the importance of feedback for their learning of disease processes and treatments. They suggested that improvements could be made in the timing of clinical documentation education and they stressed the importance of training on the job. On-the-job education with feedback in clinical documentation provides a learning opportunity for medical students and is essential in order to ensure accurate, safe, succinct and timely clinical notes. © The Author(s) 2016.

[Internet presence in surgical departments in Germany. II. Legal bases of medical Internet presence].

PubMed

Schenk, C; Nimmerfroh, O; Mugomba, G; Dabidian, R; Glaser, F

2001-09-01

In recent years, the Internet has generally been growing throughout the world, and physicians have taken to the Web as well. Besides its use for medical data research, physicians and hospitals are increasingly discovering the Internet as a vehicle for the presentation of their scope of practice. In this regard, the legal frameworks in Germany are strictly regulated. This article presents current legal standards and consequences to be faced when the law on prohibited advertising is broken. Included are references to specific laws concerning Internet pages.

Medical Student Documentation in the Electronic Medical Record: Patterns of Use and Barriers.

PubMed

Wittels, Kathleen; Wallenstein, Joshua; Patwari, Rahul; Patel, Sundip

2017-01-01

Electronic health records (EHR) have become ubiquitous in emergency departments. Medical students rotating on emergency medicine (EM) clerkships at these sites have constant exposure to EHRs as they learn essential skills. The Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Alliance for Clinical Education (ACE) have determined that documentation of the patient encounter in the medical record is an essential skill that all medical students must learn. However, little is known about the current practices or perceived barriers to student documentation in EHRs on EM clerkships. We performed a cross-sectional study of EM clerkship directors at United States medical schools between March and May 2016. A 13-question IRB-approved electronic survey on student documentation was sent to all EM clerkship directors. Only one response from each institution was permitted. We received survey responses from 100 institutions, yielding a response rate of 86%. Currently, 63% of EM clerkships allow medical students to document a patient encounter in the EHR. The most common reasons cited for not permitting students to document a patient encounter were hospital or medical school rule forbidding student documentation (80%), concern for medical liability (60%), and inability of student notes to support medical billing (53%). Almost 95% of respondents provided feedback on student documentation with supervising faculty being the most common group to deliver feedback (92%), followed by residents (64%). Close to two-thirds of medical students are allowed to document in the EHR on EM clerkships. While this number is robust, many organizations such as the AAMC and ACE have issued statements and guidelines that would look to increase this number even further to ensure that students are prepared for residency as well as their future careers. Almost all EM clerkships provided feedback on student documentation indicating the importance for

Exchanging Medical Information with Eastern Europe through the Internet.

ERIC Educational Resources Information Center

Daniels, Julie K.; Cronje, Ruth J.; Sokolowski, Beth C.

1998-01-01

Interviews foreign Information Coordinators who facilitate exchange of medical information over the Internet between healthcare providers in America and eastern Europe to learn how Internet technologies are being introduced, disseminated, and adopted in their institutions. Applies diffusion of innovations theory for interpretation. Shows technical…

A survey on internet usage and online learning behaviour among medical undergraduates.

PubMed

Venkatesh, Soma; Chandrasekaran, Venkatesh; Dhandapany, Gunasekaran; Palanisamy, Soundararajan; Sadagopan, Srinivasan

2017-05-01

To determine the magnitude and pattern of internet usage by undergraduate medical students to retrieve medical information. A pretested questionnaire-based survey was conducted among undergraduate medical students who were willing to participate. The institute ethics committee approved the study. The responses of students to the questionnaire were analysed using VassarStats online statistical programme. Categorical variables were expressed as proportions. To determine the significance of the difference between proportions, the χ 2 test or Fisher's exact test was used. Log-linear analysis was performed for significance of association among interacting variables. A p value <0.05 was considered significant. A total of 115 undergraduate medical students participated in the survey. The response was 100% and involved mainly IX and VIII semester students. Internet usage was found to be 97.4%. Of the students interviewed, 35.7% were frequent internet users and 57.4% used their mobile phones to access the internet. The majority (60.9%) had their own portable 3G internet connection. Monthly expenditure for the majority (82.6%) was less than 1000 Indian Rupees per month. The most popular medical site accessed by students was Medscape, followed by Wikipedia and WebMD. Of the students studied, 8% had attended one or more online continuing medical education programmes. On log-linear analysis, a linear relationship was found for medical time and social time. An encouraging trend is seen in the use of the internet by medical students to access medical information, but this has not translated into improved online learning behaviour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Electronic document delivery using the Internet.

PubMed Central

Bennett, V M; Palmer, E M

1994-01-01

The Health Sciences Libraries Consortium (HSLC) was established in 1985 by thirteen founding member institutions in Pennsylvania and Delaware. In 1989, the Interlibrary Loan, Document Delivery, and Union List Task Force, appointed by the HSLC Board of Directors, successfully demonstrated the feasibility of supplying 94% of all interlibrary loan (ILL) photocopy requests in forty-eight hours or less by a network application of group 3-level memory telefacsimiles. However, the expenses associated with the telefacsimile operation and the limitations associated with network polling protocols challenged participants to seek new alternatives for ILL. In 1990, the HSLC introduced HSLC HealthNET, an online wide-area network linking eleven of the thirteen institutions and their resources while providing access to the Internet. The HSLC HealthNET additionally supports a centralized shared library system, several locally mounted databases, and consortiumwide electronic mail. In 1991, a project was initiated to evaluate Ariel software, pioneered by the Research Libraries Group (RLG), compared to the existing network application of group 3-level telefacsimiles. Factors identified as critical to Ariel's potential to replace the telefacsimile network were the proprietary software specifications for Internet access, the use of HSLC's existing wide-area network (WAN), and a hardware platform that was optimal for an ILL environment. This article describes the Ariel project history, the transition to Ariel from the telefacsimile network, evaluation of equipment features for processing efficiency, and operational issues affecting ILL policy. PMID:8004018

Internet addiction in Greek medical students: an online survey.

PubMed

Tsimtsiou, Zoi; Haidich, Anna-Bettina; Spachos, Dimitris; Kokkali, Stamatia; Bamidis, Panagiotis; Dardavesis, Theodoros; Arvanitidou, Malamatenia

2015-06-01

The authors investigated the prevalence of Internet addiction (IA) in undergraduate medical students to identify possible associations with sociodemographics and Internet habits. All students at the Aristotle University of Thessaloniki School of Medicine, Greece, were invited to complete the online Internet Addiction Test (IAT) along with sociodemographics and preferences on Internet activities. The authors received 585 responses after three reminders (23.5 % response rate). Mild IA was found in 24.5 %, moderate in 5.4 %, and severe in 0.2 %. In multivariable analysis, the odds to develop IA were increased with visits in Internet cafes (Odds Ratio [OR] 3.49, 95 % Confidence Interval [CI]: 1.45, 8.46), the use of Facebook (OR 2.43, 95 % CI: 1.35, 4.38), Twitter (OR 2.45, 95 % CI: 1.37, 4.39), and online games (OR 1.95, 95 % CI: 1.29, 2.94). Using e-mails seemed to be protective against IA (OR 0.59, 95 % CI: 0.37, 0.94). This is the first IA prevalence study in a European medical school. Early-detection systems and other ways to help students with pathological behaviors should be developed.

Perceived Barriers to Information Access Among Medical Residents in Iran: Obstacles to Answering Clinical Queries in Settings with Limited Internet Accessibility

PubMed Central

Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J.

2007-01-01

Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings. PMID:18693891

Perceived barriers to information access among medical residents in Iran: obstacles to answering clinical queries in settings with limited Internet accessibility.

PubMed

Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J

2007-10-11

Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings.

Tracing medical information over the Internet.

PubMed

Mutairi, S M

2000-05-01

The Internet became with do doubt a huge and valuable source of information for researchers. The wealth of information on the Internet is second to none and medical information is no exception. Yet with the vast expansion of the Internet and the World Wide Web in specie, to find the kind of information one is looking for, he/she needs to browse thousands of web sites and the experience would be like digging into a stack of hay looking for a needle. That's why search engines and subject indexes, as means to overcome this problem, were introduced and grew so rapidly. In general, there are three approaches to retrieve data from the World Wide Web; the subject directories, search engines and detailed subject indexes. However, there is no single comprehensive search engine or directory and it is recommended to use more than one with different keywords and synonymous.

Impact of an educational intervention on medical records documentation.

PubMed

Vahedi, Hojat Sheikhmotahar; Mirfakhrai, Minasadat; Vahidi, Elnaz; Saeedi, Morteza

2018-01-01

Inaccurate and incomplete documentation can lead to poor treatment and medico-legal consequences. Studies indicate that teaching programs in this field can improve the documentation of medical records. The study aimed to evaluate the effect of an educational workshop on medical record documentation by emergency medicine residents in the emergency department. An interventional study was performed on 30 residents in their first year of training emergency medicine (PGY1), in three tertiary referral hospitals of Tehran University of Medical Sciences. The essential information that should be documented in a medical record was taught in a 3-day-workshop. The medical records completed by these residents before the training workshop were randomly selected and scored (300 records), as was a random selection of the records they completed one (300 records) and six months (300 records) after the workshop. Documentation of the majority of the essential items of information was improved significantly after the workshop. In particular documentation of the patients' date and time of admission, past medical and social history. Documentation of patient identity, requests for consultations by other specialties, first and final diagnoses were 100% complete and accurate up to 6 months of the workshop. This study confirms that an educational workshop improves medical record documentation by physicians in training.

[Security specifications for electronic medical records on the Internet].

PubMed

Mocanu, Mihai; Mocanu, Carmen

2007-01-01

The extension for the Web applications of the Electronic Medical Record seems both interesting and promising. Correlated with the expansion of Internet in our country, it allows the interconnection of physicians of different specialties and their collaboration for better treatment of patients. In this respect, the ophthalmologic medical applications consider the increased possibilities for monitoring chronic ocular diseases and for the identification of some elements for early diagnosis and risk factors supervision. We emphasize in this survey some possible solutions to the problems of interconnecting medical information systems to the Internet: the achievement of interoperability within medical organizations through the use of open standards, the automated input and processing for ocular imaging, the use of data reduction techniques in order to increase the speed of image retrieval in large databases, and, last but not least, the resolution of security and confidentiality problems in medical databases.

Computers, the Internet and medical education in Africa.

PubMed

Williams, Christopher D; Pitchforth, Emma L; O'Callaghan, Christopher

2010-05-01

OBJECTIVES This study aimed to explore the use of information and communications technology (ICT) in undergraduate medical education in developing countries. METHODS Educators (deans and heads of medical education) in English-speaking countries across Africa were sent a questionnaire to establish the current state of ICT at medical schools. Non-respondents were contacted firstly by e-mail, subsequently by two postal mailings at 3-month intervals, and finally by telephone. Main outcome measures included cross-sectional data about the availability of computers, specifications, Internet connection speeds, use of ICT by students, and teaching of ICT and computerised research skills, presented by country or region. RESULTS The mean computer : student ratio was 0.123. Internet speeds were rated as 'slow' or 'very slow' on a 5-point Likert scale by 25.0% of respondents overall, but by 58.3% in East Africa and 33.3% in West Africa (including Cameroon). Mean estimates showed that campus computers more commonly supported CD-ROM (91.4%) and sound (87.3%) than DVD-ROM (48.1%) and Internet (72.5%). The teaching of ICT and computerised research skills, and the use of computers by medical students for research, assignments and personal projects were common. CONCLUSIONS It is clear that ICT infrastructure in Africa lags behind that in other regions. Poor download speeds limit the potential of Internet resources (especially videos, sound and other large downloads) to benefit students, particularly in East and West (including Cameroon) Africa. CD-ROM capability is more widely available, but has not yet gained momentum as a means of distributing materials. Despite infrastructure limitations, ICT is already being used and there is enthusiasm for developing this further. Priority should be given to developing partnerships to improve ICT infrastructure and maximise the potential of existing technology.

An eight-year study of internet-based remote medical counselling.

PubMed

Labiris, G; Coertzen, I; Katsikas, A; Karydis, A; Petounis, A

2002-01-01

We carried out a prospective study of an Internet-based remote counselling service. A total of 15456 Internet users visited the Website over eight years. From these, 1500 users were randomly selected for analysis. Medical counselling had been granted to 901 of the people requesting it (60%). One hundred and sixty-four physicians formed project groups to process the requests and responded using email. The distribution of patients using the service was similar to the availability of the Internet: 78% were from the European Union, North America and Australia. Sixty-seven per cent of the patients lived in urban areas and the remainder were residents of remote rural areas with limited local medical coverage. Sixty-five per cent of the requests were about problems of internal medicine and 30% of the requests concerned surgical issues. The remaining 5% of the patients sought information about recent developments, such molecular medicine or aviation medicine. During the project, our portal became inaccessible five times, and counselling was not possible on 44 days. There was no hacking of the Website. Internet-based medical counselling is a helpful addition to conventional practice.

WCALive: broadcasting a major medical conference on the Internet.

PubMed

Palmer, T E; Cumpston, P H; Ruskin, K; Jones, R D

1997-11-01

Live video and sound from the 11th World Congress of Anaesthesiology in Sydney, Australia were broadcast over the Internet using the CuSeeme software package as part of an ongoing evaluation of Internet-based telecommunication in the delivery of Continuing Medical Education (CME). This was the first time such a broadcast had been attempted from a medical convention. The broadcast lasted for four days, during which a functioning combination of computer hardware and software was established. Technical issues relating to broadcast of these real time signals over ISDN links and the Internet itself were addressed. Over 200 anaesthetists from around the world were able to 'attend' the plenary sessions via the Internet. Evidenced by feedback received audio reception was quite good. Video reception was less successful for those receiving the broadcast via a modem based Internet connection. The received signal in such circumstances was adequate to provide a video presence of the speaker but inadequate to allow details of 35 mm slides to be visualised. We conclude that this technology will be of use in the delivery of CME materials to remote areas provided simultaneous viewing of high resolution still images is possible using another medium, such as the World Wide Web.

The European Glaucoma Society Glaucocard project: improved digital documentation of medical data for glaucoma patients based on standardized structured international datasets.

PubMed

Schargus, Marc; Grehn, Franz; Glaucocard Workgroup

2008-12-01

To evaluate existing international IT-based ophthalmological medical data projects, and to define a glaucoma data set based on existing international standards of medical and ophthalmological documentation. To develop the technical environment for easy data mining and data exchange in different countries in Europe. Existing clinical and IT-based projects for documentation of medical data in general medicine and ophthalmology were analyzed to create new data sets for medical documentation in glaucoma patients. Different types of data transfer methods were evaluated to find the best method of data exchange between ophthalmologists in different European countries. Data sets from existing IT projects showed a wide variability in specifications, use of codes, terms and graphical data (perimetry, optic nerve analysis etc.) in glaucoma patients. New standardized digital datasets for glaucoma patients were defined, based on existing standards, which can be used by general ophthalmologists for follow-up examinations and for glaucoma specialists to perform teleconsultation, also across country borders. Datasets are available in different languages. Different types of data exchange methods using secure medical data transfer by internet, USB stick and smartcard were tested for different countries with regard to legal acceptance, practicability and technical realization (e.g. compatibility with EMR systems). By creating new standardized glaucoma specific cross-national datasets, it is now possible to develop an electronic glaucoma patient record system for data storage and transfer based on internet, smartcard or USB stick. The digital data can be used for referrals and for teleconsultation of glaucoma specialists in order to optimize glaucoma treatment. This should lead to an increase of quality in glaucoma care, and prevent expenses in health care costs by unnecessary repeated examinations.

[Internet-based continuing medical education: as effective as live continuing medical education].

PubMed

Maisonneuve, Hervé; Chabot, Olivier

2009-10-01

E-learning consists in using new multimedia and Internet technologies to improve the quality of learning activities by facilitating access to resources and services, as well as exchanges and remote collaboration. The Internet is used for adult education in most professional domains, but its use for continuing medical education is less developed. Advantages are observed for teachers (e.g., permanent updating, interactive links, illustrations, archiving, and collective intelligence) and for the learners (e.g., accessibility, autonomy, flexibility, and adaptable pace). Research and meta-analyses have shown that e-CME is as effective as live events for immediate and retained learning. English-language educational medical websites that grant CME credits are numerous; few such French-language sites can currently grant credits. Accreditation of websites for CME, in its infancy in Europe, is common in North America.

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients.

PubMed

Moreno, Gerardo; Lin, Elizabeth H; Chang, Eva; Johnson, Ron L; Berthoud, Heidi; Solomon, Cam C; Morales, Leo S

2016-03-01

Health systems are increasingly implementing remote telephone and Internet refill systems to enhance patient access to medication refills. Remote refill systems may provide an effective approach for improving medication non-adherence, but more research is needed among patients with limited English proficiency with poor access to remote refill systems. To compare the use of remote medication refill systems among limited-English-proficiency (LEP) and English-proficient (EP) patients with chronic conditions. Cross-sectional survey in six languages/dialects (English, Cantonese, Mandarin, Korean, Vietnamese, and Spanish) of 509 adults with diabetes, hypertension, or hyperlipidemia. Primary study outcomes were self-reported use of 1) Internet refills, 2) telephone refills, and 3) any remote refill system. LEP was measured by patient self-identification of a primary language other than English and a claims record of use of an interpreter. Other measures were age, gender, education, years in the U.S., insurance, health status, chronic conditions, and number of prescribed medications. Analyses included multivariable logistic regression weighted for survey non-response. Overall, 33.1 % of patients refilled their medications by telephone and 31.6 % by Internet. Among LEP patients (n = 328), 31.5 % refilled by telephone and 21.2 % by Internet, compared with 36.7 % by telephone and 52.7 % by Internet among EP patients (n = 181). Internet refill by language groups were as follows: English (52.7 %), Cantonese (34.9 %), Mandarin (17.4 %), Korean (16.7 %), Vietnamese (24.4 %), and Spanish (12.6 %). Compared to EP patients, LEP patients had lower use of any remote refill system (adjusted odds ratio [AOR] 0.18; p < 0.001), CONCLUSIONS: LEP patients are significantly less likely than EP patients to use any remote medication refill system. Increased reliance on current systems for remote medication refills may increase disparities in health outcomes affecting LEP patients

[Doctor, know that your patient has Googled: Internet and reason for medical consultation].

PubMed

van den Bruele, Tjitske; Vos, Hedwig M M

2014-01-01

The internet is increasingly used as a source of medical information, not only by healthcare professionals but by patients as well. We describe the case of Patient A, a 32-year-old male with symptoms of sinusitis. He found a treatment on the internet and was informed when to consult a general practitioner. We also describe Patient B, a 31-year-old female with symptoms of fatigue after the delivery of her second child. Her search on the internet led to several referrals to a medical specialist due to her conviction that her symptoms were caused by a hormonal imbalance. We conclude that medical information on the internet can support both the doctor and the patient, or it can present an obstacle to proper communication during a consultation. Awareness by medical professionals of the Googling behaviour of their patients may be helpful in detecting the underlying question and worries of the patient.

Computer and Internet Utilization among the Medical Students in Qassim University, Saudi Arabia.

PubMed

Aldebasi, Yousef Homood; Ahmed, Mohamed Issa

2013-06-01

Computer-based training (CBT) and internet-based training (IBT) have become a vital part of the Medical Education. A cross-sectional study was carried out in Qassim University-Kingdom of Saudi Arabia (KSA), with the objective of assessing the pattern of the computer and Internet utilization among both male and female medical students. A total of 500 medical students from 4 different medical colleges of Qassim University participated in this study. A semi-structured, pre-tested questionnaire was used to collect the data and the data analysis was done by using SPSS, Version 17. Forty two percent female and twenty four percent male students used computers to get general information, 80% of the students reported using computers for academic activities and 52% females and 22% males used computers for entertainment. Most of the females preferred using computers at home (84%), while 54% males used computers at cyber cafés. For the information retrieval, 84% males used the internet, followed by journals/library (36%) and textbooks (35%), while the females preferred textbooks (75%) and the internet (14%). Google was found to be most commonly used search engine. The internet creates an educational delivery system; it is highly needed to increase the credit hours for the university requirement courses in computer application and the internet use for both among the male and female students.

Computer and Internet Utilization among the Medical Students in Qassim University, Saudi Arabia

PubMed Central

Aldebasi, Yousef Homood; Ahmed, Mohamed Issa

2013-01-01

Background: Computer-based training (CBT) and internet-based training (IBT) have become a vital part of the Medical Education. A cross-sectional study was carried out in Qassim University-Kingdom of Saudi Arabia (KSA), with the objective of assessing the pattern of the computer and Internet utilization among both male and female medical students. Methods: A total of 500 medical students from 4 different medical colleges of Qassim University participated in this study. A semi-structured, pre-tested questionnaire was used to collect the data and the data analysis was done by using SPSS, Version 17. Results: Forty two percent female and twenty four percent male students used computers to get general information, 80% of the students reported using computers for academic activities and 52% females and 22% males used computers for entertainment. Most of the females preferred using computers at home (84%), while 54% males used computers at cyber cafés. For the information retrieval, 84% males used the internet, followed by journals/library (36%) and textbooks (35%), while the females preferred textbooks (75%) and the internet (14%). Google was found to be most commonly used search engine. Conclusion: The internet creates an educational delivery system; it is highly needed to increase the credit hours for the university requirement courses in computer application and the internet use for both among the male and female students. PMID:23905114

Prevalence and factors associated with internet addiction among medical students - A cross-sectional study in Malaysia.

PubMed

Ching, S M; Hamidin, A; Vasudevan, R; Sazlyna, M S L; Wan Aliaa, W S; Foo, Y L; Yee, A; Hoo, F K

2017-02-01

Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia. This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis. The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09- 1.67). Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes.

Internet printing

NASA Astrophysics Data System (ADS)

Rahgozar, M. Armon; Hastings, Tom; McCue, Daniel L.

1997-04-01

The Internet is rapidly changing the traditional means of creation, distribution and retrieval of information. Today, information publishers leverage the capabilities provided by Internet technologies to rapidly communicate information to a much wider audience in unique customized ways. As a result, the volume of published content has been astronomically increasing. This, in addition to the ease of distribution afforded by the Internet has resulted in more and more documents being printed. This paper introduces several axes along which Internet printing may be examined and addresses some of the technological challenges that lay ahead. Some of these axes include: (1) submission--the use of the Internet protocols for selecting printers and submitting documents for print, (2) administration--the management and monitoring of printing engines and other print resources via Web pages, and (3) formats--printing document formats whose spectrum now includes HTML documents with simple text, layout-enhanced documents with Style Sheets, documents that contain audio, graphics and other active objects as well as the existing desktop and PDL formats. The format axis of the Internet Printing becomes even more exciting when one considers that the Web documents are inherently compound and the traversal into the various pieces may uncover various formats. The paper also examines some imaging specific issues that are paramount to Internet Printing. These include formats and structures for representing raster documents and images, compression, fonts rendering and color spaces.

Internet use by patients with psychiatric disorders in search for general and medical informations.

PubMed

Khazaal, Yasser; Chatton, Anne; Cochand, Sophie; Hoch, Aliosca; Khankarli, Mona B; Khan, Riaz; Zullino, Daniele Fabio

2008-12-01

Internet is commonly used by the general population, notably for health information-seeking. There has been little research into its use by patients treated for a psychiatric disorder. To evaluate the use of internet by patients with psychiatric disorders in searching for general and medical information. In 2007, 319 patients followed in a university hospital psychiatric out-patient clinic, completed a 28-items self-administered questionnaire. Two hundred patients surveyed were internet users. Most of them (68.5%) used internet in order to find health-related information. Only a small part of the patients knew and used criteria reflecting the quality of contents of the websites consulted. Knowledge of English and private Internet access were the factors significantly associated with the search of information on health on Internet. Internet is currently used by patients treated for psychiatric disorders, especially for medical seeking information.

Direct-to-consumer advertisements of prescription medications over the Internet.

PubMed

Fogel, Joshua; Novick, Daniel

2009-01-01

This study sought data on the impact of direct-to-consumer (DTC) advertisements and both intentions and frequency to seek more information about the drug being advertised. Data were collected from 498 college students regarding intention to seek and how frequently they obtained more information about prescription medications. For intentions, grocery or pharmacy and radio advertisements were associated with lesser intentions. For frequency, Internet advertisements were associated, while newspaper and spam e-mail advertisements were not. Types of sources associated with seeking additional information were doctor, Internet, and 1-800 information numbers. A significant interaction existed for seeing Internet advertisements for drugs and then seeking additional information from a doctor and not from the Internet. In conclusion, Internet advertising is associated with seeking additional information from a reliable source such as a doctor.

Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications.

PubMed

Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

2016-06-01

Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young's questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. More than 79.9% of students reported their general health good and very good. The student's mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. The good SRH of medical students was higher than general population but in health faculty' students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH.

Quality and correlates of medical record documentation in the ambulatory care setting

PubMed Central

Soto, Carlos M; Kleinman, Kenneth P; Simon, Steven R

2002-01-01

Background Documentation in the medical record facilitates the diagnosis and treatment of patients. Few studies have assessed the quality of outpatient medical record documentation, and to the authors' knowledge, none has conclusively determined the correlates of chart documentation. We therefore undertook the present study to measure the rates of documentation of quality of care measures in an outpatient primary care practice setting that utilizes an electronic medical record. Methods We reviewed electronic medical records from 834 patients receiving care from 167 physicians (117 internists and 50 pediatricians) at 14 sites of a multi-specialty medical group in Massachusetts. We abstracted information for five measures of medical record documentation quality: smoking history, medications, drug allergies, compliance with screening guidelines, and immunizations. From other sources we determined physicians' specialty, gender, year of medical school graduation, and self-reported time spent teaching and in patient care. Results Among internists, unadjusted rates of documentation were 96.2% for immunizations, 91.6% for medications, 88% for compliance with screening guidelines, 61.6% for drug allergies, 37.8% for smoking history. Among pediatricians, rates were 100% for immunizations, 84.8% for medications, 90.8% for compliance with screening guidelines, 50.4% for drug allergies, and 20.4% for smoking history. While certain physician and patient characteristics correlated with some measures of documentation quality, documentation varied depending on the measure. For example, female internists were more likely than male internists to document smoking history (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.27 – 2.83) but were less likely to document drug allergies (OR, 0.51; 95% CI, 0.35 – 0.75). Conclusions Medical record documentation varied depending on the measure, with room for improvement in most domains. A variety of characteristics correlated with

Application of portable CDA for secure clinical-document exchange.

PubMed

Huang, Kuo-Hsuan; Hsieh, Sung-Huai; Chang, Yuan-Jen; Lai, Feipei; Hsieh, Sheau-Ling; Lee, Hsiu-Hui

2010-08-01

Health Level Seven (HL7) organization published the Clinical Document Architecture (CDA) for exchanging documents among heterogeneous systems and improving medical quality based on the design method in CDA. In practice, although the HL7 organization tried to make medical messages exchangeable, it is still hard to exchange medical messages. There are many issues when two hospitals want to exchange clinical documents, such as patient privacy, network security, budget, and the strategies of the hospital. In this article, we propose a method for the exchange and sharing of clinical documents in an offline model based on the CDA-the Portable CDA. This allows the physician to retrieve the patient's medical record stored in a portal device, but not through the Internet in real time. The security and privacy of CDA data will also be considered.

Toward Medical Documentation That Enhances Situational Awareness Learning

PubMed Central

Lenert, Leslie A.

2016-01-01

The purpose of writing medical notes in a computer system goes beyond documentation for medical-legal purposes or billing. The structure of documentation is a checklist that serves as a cognitive aid and a potential index to retrieve information for learning from the record. For the past 50 years, one of the primary organizing structures for physicians’ clinical documentation have been the SOAP note (Subjective, Objective, Assessment, Plan). The cognitive check list is well-suited to differential diagnosis but may not support detection of changes in systems and/or learning from cases. We describe an alternative cognitive checklist called the OODA Loop (Observe, Orient, Decide, Act. Through incorporation of projections of anticipated course events with and without treatment and by making “Decisions” an explicit category of documentation in the medical record in the context of a variable temporal cycle for observations, OODA may enhance opportunities to learn from clinical care. PMID:28269872

[Readability and internet accessibility of informative documents for spinal cord injury patients in Spanish].

PubMed

Bea-Muñoz, M; Medina-Sánchez, M; Flórez-García, M T

2015-01-01

Patients with spinal cord injuries and their carers have access to leaflets on Internet that they can use as educational material to complement traditional forms of education. The aim of this study is to evaluate the readability of informative documents in Spanish, obtained from Internet and aimed at patients with spinal cord injuries. A search was made with the Google search engine using the following key words: recommendation, advice, guide, manual, self-care, education and information, adding spinal cord injury, paraplegia and tetraplegia to each of the terms. We analyzed the first 50 results of each search. The readability of the leaflets was studied with the Flesch-Szigriszt index and the INFLESZ scale, both available on the INFLESZ program. Also indicated were year of publication, country and number of authors of the documents obtained. We obtained 16 documents, developed between 2001 and 2011. Readability oscillated between 43.34 (some-what difficult) and 62 (normal), with an average value of 51.56 (somewhat difficult). Only 4 pamphlets (25%) showed a Flesch-Szigriszt index of ≥ 55 (normal). There was no difference in readability by year, authors or country of publication. The readability of 75% of the documents studied was "somewhat difficult" according to the INFLESZ scale. These results coincide with previous studies, in both Spanish and English. If the readability of this type of documents is improved, it will be easier to achieve their educational goal.

What the Internet means for the medical device industry.

PubMed

Frank, T

2000-12-01

The Internet is dramatically changing the structure of the industry. For the first time, direct communication between all suppliers and all hospitals is available. The Internet-based electronic market place not only provides the ability to choose products from a standardized catalogue, but also to send orders direct to suppliers' enterprise resource planning systems. One-to-one marketing is also becoming a reality. Medical device manufacturers are advised to test the different electronic sales and marketing initiatives that are now available.

Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications

PubMed Central

Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

2016-01-01

Introduction: Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. Methods: This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young’s questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. Results: More than 79.9% of students reported their general health good and very good. The student’s mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. Conclusion: The good SRH of medical students was higher than general population but in health faculty’ students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH. PMID:27493592

Platform-independent software for medical image processing on the Internet

NASA Astrophysics Data System (ADS)

Mancuso, Michael E.; Pathak, Sayan D.; Kim, Yongmin

1997-05-01

We have developed a software tool for image processing over the Internet. The tool is a general purpose, easy to use, flexible, platform independent image processing software package with functions most commonly used in medical image processing.It provides for processing of medical images located wither remotely on the Internet or locally. The software was written in Java - the new programming language developed by Sun Microsystems. It was compiled and tested using Microsoft's Visual Java 1.0 and Microsoft's Just in Time Compiler 1.00.6211. The software is simple and easy to use. In order to use the tool, the user needs to download the software from our site before he/she runs it using any Java interpreter, such as those supplied by Sun, Symantec, Borland or Microsoft. Future versions of the operating systems supplied by Sun, Microsoft, Apple, IBM, and others will include Java interpreters. The software is then able to access and process any image on the iNternet or on the local computer. Using a 512 X 512 X 8-bit image, a 3 X 3 convolution took 0.88 seconds on an Intel Pentium Pro PC running at 200 MHz with 64 Mbytes of memory. A window/level operation took 0.38 seconds while a 3 X 3 median filter took 0.71 seconds. These performance numbers demonstrate the feasibility of using this software interactively on desktop computes. Our software tool supports various image processing techniques commonly used in medical image processing and can run without the need of any specialized hardware. It can become an easily accessible resource over the Internet to promote the learning and of understanding image processing algorithms. Also, it could facilitate sharing of medical image databases and collaboration amongst researchers and clinicians, regardless of location.

Internet-based survey on medical manga in Japan.

PubMed

Kishi, Yukiko; Matsumura, Tomoko; Murishige, Naoko; Kodama, Yuko; Hatanaka, Nobuyo; Takita, Morihito; Sakamoto, Kenjiro; Hamaki, Tamae; Kusumi, Eiji; Kobayashi, Kazuhiko; Yuji, Koichiro; Narimatsu, Hiroto; Kami, Masahiro

2011-10-01

The more manga (Japanese graphic novels) communicate medical information, the more people are likely to be influenced by manga. We investigated through an Internet search using Google the characteristics of medical manga published in Japan, defined as those in which the main character is a medical professional and that occur in a medical setting. As of December 2008, 173 medical manga had been published. For a period of time after the first medical manga by Osamu Tezuka in 1970, the number of publications maintained a steady level, but increased rapidly in the mid 1980s. The professions of the protagonist were 134 doctors, 19 nurses, 3 dentists, 3 medical students, and 1 nursing student. Although the main character was mostly a doctor, manga featuring paramedical professionals have increased since 1990s. Medical manga may be a powerful tool for increasing the awareness of the public regarding medicine.

Medical emergencies on board commercial airlines: is documentation as expected?

PubMed Central

2012-01-01

Introduction The purpose of this study was to perform a descriptive, content-based analysis on the different forms of documentation for in-flight medical emergencies that are currently provided in the emergency medical kits on board commercial airlines. Methods Passenger airlines in the World Airline Directory were contacted between March and May 2011. For each participating airline, sample in-flight medical emergency documentation forms were obtained. All items in the sample documentation forms were subjected to a descriptive analysis and compared to a sample "medical incident report" form published by the International Air Transport Association (IATA). Results A total of 1,318 airlines were contacted. Ten airlines agreed to participate in the study and provided a copy of their documentation forms. A descriptive analysis revealed a total of 199 different items, which were summarized into five sub-categories: non-medical data (63), signs and symptoms (68), diagnosis (26), treatment (22) and outcome (20). Conclusions The data in this study illustrate a large variation in the documentation of in-flight medical emergencies by different airlines. A higher degree of standardization is preferable to increase the data quality in epidemiologic aeromedical research in the future. PMID:22397530

Medical teleconferencing with high-definition video presentation on the 'usual' Internet.

PubMed

Obuchi, Toshiro; Shima, Hiroji; Iwasaki, Akinori

2013-06-01

Although medical teleconferences on advanced academic networks have been common (Telemed J E Health 15:112-117, 1; Asian J Endosc Surg 3:185-188, 2; Surg Today 41:1579-1581, 3; Telemedicine development center of Asia. http://www.aqua.med.kyushu-u.ac.jp/eg/index.html . Accessed 6 March 2013, 4), reports regarding 'usual' Internet teleconferences or tele-lectures employing a telecommunication system for business use are very rare. Medical teleconferences and tele-lectures on the Internet were held three times between our institutions and other institutions, using the 'HD Com' made by Panasonic (HD Com. http://panasonic.biz/com/visual/ . Accessed 6 March 2013, 5), which is a high-definition telecommunication system for business tele-meeting. All of our medical telecommunications were successfully completed without any troubles. This system allows for all kinds of presentations using personal computers to be made from each station, so that discussions with high-definition surgical video presentation, which has recently been developed, could be effortlessly established despite the distance between institutions. Unlike telecommunication using advanced academic networks, this system can run without any need for specific engineering support, on the usual Internet. Medical telecommunication employing this system is likely to become common among ordinary hospitals in the near future.

Subdividing the Digital Divide: Differences in Internet Access and Use among Rural Residents with Medical Limitations

PubMed Central

2011-01-01

Background Access to health care is often contingent upon an individual’s ability to travel for services. Certain groups, such as those with physical limitations and rural residents, have more travel barriers than other groups, reducing their access to services. The use of the Internet may be a way for these groups to seek care or information to support their health care needs. Objective The purpose of this study was to examine Internet use among those whose are, for medical reasons, limited in their ability to travel. We also examined disparities in Internet use by race/ethnicity and rural residence, particularly among persons with medical conditions. Methods We used data from the 2001 National Household Travel Survey (NHTS), a nationally representative sample of US households, to examine Internet use among individuals with medical conditions, rural residents, and minority populations. Internet use was defined as any use within the past 6 months; among users, frequency of use and location of use were explored. Control variables included sociodemographics, family life cycle, employment status, region, and job density in the community. All analyses were weighted to reflect the complex NHTS sampling frame. Results Individuals with medical conditions were far less likely to report Internet use than those without medical conditions (32.6% vs 70.3%, P < .001). Similarly, rural residents were less likely to report Internet access and use than urban residents (59.7% vs 69.4%, P < .001). Nationally, 72.8% of white respondents, versus 65.7% of persons of “other” race, 51.5% of African Americans, and 38.0% of Hispanics reported accessing the Internet (P < .001). In adjusted analyses, persons with medical conditions and minority populations were less likely to report Internet use. Rural-urban differences were no longer significant with demographic and ecological characteristics held constant. Conclusions This analysis confirmed previous findings of a digital divide

The Prevalence of Internet and Social Media Based Medication Information Seeking Behavior in Saudi Arabia.

PubMed

Bahkali, Salwa; Alfurih, Suha; Aldremly, Maha; Alzayyat, Ma'an; Alsurimi, Khaled; Househ, Mowafa

2016-01-01

The internet has become an important resource to help people search for online medication information. This study aims to report the prevalence and profile of Saudi online medication seeking behavior. Conducted via a web-based survey with Twitter participants between January-February, 2015, the primary outcome measures were the self-reported rates of using the internet to search for medication related information. A valid sample of 4847 participants was collected over the period of the study. Out of the total participants, 68.3% (n=3311) were found to seek online medication related information frequently. Most of the social media users were female 83.5% (n=2766). The majority of respondents 63.6% (n= 3081) used Google, followed by Twitter 28.7% (n= 1392), Snapchat 21%, (n=1019), WhatsApp 13.8% (n= 670), Instagram 11.4%, (n= 553), and Facebook 5.5 % (n= 267), with few searching YouTube 1.3% (n=65) to access online medication information. Findings indicate that the Saudi population actively uses the internet and social media to obtain medication information. Further studies are needed to explore the influence of the internet and social media on user perception, attitude, and behavior with the use of online medication information.

Medical Documentation: An English Composition Professor's Perspective.

ERIC Educational Resources Information Center

Freeman, Mary G.

Nursing textbooks which address the subject of medical documentation tend to equate good documentation of a patient's behavior and state with strong interpersonal skills on the part of the nurse. Rarely do they point out the importance of developing a deep concentrated attention to the sensory world around oneself in order to be a good medical…

World Wide Web and Internet: applications for radiologists.

PubMed

Wunderbaldinger, P; Schima, W; Turetschek, K; Helbich, T H; Bankier, A A; Herold, C J

1999-01-01

Global exchange of information is one of the major sources of scientific progress in medicine. For management of the rapidly growing body of medical information, computers and their applications have become an indispensable scientific tool. Approximately 36 million computer users are part of a worldwide network called the Internet or "information highway" and have created a new infrastructure to promote rapid and efficient access to medical, and thus also to radiological, information. With the establishment of the World Wide Web (WWW) by a consortium of computer users who used a standardized, nonproprietary syntax termed HyperText Markup Language (HTML) for composing documents, it has become possible to provide interactive multimedia presentations to a wide audience. The extensive use of images in radiology makes education, worldwide consultation (review) and scientific presentation via the Internet a major beneficiary of this technical development. This is possible, since both information (text) as well as medical images can be transported via the Internet. Presently, the Internet offers an extensive database for radiologists. Since many radiologists and physicians have to be considered "Internet novices" and, hence, cannot yet avail themselves of the broad spectrum of the Internet, the aim of this article is to present a general introduction to the WWW/Internet and its applications for radiologists. All Internet sites mentioned in this article can be found at the following Internet address: http://www.univie.ac. at/radio/radio.html (Department of Radiology, University of Vienna)

Prevalence of internet addiction and associated factors among medical students from mashhad, iran in 2013.

PubMed

Salehi, Maryam; Norozi Khalili, Mina; Hojjat, Seyed Kaveh; Salehi, Mahta; Danesh, Ali

2014-05-01

Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students. This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences. A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior. It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption. Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group.

Prevalence of Internet Addiction and Associated Factors Among Medical Students From Mashhad, Iran in 2013

PubMed Central

Salehi, Maryam; Norozi Khalili, Mina; Hojjat, Seyed Kaveh; Salehi, Mahta; Danesh, Ali

2014-01-01

Background: Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students. Objectives: This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences. Materials and Methods: A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior. Results: It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption. Conclusions: Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group. PMID:25031856

Introduction to an open source internet-based testing program for medical student examinations.

PubMed

Lee, Yoon-Hwan

2009-12-20

The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.

Reimbursement for injury-induced medical expenses in Chinese social medical insurance schemes: A systematic analysis of legislative documents

PubMed Central

Gao, Yuyan; Li, Li; Schwebel, David C.; Ning, Peishan; Cheng, Peixia

2018-01-01

Social medical insurance schemes are crucial for realizing universal health coverage and health equity. The aim of this study was to investigate whether and how reimbursement for injury-induced medical expenses is addressed in Chinese legislative documents relevant to social medical insurance. We retrieved legislative documents from the China National Knowledge Infrastructure and the Lawyee databases. Four types of social medical insurance schemes were included: urban employee basic medical insurance, urban resident basic medical insurance, new rural cooperative medical system, and urban and rural resident medical insurance. Text analyses were conducted on all identified legislative documents. As a result, one national law and 1,037 local legislative documents were identified. 1,012 of the 1,038 documents provided for reimbursement. Of the 1,012 documents, 828 (82%) provided reimbursement only for injuries without a legally responsible person/party or not caused by self-harm, alcohol use, drug use, or other law violations, and 162 (16%) did not include any details concerning implementation. Furthermore, 760 (92%) of the 828 did not provide an exception clause applying to injuries when a responsible person/party could not be contacted or for situations when the injured person cannot obtain reimbursement from the responsible person/party. Thus, most Chinese legislative documents related to social medical insurance do not provide reimbursement for medical expenses from injuries having a legally responsible person/party or those caused by illegal behaviors. We argue that all injury-induced medical expenses should be covered by legislative documents related to social medical insurance in China, no matter what the cause of the injury. Further research is needed to explore the acceptability and feasibility of such policy changes. PMID:29543913

A classification of errors in lay comprehension of medical documents.

PubMed

Keselman, Alla; Smith, Catherine Arnott

2012-12-01

Emphasis on participatory medicine requires that patients and consumers participate in tasks traditionally reserved for healthcare providers. This includes reading and comprehending medical documents, often but not necessarily in the context of interacting with Personal Health Records (PHRs). Research suggests that while giving patients access to medical documents has many benefits (e.g., improved patient-provider communication), lay people often have difficulty understanding medical information. Informatics can address the problem by developing tools that support comprehension; this requires in-depth understanding of the nature and causes of errors that lay people make when comprehending clinical documents. The objective of this study was to develop a classification scheme of comprehension errors, based on lay individuals' retellings of two documents containing clinical text: a description of a clinical trial and a typical office visit note. While not comprehensive, the scheme can serve as a foundation of further development of a taxonomy of patients' comprehension errors. Eighty participants, all healthy volunteers, read and retold two medical documents. A data-driven content analysis procedure was used to extract and classify retelling errors. The resulting hierarchical classification scheme contains nine categories and 23 subcategories. The most common error made by the participants involved incorrectly recalling brand names of medications. Other common errors included misunderstanding clinical concepts, misreporting the objective of a clinical research study and physician's findings during a patient's visit, and confusing and misspelling clinical terms. A combination of informatics support and health education is likely to improve the accuracy of lay comprehension of medical documents. Published by Elsevier Inc.

Medical Data Mining on the Internet: Research on a Cancer Information System

DTIC Science & Technology

1999-01-01

Internet : Research on a Cancer Information System ANDREA L. HOUSTON1, HSINCHUN CHEN1, SUSAN M. HUBBARD2, BRUCE R. SCHATZ3, TOBUN D. NG1, ROBIN R. SEWELL4...SUBTITLE Medical Data Mining on the Internet : Research on a Cancer Information System 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

Acquisition and review of diagnostic images for use in medical research and medical testing examinations via the Internet

NASA Astrophysics Data System (ADS)

Pauley, Mark A.; Dalrymple, Glenn V.; Zhu, Quiming; Chu, Wei-Kom

2000-12-01

With the continued centralization of medical care into large, regional centers, there is a growing need for a flexible, inexpensive, and secure system to rapidly provide referring physicians in the field with the results of the sophisticated medical tests performed at these facilities. Furthermore, the medical community has long recognized the need for a system with similar characteristics to maintain and upgrade patient case sets for oral and written student examinations. With the move toward filmless radiographic instrumentation, the widespread and growing use of digital methods and the Internet, both of these processes can now be realized. This article describes the conceptual development and testing of a protocol that allow users to transmit, modify, remotely store and display the images and textual information of medical cases via the Internet. We also discuss some of the legal issues we encountered regarding the transmission of medical information; these issues have had a direct impact on the implementation of the results of this project.

Introduction to an Open Source Internet-Based Testing Program for Medical Student Examinations

PubMed Central

2009-01-01

The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education. PMID:20046457

Seeking Medical Information Using Mobile Apps and the Internet: Are Family Caregivers Different from the General Public?

PubMed

Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip

2017-03-01

Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.

Patient-directed Internet-based Medical Image Exchange: Experience from an Initial Multicenter Implementation

PubMed Central

Greco, Giampaolo; Patel, Anand S.; Lewis, Sara C.; Shi, Wei; Rasul, Rehana; Torosyan, Mary; Erickson, Bradley J.; Hiremath, Atheeth; Moskowitz, Alan J.; Tellis, Wyatt M.; Siegel, Eliot L.; Arenson, Ronald L.; Mendelson, David S.

2015-01-01

Rationale and Objectives Inefficient transfer of personal health records among providers negatively impacts quality of health care and increases cost. This multicenter study evaluates the implementation of the first Internet-based image-sharing system that gives patients ownership and control of their imaging exams, including assessment of patient satisfaction. Materials and Methods Patients receiving any medical imaging exams in four academic centers were eligible to have images uploaded into an online, Internet-based personal health record. Satisfaction surveys were provided during recruitment with questions on ease of use, privacy and security, and timeliness of access to images. Responses were rated on a five-point scale and compared using logistic regression and McNemar's test. Results A total of 2562 patients enrolled from July 2012 to August 2013. The median number of imaging exams uploaded per patient was 5. Most commonly, exams were plain X-rays (34.7%), computed tomography (25.7%), and magnetic resonance imaging (16.1%). Of 502 (19.6%) patient surveys returned, 448 indicated the method of image sharing (Internet, compact discs [CDs], both, other). Nearly all patients (96.5%) responded favorably to having direct access to images, and 78% reported viewing their medical images independently. There was no difference between Internet and CD users in satisfaction with privacy and security and timeliness of access to medical images. A greater percentage of Internet users compared to CD users reported access without difficulty (88.3% vs. 77.5%, P < 0.0001). Conclusion A patient-directed, interoperable, Internet-based image-sharing system is feasible and surpasses the use of CDs with respect to accessibility of imaging exams while generating similar satisfaction with respect to privacy. PMID:26625706

A study of Internet searches for medical information in dermatology patients: The patient-physician relationship.

PubMed

Orgaz-Molina, J; Cotugno, M; Girón-Prieto, M S; Arrabal-Polo, M A; Ruiz-Carrascosa, J C; Buendía-Eisman, A; Arias-Santiago, S

2015-01-01

The use of the Internet to search for medical information is considered by some physicians as an invasion of their medical domain and a reflection of a lack of trust in their advice and recommendations. The main objective of this study was to estimate the amount of medical information gathered from the Internet and to establish whether these online searches reflect a lower degree of patient satisfaction. A survey was conducted among 175 patients seen at the melanoma and psoriasis units of San Cecilio University Hospital in Granada, Spain between May 2010 and December 2011. Online searches for medical information were performed by 44.4% of patients who returned correctly completed questionnaires. The main reasons given for these searches were to complement appropriate information provided by the physician (67.3%) and to gather information before consultation with the physician (36.5%). Variables associated with the search for medical information on the Internet in the multivariate analysis were a higher educational level, a higher score on two items in the Need for Cognition Scale, and consultation of mass media other than the Internet. Studies with larger numbers of patients and other diseases, however, are required to confirm these results. The search for medical information is a widespread reality among patients with psoriasis and melanoma and it is not associated with a poor relationship with the physician. Dermatologists can play a beneficial role by recommending trustworthy Internet sites during the patient's visit and by promoting the development of pages by scientific societies to provide high-quality information. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia.

PubMed

Klinar, Ivana; Balazin, Ana; Barsić, Bruno; Tiljak, Hrvoje

2011-08-15

To identify users' reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service 'Your Questions.' Users of a free internet medical consultation service 'Your Questions' (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, P<0.001). The factors associated with the use of internet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician's office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults.

An assessment of pregnant women's knowledge and use of the Internet for medication safety information and purchase.

PubMed

Sinclair, Marlene; Lagan, B M; Dolk, Helen; McCullough, Julie E M

2018-01-01

The aim of this study was to assess pregnant women's Internet searching activity about medication safety, knowledge and perceptions of medication risk and willingness to take prescribed and non-prescribed medication or make online medication purchases. Online medication advice for pregnant women is complex. The quality and veracity of this data is increasingly important as more midwives report women are bringing retrieved online information to clinical appointments. Pregnant women's use of the Internet for seeking medication advice and purchasing medications has not yet been fully investigated. Online survey conducted from January - March 2013. Of the 284 respondents, 39% were taking a medication when they became pregnant and 76% had searched the Internet for medication safety information. Analgesics were the most commonly searched category (41%). Health service sites were the most common online source and regarded as the most helpful and trusted. Regardless of age and education level, 90% of women agreed that if trying to become pregnant they would reconsider taking any medications because of the potential risk to their unborn baby. Forty-six percent of women with higher levels of education consider buying medication online as safe, a greater proportion than those of lower education. Five percent of women reported buying medication online. The lack of specific recommendations for medication use during pregnancy is challenging for healthcare staff and pregnant women who need robust evidence to make informed treatment decisions. The Internet is a recognized, commonly accessed, source of medication information for pregnant women. © 2017 John Wiley & Sons Ltd.

Patient-directed Internet-based Medical Image Exchange: Experience from an Initial Multicenter Implementation.

PubMed

Greco, Giampaolo; Patel, Anand S; Lewis, Sara C; Shi, Wei; Rasul, Rehana; Torosyan, Mary; Erickson, Bradley J; Hiremath, Atheeth; Moskowitz, Alan J; Tellis, Wyatt M; Siegel, Eliot L; Arenson, Ronald L; Mendelson, David S

2016-02-01

Inefficient transfer of personal health records among providers negatively impacts quality of health care and increases cost. This multicenter study evaluates the implementation of the first Internet-based image-sharing system that gives patients ownership and control of their imaging exams, including assessment of patient satisfaction. Patients receiving any medical imaging exams in four academic centers were eligible to have images uploaded into an online, Internet-based personal health record. Satisfaction surveys were provided during recruitment with questions on ease of use, privacy and security, and timeliness of access to images. Responses were rated on a five-point scale and compared using logistic regression and McNemar's test. A total of 2562 patients enrolled from July 2012 to August 2013. The median number of imaging exams uploaded per patient was 5. Most commonly, exams were plain X-rays (34.7%), computed tomography (25.7%), and magnetic resonance imaging (16.1%). Of 502 (19.6%) patient surveys returned, 448 indicated the method of image sharing (Internet, compact discs [CDs], both, other). Nearly all patients (96.5%) responded favorably to having direct access to images, and 78% reported viewing their medical images independently. There was no difference between Internet and CD users in satisfaction with privacy and security and timeliness of access to medical images. A greater percentage of Internet users compared to CD users reported access without difficulty (88.3% vs. 77.5%, P < 0.0001). A patient-directed, interoperable, Internet-based image-sharing system is feasible and surpasses the use of CDs with respect to accessibility of imaging exams while generating similar satisfaction with respect to privacy. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia

PubMed Central

Klinar, Ivana; Balažin, Ana; Baršić, Bruno; Tiljak, Hrvoje

2011-01-01

Aim To identify users’ reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service ‘Your Questions.’ Methods Users of a free internet medical consultation service ‘Your Questions’ (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). Results The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, P < 0.001). Conclusion The factors associated with the use of internet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician’s office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults. PMID:21853551

Psychotropics without borders: ethics and legal implications of internet-based access to psychiatric medications.

PubMed

Klein, Carolina A

2011-01-01

Medical practitioners are revisiting many of the ethics and the legal implications surrounding the clinical frameworks within which we operate. In today's world, distinguishing between virtual and physical reality continues to be increasingly difficult. The physician may be found grappling with the decision of whether to continue to treat a patient who may be obtaining psychotropic medications through the Internet. This article approaches some of the clinical and legal implications and the ethics regarding the availability of prescription psychotropics over the Internet.

A systematic approach to finding answers over the Internet.

PubMed Central

Potter, L A

1995-01-01

New users often are surprised at how chaotic the Internet appears. They have heard so much about it and then find that it is a jumble of menus and resources. Even so, it is possible to find answers to reference questions on the Internet. This paper outlines a method for doing so. The method involves five steps: gather information and tools, learn the terminology, assemble a manual, write a strategy, and make bookmarks. The paper offers medical reference scenarios that illustrate how to search a database, find a program, find a document, and telnet to another site on the Internet. PMID:7581183

Understanding the mobile internet to develop the next generation of online medical teaching tools

PubMed Central

Christiano, Cynthia; Ferris, Maria

2011-01-01

Healthcare providers (HCPs) use online medical information for self-directed learning and patient care. Recently, the mobile internet has emerged as a new platform for accessing medical information as it allows mobile devices to access online information in a manner compatible with their restricted storage. We investigated mobile internet usage parameters to direct the future development of mobile internet teaching websites. Nephrology On-Demand Mobile (NODM) (http://www.nephrologyondemand.org) was made accessible to all mobile devices. From February 1 to December 31, 2010, HCP use of NODM was tracked using code inserted into the root files. Nephrology On-Demand received 15 258 visits, of which approximately 10% were made to NODM, with the majority coming from the USA. Most access to NODM was through the Apple iOS family of devices and cellular connections were the most frequently used. These findings provide a basis for the future development of mobile nephrology and medical teaching tools. PMID:21659443

Understanding the mobile internet to develop the next generation of online medical teaching tools.

PubMed

Desai, Tejas; Christiano, Cynthia; Ferris, Maria

2011-01-01

Healthcare providers (HCPs) use online medical information for self-directed learning and patient care. Recently, the mobile internet has emerged as a new platform for accessing medical information as it allows mobile devices to access online information in a manner compatible with their restricted storage. We investigated mobile internet usage parameters to direct the future development of mobile internet teaching websites. Nephrology On-Demand Mobile (NOD(M)) (http://www.nephrologyondemand.org) was made accessible to all mobile devices. From February 1 to December 31, 2010, HCP use of NOD(M) was tracked using code inserted into the root files. Nephrology On-Demand received 15,258 visits, of which approximately 10% were made to NOD(M), with the majority coming from the USA. Most access to NOD(M) was through the Apple iOS family of devices and cellular connections were the most frequently used. These findings provide a basis for the future development of mobile nephrology and medical teaching tools.

Mission statements and vision documents in medical practices.

PubMed

Drury, Ivo; Slomski, Carol

2006-01-01

Thoughtful, carefully constructed mission statements and vision documents serve both to signal the purpose of a medical practice to the public and other professional colleagues, and to keep the practice's providers focused on its key purposes. Practice culture is the primary driver ofmission and vision. We clarify the differences between mission statements and vision documents, and offer guidelines to aid in constructing them.

Hierarchical Medical System Based on Big Data and Mobile Internet: A New Strategic Choice in Health Care

PubMed Central

2017-01-01

China is setting up a hierarchical medical system to solve the problems of biased resource allocation and high patient flows to large hospitals. The development of big data and mobile Internet technology provides a new perspective for the establishment of hierarchical medical system. This viewpoint discusses the challenges with the hierarchical medical system in China and how big data and mobile Internet can be used to mitigate these challenges. PMID:28790024

Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial.

PubMed

Kashiwagi, Kenji; Tsukahara, Shigeo

2014-01-15

Glaucoma is one of the leading causes of blindness. Reduction of intraocular pressure is the only proven way to prevent progression of glaucomatous optic neuropathy. The majority of glaucoma patients need to use antiglaucoma ophthalmic solutions over the course of their life. Thus, good adherence and persistency of glaucoma treatment are important factors for better glaucoma care. The purpose of this study was to investigate the impact of an Internet-based glaucoma care support system on glaucoma medication use. Patients were randomly divided into two groups. The non-Internet access (NIA) group consisted of patients who had access to the Internet-based glaucoma care support system during the 4-year period only when they were examined by ophthalmologists. The Internet access (IA) group consisted of patients who had the same Internet-based glaucoma care support system access as the NIA group for the first 2 years following enrollment but who were also given free access to the glaucoma care support system for the remaining 2 years. Changes in glaucoma medication use were investigated. In total, 81 patients in the IA group and 90 patients in the NIA group satisfied the study protocol. The number of antiglaucoma ophthalmic solutions used during the study period significantly increased in the NIA group (P<.03) but not in the IA group. The percentages of patients with unchanged, increased, and decreased antiglaucoma ophthalmic solution use during the study period were 61.1% (55/90), 17.8% (16/90), and 3.3% (3/90), respectively, in the NIA group, and 56.8% (46/81), 8.6% (7/81), and 13.6% (11/81), respectively, in the IA group (P<.001). Internet access significantly shifted from an increasing intraocular pressure trend to a decreasing trend in the IA group (P=.002) among the patients who did not have any medication changes. Allowing patients to browse their medical data may reduce the use and improve the effectiveness of glaucoma medication. UMIN-CTR Clinical Trial Number

eLearning: A Review of Internet-Based Continuing Medical Education

ERIC Educational Resources Information Center

Wutoh, Rita; Boren, Suzanne Austin; Balas, E. Andrew

2004-01-01

Introduction: The objective was to review the effect of Internet-based continuing medical education (CME) interventions on physician performance and health care outcomes. Methods: Data sources included searches of MEDLINE (1966 to January 2004), CINAHL (1982 to December 2003), ACP Journal Club (1991 to July/August 2003), and the Cochrane Database…

Exploiting domain information for Word Sense Disambiguation of medical documents.

PubMed

Stevenson, Mark; Agirre, Eneko; Soroa, Aitor

2012-01-01

Current techniques for knowledge-based Word Sense Disambiguation (WSD) of ambiguous biomedical terms rely on relations in the Unified Medical Language System Metathesaurus but do not take into account the domain of the target documents. The authors' goal is to improve these methods by using information about the topic of the document in which the ambiguous term appears. The authors proposed and implemented several methods to extract lists of key terms associated with Medical Subject Heading terms. These key terms are used to represent the document topic in a knowledge-based WSD system. They are applied both alone and in combination with local context. A standard measure of accuracy was calculated over the set of target words in the widely used National Library of Medicine WSD dataset. The authors report a significant improvement when combining those key terms with local context, showing that domain information improves the results of a WSD system based on the Unified Medical Language System Metathesaurus alone. The best results were obtained using key terms obtained by relevance feedback and weighted by inverse document frequency.

Documentation of Dual Sensory Impairment in Electronic Medical Records.

PubMed

Dullard, Brittney; Saunders, Gabrielle H

2016-04-01

To examine the documentation of sensory impairment in the electronic medical records (EMRs) of Veterans with both hearing and vision losses (dual sensory impairment [DSI]). A retrospective chart review of the EMRs of 20 patients with DSI was conducted. Providers' documentation of the presence of sensory impairment, the use of assistive technology during clinical appointments, and the content of notes mentioning communication issues were extracted from each chart note in the EMR for the prior 6 years. Primary care providers documented DSI in 50% of EMRs, vision loss alone in 40%, and hearing loss alone in 10% of EMRs. Audiologists documented vision loss in 50% of cases, whereas ophthalmologists/optometrists documented hearing loss in 15% of cases. Examination of two selected cases illustrates that care can be compromised when providers do not take note of sensory impairments during planning and provision of clinical care. Sensory impairment is poorly documented by most providers in EMRs. This is alarming because vision and hearing affect patient-physician communication and the use of medical interventions. The results of this study raise awareness about the need to document the presence of sensory impairments and use the information when planning treatment for individuals with DSI. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Documentation systems for educators seeking academic promotion in U.S. medical schools.

PubMed

Simpson, Deborah; Hafler, Janet; Brown, Diane; Wilkerson, LuAnn

2004-08-01

To explore the state and use of teaching portfolios in promotion and tenure in U.S. medical schools. A two-phase qualitative study using a Web-based search procedure and telephone interviews was conducted. The first phase assessed the penetration of teaching portfolio-like systems in U.S. medical schools using a keyword search of medical school Web sites. The second phase examined the current use of teaching portfolios in 16 U.S. medical schools that reported their use in a survey in 1992. The individual designated as having primary responsibility for faculty appointments/promotions was contacted to participate in a 30-60 minute interview. The Phase 1 search of U.S. medical schools' Web sites revealed that 76 medical schools have Web-based access to information on documenting educational activities for promotion. A total of 16 of 17 medical schools responded to Phase 2. All 16 continued to use a portfolio-like system in 2003. Two documentation categories, honors/awards and philosophy/personal statement regarding education, were included by six more of these schools than used these categories in 1992. Dissemination of work to colleagues is now a key inclusion at 15 of the Phase 2 schools. The most common type of evidence used to document education was learner and/or peer ratings with infrequent use of outcome measures and internal/external review. The number of medical schools whose promotion packets include portfolio-like documentation associated with a faculty member's excellence in education has increased by more than 400% in just over ten years. Among early-responder schools the types of documentation categories have increased, but students' ratings of teaching remain the primary evidence used to document the quality or outcomes of the educational efforts reported.

Documentation of medication changes in inpatient clinical notes: an audit to support quality improvement.

PubMed

Peusschers, Elsie; Twine, Jaryth; Wheeler, Amanda; Moudgil, Vikas; Patterson, Sue

2015-04-01

To describe completeness and accuracy of recording medication changes in progress notes during psychiatric inpatient admissions. A retrospective audit of records of 54 randomly selected psychiatric admissions at a metropolitan tertiary hospital. Medication changes recorded on National Inpatient Medication Chart (NIMC) were compared to documentation in the clinical progress records and assessed for completeness against seven quality criteria. With between one and 32 medication changes per admission, a total of 519 changes were recorded in NIMCs. Just over half were documented in progress notes. Psychotropic and regular medications were more frequently charted than 'other' and 'if required' medications. Documentation was seldom comprehensive. Medication name was most frequently documented; desired therapeutic effect or potential adverse effects were rarely documented. Evidence of patient involvement in, and an explicit rationale for, a change were infrequently recorded. Revealing substantial gaps in communication about medication changes during psychiatric admission, this audit sheds light on a previously undescribed source of medication error, warranting attention. Further research is needed to examine barriers to best practice, to support design and implementation of quality improvement activities but in the interim, attention should be addressed to development and articulation of content and procedures for documentation. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Usage of medical internet and e-health services by the elderly.

PubMed

Bujnowska-Fedak, Maria M; Mastalerz-Migas, Agnieszka

2015-01-01

Internet and e-health services have a substantial potential to support efficient and effective care for the elderly. The aim of the study was to investigate the use of Internet for health-related purposes among Polish elderly, the frequency and reasons of use, the importance of e-health services, and factors affecting their use. A total of 242 elderly at the age of ≥60 years were selected from the Polish population by random sampling. Data collection was carried out by phone interviews in October-November 2012. The study shows that the Internet was ever used by 32% of the elderly and 1/5 claimed a regular use. Among the Internet users, 81% of older people used it to obtain information about health or illness. The Internet was one of the less important sources of information (important for 27% of respondents), face to face contact with health professionals and family and friends are still the most required source of medical information (75%). Only 7% of elderly Internet users approached the family physician, specialists, or other health professionals over the Internet. Factors that positively affected the use of Internet among elderly were male gender, younger age, higher education, living with family, mobile phone use, and a subjective assessment of one's own health as good. The doctor's provision of Internet-based services was important in the opinion of approximately 1/4 of older people. We conclude that the development of information and communications technology (ICT) tools increasingly meets the evolving needs of patients in the field of e-health. More and more elderly become beneficiaries of these services.

Policies on documentation and disciplinary action in hospital pharmacies after a medication error.

PubMed

Bauman, A N; Pedersen, C A; Schommer, J C; Griffith, N L

2001-06-15

Hospital pharmacies were surveyed about policies on medication error documentation and actions taken against pharmacists involved in an error. The survey was mailed to 500 randomly selected hospital pharmacy directors in the United States. Data were collected on the existence of medication error reporting policies, what types of errors were documented and how, and hospital demographics. The response rate was 28%. Virtually all of the hospitals had policies and procedures for medication error reporting. Most commonly, documentation of oral and written reprimand was placed in the personnel file of a pharmacist involved in an error. One sixth of respondents had no policy on documentation or disciplinary action in the event of an error. Approximately one fourth of respondents reported that suspension or termination had been used as a form of disciplinary action; legal action was rarely used. Many respondents said errors that caused harm (42%) or death (40%) to the patient were documented in the personnel file, but 34% of hospitals did not document errors in the personnel file regardless of error type. Nearly three fourths of respondents differentiated between errors caught and not caught before a medication leaves the pharmacy and between errors caught and not caught before administration to the patient. More emphasis is needed on documentation of medication errors in hospital pharmacies.

Internet resources for dentistry: government and medical sites for the dental professional.

PubMed

Guest, G F

2000-02-15

As society transitions deeper into the Information Age, Information Technology has become a critical tool that supports all facets of the global economy. The Internet, via the World-Wide Web (WWW), has become a major component of business operations for corporate and educational organizational entities. An estimated 10,000 or more health-related websites are providing information for both consumers and healthcare professionals. In addition to private and state-supported institutions being present on the Internet, the federal government has moved rapidly toward disseminating information electronically, with significant utilization of the WWW as the technological vehicle. All branches of the US Government and federal-related agencies are now represented on the Internet in an effort to deliver content to their end users, primarily the public. The intent of this article is to complement the previous publication, "Internet Resources for Dentistry: Utilization of the Internet to Support Professional Growth, Decision Making, and Patient Care," by presenting dental healthcare professionals with information on additional governmental and medical "Internet" sites. In addition, healthcare professionals must arm themselves with more than just access itself, but also the ability to critically judge the quality of information retrieved from the WWW.

[Some documents on the education in the Ottoman Medical School].

PubMed

Dramur, R

1999-01-01

After the foundation of the Ottoman Medical School in 1838 in Galatasaray in Istanbul, we have examined in the Ottoman archives some documents about the physician and professors who are in charge of the Ottoman Medical School. We have learned with these documents that the chief physician Abdülhâk Molla was honored with a mension and an ordonnance was given by the sultan for the publication of his book, and in the chemical laboratory of the medical school all of the examinations are done without payment. In 1867 when it was an epidemic of cholera in Istanbul, Mr. Georges Ralli was charged in the Hospital of Humbarahane. The directory of the Medical School ordered cupboards for the School. When the typhoid fever epidemic appeared in 1865 in Istanbul a physician was attended in the Medical School. An order was given by the sultan for the pick up of the medical opium in the mounth Uludağ for the pharmacy of the medical school and for the exercise of the lessons of obstetrics in the Medical School, a lady was invited from Austria. Many professors in the Medical School received different compensations.

Exploiting domain information for Word Sense Disambiguation of medical documents

PubMed Central

Agirre, Eneko; Soroa, Aitor

2011-01-01

Objective Current techniques for knowledge-based Word Sense Disambiguation (WSD) of ambiguous biomedical terms rely on relations in the Unified Medical Language System Metathesaurus but do not take into account the domain of the target documents. The authors' goal is to improve these methods by using information about the topic of the document in which the ambiguous term appears. Design The authors proposed and implemented several methods to extract lists of key terms associated with Medical Subject Heading terms. These key terms are used to represent the document topic in a knowledge-based WSD system. They are applied both alone and in combination with local context. Measurements A standard measure of accuracy was calculated over the set of target words in the widely used National Library of Medicine WSD dataset. Results and discussion The authors report a significant improvement when combining those key terms with local context, showing that domain information improves the results of a WSD system based on the Unified Medical Language System Metathesaurus alone. The best results were obtained using key terms obtained by relevance feedback and weighted by inverse document frequency. PMID:21900701

Discrepancies between home medication and patient documentation in primary care.

PubMed

Rose, Olaf; Jaehde, Ulrich; Köberlein-Neu, Juliane

2018-04-01

Medication Reconciliation leads to quick detection of drug-related problems, studies in ambulatory care are scarce. The recently introduced Medication Plan in Germany serves as an ideal basis for Medication Reconciliation. The study aim was to provide accurate data on the magnitude of discrepancy between the prescription and the actually taken medicine. Clinical relevance of discrepancies was assessed to estimate the impact on medication safety. Patients were assessed at home, data was reconciled with the physician's documentation. Discrepancies were analyzed and stratified. Risk for hospitalization, risk for falls and the potential for drug-drug interactions was estimated based on literature. Drugs were tested for its origin and grouped to indication clusters. Detected DRPs at a Medication Review were linked to the results at Medication Reconciliation. Medication of 142 elderly patients from 12 practices was reconciled. 1498 drugs were found at the home assessment, 1099 (73.4%) of which were detected in the physician's documentation. 94.4% of the patients were affected by discrepancies. A total of 2.8 ± 2.4 drugs was undocumented per patient. 26.6% of missing drugs were prescribed by medical specialists, 42.5% of drugs of unknown origin were prescription drugs. 53.9% of the patients used a undocumented drug, which carried a high risk for hospitalization. 23.1% of the drugs not covered were used for treatment of cardiovascular diseases. 65.8% of the differing drugs caused at least one DRP. A high discrepancy between the drugs used by the patient and the medication documented by the primary care physician could be found. Relating drugs had a profound systemic effect and were particular relevant to medication safety. Many drugs were prescription drugs. The majority of differing drugs caused DRPs. A collaborative Medication Reconciliation as part of a Medication Management could compile the entire medication and increase patient safety. Copyright © 2017 Elsevier Inc

Prediction of internet addiction based on information literacy among students of Iran University of Medical Sciences.

PubMed

Langarizadeh, Mostafa; Naghipour, Majid; Tabatabaei, Seyed Mohsen; Mirzaei, Abbas; Vaghar, Mohammad Eslami

2018-02-01

A considerable group of internet users consists of university users; however, despite internet benefits and capabilities, internet overuse is a threat to societies especially to young people and students. The objective of this study was to determine the predictive role of information literacy in internet addiction among students of Iran University of Medical Sciences during 2016. This analytical cross-sectional study was conducted in Iran University of Medical Sciences in 2016. Using stratified random sampling method, 365 students from different disciplines were selected. Measuring tools included the Information Literacy Questionnaire, the Yang Online Drug Addiction Scale and the General Health Questionnaire. The collected data were analyzed by Pearson product-moment correlation, independent samples t-test and multiple linear regression using SPSS version 22. According to this study, 31.2% of students had internet addiction (29.9% were mildly addicted and 1.3% had severe addiction). There was a significant and inverse relationship between higher information literacy and internet addiction (R= -0.45) and (p<0.001). The predictor variable "Information literacy" explained 20% of the variation in the outcome variable "Internet addiction". Students play a substantial role in promoting the cultural and scientific level of knowledge in society; the higher their information literacy, the lower the level of Internet addiction, and consequently the general health of society will improve. It seems that wise planning by authorities of Iran's universities to prevent internet addiction and to increase information literacy among students is needed.

Internet FAQ Archives - Online Education - faqs.org

Science.gov Websites

faqs.org Internet FAQ Archives - Online Education faqs.org faqs.org - Internet FAQ Archives Internet FAQ Archives Online Education Internet RFC Index Usenet FAQ Index Other FAQs Documents Tools IFC Rated FAQs Internet RFC/STD/FYI/BCP Archives The Internet RFC series of documents is also available from

Ngi and Internet2: accelerating the creation of tomorrow's internet.

PubMed

Kratz, M; Ackerman, M; Hanss, T; Corbato, S

2001-01-01

Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institutions at speeds that are sufficient to demonstrate new technologies and support future research. The aim of the applications track is to demonstrate new applications, enabled by the NGI networks, to meet important national goals and missions [2]. [http://www.ngi.gov/] The Internet2/NGI backbone networks, Abilene and vBNS (very high performance Backbone Network Service), provide the basis of collaboration and development for a new breed of advanced medical applications. Academic medical centers leverage the resources available throughout the Internet2 high-performance networking community for high-capacity broadband and selectable quality of service to make effective use of national repositories. The Internet2 Health Sciences Initiative enables a new generation of emerging medical applications whose architecture and development have been restricted by or are beyond the constraints of traditional Internet environments. These initiatives facilitate a variety of activities to foster the

Automatic Classification Using Supervised Learning in a Medical Document Filtering Application.

ERIC Educational Resources Information Center

Mostafa, J.; Lam, W.

2000-01-01

Presents a multilevel model of the information filtering process that permits document classification. Evaluates a document classification approach based on a supervised learning algorithm, measures the accuracy of the algorithm in a neural network that was trained to classify medical documents on cell biology, and discusses filtering…

Prevalence, associated factors and impact of loneliness and interpersonal problems on internet addiction: A study in Chiang Mai medical students.

PubMed

Simcharoen, Sutapat; Pinyopornpanish, Manee; Haoprom, Pattaraporn; Kuntawong, Pimolpun; Wongpakaran, Nahathai; Wongpakaran, Tinakon

2018-01-01

Internet addiction is common among medical students, and the prevalence is higher than the general population. Identifying and creating solutions for this problem is important. The aim of this study was to examine the prevalence and associated factors, particularly loneliness and interpersonal problems among Chiang Mai medical students. Of 324 first to sixth year medical students, 56.8% comprised females with a mean age of 20.88 (SD 1.8). All completed questionnaires related to the objectives and activities of internet use, the Young Internet Addiction Test, the UCLA loneliness scale, and the Interpersonal Problems Inventory were employed to identify internet addiction. In all, 36.7% of the subjects exhibited internet addiction, mostly at mild level. Amount of time used daily, loneliness and interpersonal problems were strong predictors (beta = 0.441, p < 0.05, beta = 0.219, p < 0.001 and beta = 0.203 p < 0.001, respectively), whereas age and sex were not. All objectives of using internet contributed to the variance of internet addiction score. For internet activities, only non-academic or studying contributed. The final model accounted for 42.8% of total variance of the internet addiction score. Even though most addiction was at a mild level, careful strategies should be applied to better understand the situation. Along with a screening for potential internet addiction among medical students, attention should be paid to identifying those who experience loneliness and interpersonal problems, because both are strong predictors that can be improved by a variety of appropriate intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

Digitization of medical documents: an X-Windows application for fast scanning.

PubMed

Muñoz, A; Salvador, C H; Gonzalez, M A; Dueñas, A

1992-01-01

This paper deals with digitization, using a commercial scanner, of medical documents as still images for introduction into a computer-based Information System. Document management involves storing, editing and transmission. This task has usually been approached from the perspective of the difficulties posed by radiologic images because of their indisputable qualitative and quantitative significance. However, healthcare activities require the management of many other types of documents and involve the requirements of numerous users. One key to document management will be the availability of a digitizer to deal with the greatest possible number of different types of documents. This paper describes the relevant aspects of documents and the technical specifications that digitizers must fulfill. The concept of document type is introduced as the ideal set of digitizing parameters for a given document. The use of document type parameters can drastically reduce the time the user spends in scanning sessions. Presentation is made of an application based on Unix, X-Windows and OSF/Motif, with a GPIB interface, implemented around the document type concept. Finally, the results of the evaluation of the application are presented, focusing on the user interface, as well as on the viewing of color images in an X-Windows environment and the use of lossy algorithms in the compression of medical images.

Translating medical documents into plain language enhances communication skills in medical students--A pilot study.

PubMed

Bittner, Anja; Jonietz, Ansgar; Bittner, Johannes; Beickert, Luise; Harendza, Sigrid

2015-09-01

To train and assess undergraduate medical students' written communication skills by exercises in translating medical reports into plain language for real patients. 27 medical students participated in a newly developed communication course. They attended a 3-h seminar including a briefing on patient-centered communication and an introduction to working with the internet platform http://washabich.de. In the following ten weeks, participants "translated" one medical report every fortnight on this platform receiving feedback by a near-peer supervisor. A pre- and post-course assignment consisted of a self-assessment questionnaire on communication skills, analysis of a medical text with respect to medical jargon, and the translation of a medical report into plain language. In the self-assessment, students rated themselves in most aspects of patient-centered communication significantly higher after attending the course. After the course they marked significantly more medical jargon terms correctly than before (p<0.001). In a written plain language translation of a medical report they scored significantly higher with respect to communicative aspects (p<0.05) and medical correctness (p<0.001). Translating medical reports into plain language under near-peer supervision is associated with improved communication skills and medical knowledge in undergraduate medical students. To include translation exercises in the undergraduate medical curriculum. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prediction of internet addiction based on information literacy among students of Iran University of Medical Sciences

PubMed Central

Langarizadeh, Mostafa; Tabatabaei, Seyed Mohsen; Mirzaei, Abbas; Vaghar, Mohammad Eslami

2018-01-01

Background A considerable group of internet users consists of university users; however, despite internet benefits and capabilities, internet overuse is a threat to societies especially to young people and students. Objective The objective of this study was to determine the predictive role of information literacy in internet addiction among students of Iran University of Medical Sciences during 2016. Methods This analytical cross-sectional study was conducted in Iran University of Medical Sciences in 2016. Using stratified random sampling method, 365 students from different disciplines were selected. Measuring tools included the Information Literacy Questionnaire, the Yang Online Drug Addiction Scale and the General Health Questionnaire. The collected data were analyzed by Pearson product-moment correlation, independent samples t-test and multiple linear regression using SPSS version 22. Results According to this study, 31.2% of students had internet addiction (29.9% were mildly addicted and 1.3% had severe addiction). There was a significant and inverse relationship between higher information literacy and internet addiction (R= −0.45) and (p<0.001). The predictor variable “Information literacy” explained 20% of the variation in the outcome variable “Internet addiction”. Conclusion Students play a substantial role in promoting the cultural and scientific level of knowledge in society; the higher their information literacy, the lower the level of Internet addiction, and consequently the general health of society will improve. It seems that wise planning by authorities of Iran’s universities to prevent internet addiction and to increase information literacy among students is needed. PMID:29629056

Physicians utilisation of internet medical databases at the tertiary health institutions in Osun State, south west, Nigeria.

PubMed

Shabi, Iwok N; Shabi, Olabode M; Akewukereke, Modupe A; Udofia, Emem P

2011-12-01

To determine the extent, purpose, determinants and the impact of the utilization of Internet medical databases among the respondents. A descriptive cross sectional survey of 540 randomly selected physicians at the two tertiary health institutions in Osun State, south west, Nigeria. A total of 444 (82.2%) physicians completed the questionnaires. All the respondents have used the internet medical databases within the last 4 weeks of the study. Majority, (53.8%) used the internet resources at least once in 2 weeks, while 12.2% used the resources every day. The online resources are mainly sought for Routine patient care and for Research purposes. pubmed (70.3%), hinari (69.0%), and Free medical journals (60.1%) are the frequently used online databases/digital archives. The internet resources has positively impacted the Clinical practice (40.0%) and Research output (65.5%) of the physicians. There had been considerable increase in the extent and quality of utilization of online medical databases which has positively impacted on the Clinical practice and Research output of the physicians. Ease of finding the needed information and the availability of evidence based resources are the major determinants of the databases utilized. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

A Cross-Sectional Study on the Prevalence, Risk Factors, and Ill Effects of Internet Addiction Among Medical Students in Northeastern India

PubMed Central

Nath, Kamal; Naskar, Subrata; Victor, Robin

2016-01-01

Objective To evaluate Internet addiction among medical students in northeastern India and gain detailed knowledge about the prevalence, risk factors, and ill effects commonly associated with the disorder. Method The cross-sectional study sample comprised 188 medical students from Silchar Medical College and Hospital (Silchar, Assam, India). Students completed a sociodemographic form and an Internet use questionnaire, both created for this study, and the Young’s 20-Item Internet Addiction Test after they received brief instructions. Data were collected during a10-day period in June 2015. Results Of the 188 medical students, 46.8% were at increased risk of Internet addiction. Those who were found to be at increased risk had longer years of Internet exposure (P = .046) and always online status (P = .033). Also, among this group, the men were more prone to develop an online relationship. Excessive Internet usage also led to poor performance in college (P < .0001) and feeling moody, anxious, and depressed (P < .0001). Conclusions The ill effects of Internet addiction include withdrawal from real-life relationships, deterioration in academic activities, and a depressed and nervous mood. Internet use for nonacademic purposes is increasing among students, thus there is an immediate need for strict supervision and monitoring at the institutional level. The possibility of becoming addicted to the Internet should be emphasized to students and their parents through awareness campaigns so that interventions and restrictions can be implemented at the individual and family levels. PMID:27486546

A Cross-Sectional Study on the Prevalence, Risk Factors, and Ill Effects of Internet Addiction Among Medical Students in Northeastern India.

PubMed

Nath, Kamal; Naskar, Subrata; Victor, Robin

2016-01-01

To evaluate Internet addiction among medical students in northeastern India and gain detailed knowledge about the prevalence, risk factors, and ill effects commonly associated with the disorder. The cross-sectional study sample comprised 188 medical students from Silchar Medical College and Hospital (Silchar, Assam, India). Students completed a sociodemographic form and an Internet use questionnaire, both created for this study, and the Young's 20-Item Internet Addiction Test after they received brief instructions. Data were collected during a10-day period in June 2015. Of the 188 medical students, 46.8% were at increased risk of Internet addiction. Those who were found to be at increased risk had longer years of Internet exposure (P = .046) and always online status (P = .033). Also, among this group, the men were more prone to develop an online relationship. Excessive Internet usage also led to poor performance in college (P < .0001) and feeling moody, anxious, and depressed (P < .0001). The ill effects of Internet addiction include withdrawal from real-life relationships, deterioration in academic activities, and a depressed and nervous mood. Internet use for nonacademic purposes is increasing among students, thus there is an immediate need for strict supervision and monitoring at the institutional level. The possibility of becoming addicted to the Internet should be emphasized to students and their parents through awareness campaigns so that interventions and restrictions can be implemented at the individual and family levels.

Medical information on the internet: a tool for measuring consumer perception of quality aspects.

PubMed

Dubowicz, Arthur; Schulz, Peter J

2015-03-30

Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the "online-diagnosers" independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<.001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. The scale reliably distinguished high- and low-quality of medical advice given on websites.

Availability and quality of illegitimate somatropin products obtained from the Internet.

PubMed

Vida, Róbert György; Fittler, András; Mikulka, Ivett; Ábrahám, Eszter; Sándor, Viktor; Kilár, Ferenc; Botz, Lajos

2017-02-01

Background Growth hormones are widely available on the Internet for those who want to enhance their physical performance and improve body satisfaction. Illegitimate websites market somatropin injections without medical prescription and encourage misuse. Customers potentially put their health at risk when purchasing parenteral medications online. Objective The objective of our study was to evaluate the online market of no-prescription somatropin products and to analyse and document Internet pharmacy characteristics, distribution and pharmaceutical quality. Setting Websites indexed in Google promoting somatropin for sale direct to patients. Method Websites promoting the sale of growth hormone products were identified and analysed from June to August 2014. Internet vendor sites were evaluated to identify possible patient and medication safety concerns. Website characteristics, delivery time, storage conditions, packaging and attached product information were assessed. Investigation of the somatropin content was achieved using capillary electrophoresis with UV detection and electrospray ionization mass spectrometry. Main outcome measure Accessibility and quality of somatropin injections. Results Seventeen individual Internet vendor websites distributed somatropin products directly to patients, majority (94%) did not require a valid medical prescription before dispensing the products. Majority (70%) of Internet pharmacies displayed no medical information and none (0%) of the vendors displayed any regulatory body logo. All online samples had significantly (p < 0.001) lower somatropin concentration than labelled. Conclusion Our results clearly illustrate that prescription only biologic drugs are widely available online and can be easily accessed by anyone. Unprofessional distribution and handling is likely to cause degradation and possible patient safety concerns.

Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation

PubMed Central

Grimes, Tamasine C; Duggan, Catherine A; Delaney, Tim P; Graham, Ian M; Conlon, Kevin C; Deasy, Evelyn; Jago-Byrne, Marie-Claire; O' Brien, Paul

2011-01-01

AIMS Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care. PMID:21284705

Documentation of Functional Medication Management in Older Adults: A Retrospective Chart Review in Acute Care Hospitalization.

PubMed

Bolina, Monika; Jones, C Allyson; Koshman, Sheri; Heintz, Erin; Sadowski, Cheryl A

2016-12-01

Functional skills can affect the ability of older adults to appropriately manage their medication regimens. Research evaluating a patient's functional ability or the assessment of medication management is limited. Our objective was to describe the documented components of functional medication management (FMM) in adults aged ≥65 years during an acute hospital stay. The secondary objective was to describe the characteristics of the healthcare providers (HCP) who document FMM. This study was a retrospective chart review of a sample of patients aged ≥65 years admitted to medical units in a tertiary hospital from January 2013 to October 2014. FMM was defined as the steps required to take medications-including ordering, picking up, organizing, preparing, administering, and monitoring medications-and the functional abilities necessary to perform these tasks. The mean (standard deviation [SD]) age of patients was 78.9 (8.4) years; 72 (52 %) were female. Of the 190 charts screened, 140 were eligible for inclusion. The mean (SD) number of documented scheduled oral medications was eight (3.1) per patient, and 108 (77.1 %) charts contained documented FMM-related information. Commonly documented FMM components included whether the patient could administer medications independently (73 [52 %]) or schedule medication (46 [33 %]). These activities were most frequently documented by physicians (124 [39 %]) and occupational therapists (108 [34 %]). FMM assessments for older adult inpatients with multiple comorbidities and complex medication regimens were not documented comprehensively or frequently. Given the complexity of medication regimens and the functional skills required to manage medications at home, failing to document these assessments when evaluating patients in hospital reflects a lost opportunity.

Guidelines for medical and health information sites on the internet: principles governing AMA web sites. American Medical Association.

PubMed

Winker, M A; Flanagin, A; Chi-Lum, B; White, J; Andrews, K; Kennett, R L; DeAngelis, C D; Musacchio, R A

Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.

[Modern information and communication technology in medical rehabilitation. Enhanced sustainability through Internet-delivered aftercare].

PubMed

Kordy, H; Theis, F; Wolf, M

2011-04-01

Internet and mobile phones open new avenues for the optimization of health services in medical rehabilitation. Various models of Internet-delivered aftercare after psychosomatic inpatient treatment have shown promising results. The focus of this report is on the experience in translating one of the promising models, the Internet-Bridge ("Internet-Brücke"), to every day health care. Effectiveness was estimated through comparison of 254 patients who were treated in a hospital specialized in psychosomatic medicine and who participated in the Internet-Bridge as well as in the 1-year follow-up in the frame of standard quality assurance between 2003-2010 with 364 patients of the same hospital who also participated in the 1-year follow-up, but did not utilize the aftercare. Sustainable, reliable, and clinically significant improvements were more frequent in participants of the Internet-Bridge, especially with regard to psychological well-being, social problems, and psychosocial competence-at small additional costs. Results are understood as encouragement to start translation to routine care accompanied by research.

Physician Internet Medical Information Seeking and On-line Continuing Education Use Patterns.

ERIC Educational Resources Information Center

Casebeer, Linda; Bennett, Nancy; Kristofco, Robert; Carillo, Anna; Centor, Robert

2002-01-01

Responses from 2,200 physicians indicated that nearly all have Internet access and use it primarily for medical information and professional development, not for communicating with patients. Credibility of source, speed, accessibility, and searching ease were most important. Barriers included information overload and too little information…

The Delphi Method Online: Medical Expert Consensus Via the Internet

PubMed Central

Cam, Kenneth M.; McKnight, Patrick E.; Doctor, Jason N.

2002-01-01

Delphi is an expert consensus method. The theory behind the Delphi method is that the interaction of experts may lead to a reduction in individual bias. We have developed software that carries out all aspects of the Delphi method via the Internet. The Delphi method online consists of three components: 1) authorship, 2) interactive polling, and 3) reporting/results. We hope that researchers use this tool in future medical expert systems.

Medication order communication using fax and document-imaging technologies.

PubMed

Simonian, Armen I

2008-03-15

The implementation of fax and document-imaging technology to electronically communicate medication orders from nursing stations to the pharmacy is described. The evaluation of a commercially available pharmacy order imaging system to improve order communication and to make document retrieval more efficient led to the selection and customization of a system already licensed and used in seven affiliated hospitals. The system consisted of existing fax machines and document-imaging software that would capture images of written orders and send them from nursing stations to a central database server. Pharmacists would then retrieve the images and enter the orders in an electronic medical record system. The pharmacy representatives from all seven hospitals agreed on the configuration and functionality of the custom application. A 30-day trial of the order imaging system was successfully conducted at one of the larger institutions. The new system was then implemented at the remaining six hospitals over a period of 60 days. The transition from a paper-order system to electronic communication via a standardized pharmacy document management application tailored to the specific needs of this health system was accomplished. A health system with seven affiliated hospitals successfully implemented electronic communication and the management of inpatient paper-chart orders by using faxes and document-imaging technology. This standardized application eliminated the problems associated with the hand delivery of paper orders, the use of the pneumatic tube system, and the printing of traditional faxes.

eLearning: a review of Internet-based continuing medical education.

PubMed

Wutoh, Rita; Boren, Suzanne Austin; Balas, E Andrew

2004-01-01

The objective was to review the effect of Internet-based continuing medical education (CME) interventions on physician performance and health care outcomes. Data sources included searches of MEDLINE (1966 to January 2004), CINAHL (1982 to December 2003), ACP Journal Club (1991 to July/August 2003), and the Cochrane Database of Systematic Reviews (third quarter, 2003). Studies were included in the analyses if they were randomized controlled trials of Internet-based education in which participants were practicing health care professionals or health professionals in training. CME interventions were categorized according to the nature of the intervention, sample size, and other information about educational content and format. Sixteen studies met the eligibility criteria. Six studies generated positive changes in participant knowledge over traditional formats; only three studies showed a positive change in practices. The remainder of the studies showed no difference in knowledge levels between Internet-based interventions and traditional formats for CME. The results demonstrate that Internet-based CME programs are just as effective in imparting knowledge as traditional formats of CME. Little is known as to whether these positive changes in knowledge are translated into changes in practice. Subjective reports of change in physician behavior should be confirmed through chart review or other objective measures. Additional studies need to be performed to assess how long these new learned behaviors could be sustained. eLearning will continue to evolve as new innovations and more interactive modes are incorporated into learning.

The nonmedical use of prescription ADHD medications: results from a national Internet panel

PubMed Central

Novak, Scott P; Kroutil, Larry A; Williams, Rick L; Van Brunt, David L

2007-01-01

Background Emerging evidence suggests that nonmedical use (NMU) of prescription attention deficit/hyperactivity disorder (ADHD) medications is rising, but many previous investigations have used clinical or regionally based samples or limited their investigations to stimulants rather than to medications specifically used to treat ADHD. Using an Internet-based epidemiological survey, this paper advances understanding of the prevalence and correlates of NMU of medications used to treat ADHD, sources of diverted medications, motivations for use, and consumption patterns. Methods The study used a self-administered Internet survey of civilian, noninstitutionalized adults (N = 4,297) aged 18 to 49 in the United States. National-level estimates were created using propensity scoring methods and weighting procedures using data from three nationally representative probability surveys: a random-digit dialed telephone survey, the current U.S. Census, and the National Survey on Drug Use and Health (NSDUH). Results Past-year prevalence of NMU of ADHD medications was approximately 2%, with 4.3% reported among those aged 18 to 25 and 1.3% among those aged 26 to 49. Most respondents reporting NMU used on multiple occasions. Receipt of medications for ADHD was a significant correlate of past-year NMU, though most nonmedical users never had a prescription. Among persons who had never been prescribed medication to treat ADHD, friends or family members were the most common source. Productivity was the most frequently endorsed reason for NMU. Alcohol was the substance most commonly used in combination with ADHD drugs. Conclusion Because most prescription ADHD medications currently are highly regulated, policy options for supply-side reduction of nonmedical use may include identifying those medications with lower abuse liability for inclusion on insurance formularies. Patient and physician education programs also may be useful tools to heighten awareness of intentional and unintentional

[Development of a medical equipment support information system based on PDF portable document].

PubMed

Cheng, Jiangbo; Wang, Weidong

2010-07-01

According to the organizational structure and management system of the hospital medical engineering support, integrate medical engineering support workflow to ensure the medical engineering data effectively, accurately and comprehensively collected and kept in electronic archives. Analyse workflow of the medical, equipment support work and record all work processes by the portable electronic document. Using XML middleware technology and SQL Server database, complete process management, data calculation, submission, storage and other functions. The practical application shows that the medical equipment support information system optimizes the existing work process, standardized and digital, automatic and efficient orderly and controllable. The medical equipment support information system based on portable electronic document can effectively optimize and improve hospital medical engineering support work, improve performance, reduce costs, and provide full and accurate digital data

A pilot study on the evaluation of medical student documentation: assessment of SOAP notes.

PubMed

Seo, Ji-Hyun; Kong, Hyun-Hee; Im, Sun-Ju; Roh, HyeRin; Kim, Do-Kyong; Bae, Hwa-Ok; Oh, Young-Rim

2016-06-01

The purpose of this study was evaluation of the current status of medical students' documentation of patient medical records. We checked the completeness, appropriateness, and accuracy of 95 Subjective-Objective-Assessment-Plan (SOAP) notes documented by third-year medical students who participated in clinical skill tests on December 1, 2014. Students were required to complete the SOAP note within 15 minutes of an standard patient (SP)-encounter with a SP complaining rhinorrhea and warring about meningitis. Of the 95 SOAP notes reviewed, 36.8% were not signed. Only 27.4% documented the patient's symptoms under the Objective component, although all students completed the Subjective notes appropriately. A possible diagnosis was assessed by 94.7% students. Plans were described in 94.7% of the SOAP notes. Over half the students planned workups (56.7%) for diagnosis and treatment (52.6%). Accurate documentation of the symptoms, physical findings, diagnoses, and plans were provided in 78.9%, 9.5%, 62.1%, and 38.0% notes, respectively. Our results showed that third-year medical students' SOAP notes were not complete, appropriate, or accurate. The most significant problems with completeness were the omission of students' signatures, and inappropriate documentation of the physical examinations conducted. An education and assessment program for complete and accurate medical recording has to be developed.

Translating medical documents improves students' communication skills in simulated physician-patient encounters.

PubMed

Bittner, Anja; Bittner, Johannes; Jonietz, Ansgar; Dybowski, Christoph; Harendza, Sigrid

2016-02-27

Patient-physician communication should be based on plain and simple language. Despite communication skill trainings in undergraduate medical curricula medical students and physicians are often still not aware of using medical jargon when communicating with patients. The aim of this study was to compare linguistic communication skills of undergraduate medical students who voluntarily translate medical documents into plain language with students who do not participate in this voluntary task. Fifty-nine undergraduate medical students participated in this study. Twenty-nine participants were actively involved in voluntarily translating medical documents for real patients into plain language on the online-platform https://washabich.de (WHI group) and 30 participants were not (non-WHI group). The assessment resembled a virtual consultation hour, where participants were connected via skype to six simulated patients (SPs). The SPs assessed participants' communication skills. All conversations were transcribed and assessed for communication skills and medical correctness by a blinded expert. All participants completed a self-assessment questionnaire on their communication skills. Across all raters, the WHI group was assessed significantly (p = .007) better than the non-WHI group regarding the use of plain language. The blinded expert assessed the WHI group significantly (p = .018) better regarding the use of stylistic devices of communication. The SPs would choose participants from the WHI group significantly (p = .041) more frequently as their personal physician. No significant differences between the two groups were observed with respect to the medical correctness of the consultations. Written translation of medical documents is associated with significantly more frequent use of plain language in simulated physician-patient encounters. Similar extracurricular exercises might be a useful tool for medical students to enhance their communication skills with

The Prevalence of Problematic Internet Use and the Related Factors in Medical Students, Kerman, Iran

PubMed Central

Mazhari, Shahrzad

2012-01-01

Background Although problematic Internet use (PIU) is a growing problem among adolescents, few studies have examined its prevalence among university students in Iran. This study was designed to investigate the prevalence of PIU and its potential risk factors among students at Kerman University of Medical Sciences, Kerman, Iran. Methods In a cross-sectional study, data was collected from 976 university students. PIU was assessed by the 18-item Problematic Internet Use Questionnaire. In addition, information on demographics and Internet usage pattern was also collected. Findings A total of 920 students completed the survey (response rate = 94.8%). Of them, 98% were Internet users. Overall, 21% of the students were identified as problematic Internet users. Logistic regression analysis showed that spending more time online, having a history of psychiatric disorders, and using the Internet for chatting and playing games were risk factors for PIU. Conclusion PIU is a common problem among university students. These results suggest the need for preventive and interventional strategies for this vulnerable group. PMID:24494141

The Value of Internet Tools in Undergraduate Surgical Education: Perspective of Medical Students in a Developing Country.

PubMed

Ekenze, S O; Okafor, C I; Ekenze, O S; Nwosu, J N; Ezepue, U F

2017-03-01

Advances in information technology (IT) in the past decade present opportunities and challenges in undergraduate surgical education. There may be need to evaluate the knowledge base and the use of Internet tools among medical students in settings where traditional mode of education is preeminent. This may help to establish a conceptual framework for integrating e-learning into the traditional teaching to enhance learning experience. In this study, we evaluated the medical students' knowledge and use of Internet tools, and their opinion on the application of these tools in surgical education. We undertook a cross-sectional survey of 2013 and 2014 graduating medical class of College of Medicine University of Nigeria, Enugu using structured self-administered questionnaire. The survey assessed the knowledge, utility, and application of Internet tools in surgical education using 5-point Likert scale. Overall response rate was 78% (227/291) comprising 151 (66.5%) males and 76 (33.5%) females. The median age was 24 years (range 20-33 years). Although 106 (46.7%) had formal training on information technology, 223 (98.2%) can access Internet, and 162 (71.4%) use one or more of the Internet tools, 90.6% (96/106) of those trained on ICT use Internet for education/learning compared to 88.4% (107/121) of those without ICT training (p = 0.76). Google™ search tool had the highest rating in terms of familiarity and utility for education/learning (mean rating 4.3 on a scale of 5.0), while Skype™ had the least rating (mean 2.0). Overall, 89% of respondents (mean rating 4.5 on a scale of 5.0) indicated that Internet tools could be effectively applied in surgical education specifically in areas of lectures, assignments, real-time procedure demonstration, case discussion, and interaction with surgical experts. The key benefits are utility as a regular self-assessment tool (mean rating = 4.6) and offer of flexible learning schedule (mean rating = 4.0). Fifty-two percent (118

Digitization of Full-Text Documents Before Publishing on the Internet: A Case Study Reviewing the Latest Optical Character Recognition Technologies.

ERIC Educational Resources Information Center

McClean, Clare M.

1998-01-01

Reviews strengths and weaknesses of five optical character recognition (OCR) software packages used to digitize paper documents before publishing on the Internet. Outlines options available and stages of the conversion process. Describes the learning experience of Eurotext, a United Kingdom-based electronic libraries project (eLib). (PEN)

Basic Internet Software Toolkit.

ERIC Educational Resources Information Center

Buchanan, Larry

1998-01-01

Once schools are connected to the Internet, the next step is getting network workstations configured for Internet access. This article describes a basic toolkit comprising software currently available on the Internet for free or modest cost. Lists URLs for Web browser, Telnet, FTP, file decompression, portable document format (PDF) reader,…

Internet-based medical education: a realist review of what works, for whom and in what circumstances

PubMed Central

2010-01-01

Background Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. We aimed to produce theory driven criteria to guide the development and evaluation of Internet-based medical courses. Methods Realist review - a qualitative systematic review method whose goal is to identify and explain the interaction between context, mechanism and outcome. We searched 15 electronic databases and references of included articles, seeking to identify theoretical models of how the Internet might support learning from empirical studies which (a) used the Internet to support learning, (b) involved doctors or medical students; and (c) reported a formal evaluation. All study designs and outcomes were considered. Using immersion and interpretation, we tested theories by considering how well they explained the different outcomes achieved in different educational contexts. Results 249 papers met our inclusion criteria. We identified two main theories of the course-in-context that explained variation in learners' satisfaction and outcomes: Davis's Technology Acceptance Model and Laurillard's model of interactive dialogue. Learners were more likely to accept a course if it offered a perceived advantage over available non-Internet alternatives, was easy to use technically, and compatible with their values and norms. 'Interactivity' led to effective learning only if learners were able to enter into a dialogue - with a tutor, fellow students or virtual tutorials - and gain formative feedback. Conclusions Different modes of course delivery suit different learners in different contexts. When designing or choosing an Internet-based course, attention must be given to the fit between its technical attributes and learners' needs and priorities; and to ways of

Web-based document image processing

NASA Astrophysics Data System (ADS)

Walker, Frank L.; Thoma, George R.

1999-12-01

Increasing numbers of research libraries are turning to the Internet for electron interlibrary loan and for document delivery to patrons. This has been made possible through the widespread adoption of software such as Ariel and DocView. Ariel, a product of the Research Libraries Group, converts paper-based documents to monochrome bitmapped images, and delivers them over the Internet. The National Library of Medicine's DocView is primarily designed for library patrons are beginning to reap the benefits of this new technology, barriers exist, e.g., differences in image file format, that lead to difficulties in the use of library document information. To research how to overcome such barriers, the Communications Engineering Branch of the Lister Hill National Center for Biomedical Communications, an R and D division of NLM, has developed a web site called the DocMorph Server. This is part of an ongoing intramural R and D program in document imaging that has spanned many aspects of electronic document conversion and preservation, Internet document transmission and document usage. The DocMorph Server Web site is designed to fill two roles. First, in a role that will benefit both libraries and their patrons, it allows Internet users to upload scanned image files for conversion to alternative formats, thereby enabling wider delivery and easier usage of library document information. Second, the DocMorph Server provides the design team an active test bed for evaluating the effectiveness and utility of new document image processing algorithms and functions, so that they may be evaluated for possible inclusion in other image processing software products being developed at NLM or elsewhere. This paper describes the design of the prototype DocMorph Server and the image processing functions being implemented on it.

Association between Internet addiction and depression in Thai medical students at Faculty of Medicine, Ramathibodi Hospital.

PubMed

Boonvisudhi, Thummaporn; Kuladee, Sanchai

2017-01-01

To study the extent of Internet addiction (IA) and its association with depression in Thai medical students. A cross-sectional study was conducted at Faculty of Medicine, Ramathibodi Hospital. Participants were first- to fifth-year medical students who agreed to participate in this study. Demographic characteristics and stress-related factors were derived from self-rated questionnaires. Depression was assessed using the Thai version of Patient Health Questionnaire (PHQ-9). A total score of five or greater derived from the Thai version of Young Diagnostic Questionnaire for Internet Addiction was classified as "possible IA". Then chi-square test and logistic regression were used to evaluate the associations between possible IA, depression and associated factors. From 705 participants, 24.4% had possible IA and 28.8% had depression. There was statistically significant association between possible IA and depression (odds ratio (OR) 1.92, 95% confidence interval (CI): 1.34-2.77, P-value <0.001). Logistic regression analysis illustrated that the odds of depression in possible IA group was 1.58 times of the group of normal Internet use (95% CI: 1.04-2.38, P-value = 0.031). Academic problems were found to be a significant predictor of both possible IA and depression. IA was likely to be a common psychiatric problem among Thai medical students. The research has also shown that possible IA was associated with depression and academic problems. We suggest that surveillance of IA should be considered in medical schools.

The Document Management Alliance.

ERIC Educational Resources Information Center

Fay, Chuck

1998-01-01

Describes the Document Management Alliance, a standards effort for document management systems that manages and tracks changes to electronic documents created and used by collaborative teams, provides secure access, and facilitates online information retrieval via the Internet and World Wide Web. Future directions are also discussed. (LRW)

Internet Search Engines - Fluctuations in Document Accessibility.

ERIC Educational Resources Information Center

Mettrop, Wouter; Nieuwenhuysen, Paul

2001-01-01

Reports an empirical investigation of the consistency of retrieval through Internet search engines. Evaluates 13 engines: AltaVista, EuroFerret, Excite, HotBot, InfoSeek, Lycos, MSN, NorthernLight, Snap, WebCrawler, and three national Dutch engines: Ilse, Search.nl and Vindex. The focus is on a characteristic related to size: the degree of…

Medical surfing.

PubMed

Khan, L A; Khan, S A

2001-11-01

The Internet has revolutionized information technology. Vast amounts of latest information are available on the Internet to medical professionals. Medical surfing is fast becoming part of a doctor's profession. But the way to approach the Internet and retrieve useful information from myriads of medical websites seems a daunting task to many. This review aims to help the newcomer, the medical students and doctors in obtaining fruitful medical information while surfing. It will prevent them from the feeling of getting drowned in the ocean of medical information. As medical information is not restricted to books and journals, providing Internet addresses of different medical bodies with few salient features, will go a long way in helping attain the required information without wasting time. The Internet will soon become a universal library. Medical surfing should be included in the curriculum of all medical schools and universities.

Validity of medical record documented varicella-zoster virus among unvaccinated cohorts

PubMed Central

Mohanty, Salini; Perella, Dana; Jumaan, Aisha; Robinson, Donovan; Forke, Christine M; Schmid, D Scott; Renwick, Mia; Mankodi, Foram; Watson, Barbara; Fiks, Alexander G

2013-01-01

Background: A varicella diagnosis or verification of disease history by any healthcare provider is currently accepted for determining evidence of immunity by the Advisory Committee on Immunization Practices (ACIP). Objective: To examine the accuracy of medical record (MR) documented varicella history as a measure of varicella-zoster virus (VZV) immunity among unvaccinated individuals born after 1980. We also assessed methods to practically implement ACIP guidelines to verify varicella history using medical records. Study Design: As part of a larger cross-sectional study conducted at three Philadelphia clinics from 2004–2006, we recruited 536 unvaccinated patients aged 5–19 y (birth years: 1985–2001). Varicella history was obtained from three sources: parent/patient interview, any MR documentation (sick and well visits) and MR documentation of a sick visit for varicella. All participants were tested for VZV IgG. For each source and three age groups (5–9, 10–14, 15–19 y old), positive predictive value (PPV) was calculated. Specificity of varicella history was compared between different sources using McNemar’s Chi-square. Results: Among participants aged 5–9, 10–14 and 15–19 y the PPV for any MR documentation and sick visit diagnosis were 96% and 100%, 92% and 97%, and 99% and 100%, respectively. The specificity for sick visit documentation was higher than any MR documentation and patient/parent recall among all age groups; however, these differences were only statistically significant when comparing sick visit documentation to parent/patient recall for 10-14 y olds. Conclusion: Sick visit documentation of varicella in the MR is an accurate predictor of varicella seropositivity and useful for confirming disease history among unvaccinated persons (birth years: 1985–2001). This method is a practical way to verify varicella history using the ACIP guidelines. PMID:23807363

Introducing the Internet.

PubMed

Pallen, M

1995-11-25

The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rules of behaviour or "netiquette." There are several types of Internet connection and various ways of acquiring a connection. Once connected, you can obtain, free of charge, programs that allow easy use of the Internet's resources and help on how to use these resources; you can access many of these resources through the hypertext references in the on line version of this series (go to http:@www.bmj.com/bmj/ to reach the electronic version). You can then explore the various methods for accessing, manipulating, or disseminating data on the Internet, such as electronic mail, telnet, file transfer protocol, and the world wide web. Results from a search of the world wide web for information on the rare condition of Recklinghausen's neurofibromatosis illustrate the breadth of medical information available on the Internet.

[What Psychiatrists Should Know about the Medical Documentation They Issue: Admission for Medical Care and Protection, Medical Treatment for Persons with Disabilities, Mental Health Disability Certification, etc].

PubMed

Yamasaki, Masao

2015-01-01

Psychiatrists issue a wide variety of documentation, among which are torms such as Registration of Admission for Medical Care and Protection, Periodic Report of Condition, Certification of Medical Treatment for Persons with Disabilities, and Mental Health Disability Certification, which are required under laws such as the Act on Mental Health and Welfare for the Mentally Disabled. These documents are important in that they are related to protecting the human rights of people with mental disorders, as well as securing appropriate medical and welfare services for them. However, in the course of reviewing and evaluating documentation at our Mental Health and Welfare Center, we encounter forms which are incomplete, or which contain inappropriate content. In order to protect the human rights of people with mental disorders, and to ensure the provision of appropriate medical and welfare services for them, I call on psychiatrists to issue carefully written and appropriate documentation. In this talk I will focus primarily on what psychiatrists should know when filling in forms in the course of their day-to-day clinical work.

Evacuation support system for improved medical documentation and information flow in the field.

PubMed

Walderhaug, Ståle; Meland, Per Håkon; Mikalsen, Marius; Sagen, Terje; Brevik, John Ivar

2008-02-01

Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care

Secure HL7 transactions using Internet mail (Internet draft).

PubMed

Schadow, Gunther; Tucker, Mark; Rishel, Wes

2002-01-01

The document describes the applicability of the Internet standardisation efforts on secure electronic data interchange (EDI) transactions for Health Level-7 (HL7), an EDI standard for Healthcare used world-wide. The document heavily relies on the work in progress by the IETF EDIINT working group. It is in most parts a restatement of the EDIINTs requirements document and application statement 1 (AS#1) tailored to the needs of the HL7 audience. The authors tried to make the document as self consistent as possible. The goal is to give to the reader who is not a security or Internet standards expert enough foundational and detail information to enable him to build communication software that complies to the Internet standards. Even though the authors rely on and promote the respective Internet standards and drafts, they did not withstand from commenting on and criticising the work where they see upcoming problems in use with HL7 or other EDI protocols that have not been in the initial focus of the EDIINT working group. The authors make suggestions to add parameters to the specification of the MIME type for EDI messages in RFC 1767 in order to enhance functionality. The authors give use cases for a larger subset of disposition types and modifiers of message disposition notifications. One key issue where the document goes beyond the current EDIINT drafts is the concept of non-repudiation of commitment to an EDI transaction. Secure EDI transactions should be regarded as "distributed contracts," i.e. not only the sending and receiving of single messages should be non-refutable but also the connection between messages interchanges. In anticipation of this requirement HL7 usually requires a response message to be sent to acknowledge every transaction. The authors therefore have the requirement to securely couple an EDI response message to its request message. Given the current shape of RFC 1767 this is generally possible only if a response message is coupled with an MDN

Use of dietary supplements among people living with HIV/AIDS is associated with vulnerability to medical misinformation on the internet

PubMed Central

2012-01-01

Background Use of dietary supplements is common among people living with HIV/AIDS. Because dietary supplements are used in the context of other health behaviors, they may have direct and indirect health benefits. However, supplements may also be associated with vulnerability to medical misinformation and unfounded health claims. We examined use of dietary supplements among people living with HIV/AIDS (PLWH) and the association between use of dietary supplements and believing medical misinformation. Methods A convenience sample of 268 men and 76 women living with HIV was recruited from AIDS services and clinics in Atlanta, GA. Participants completed measures of demographic and health characteristics, dietary supplement use, beliefs about dietary supplements, internet use, and an internet evaluation task designed to assess vulnerability to medical misinformation. Results One out of four PLWH currently used at least one dietary supplement product excluding vitamins. Dietary supplement use was associated with higher education and greater use of the internet for health-related information. Dietary supplement users also endorsed greater believability and trust in unfounded claims for HIV cures. Conclusions Dietary supplement use is common among PLWH and is associated with a broad array of health information seeking behaviors. Interventions are needed to reduce the vulnerability of PLWH, particularly dietary supplement users, to medical misinformation propagated on the internet. PMID:22233928

[Integration of the Internet into medical education].

PubMed

Taradi, Suncana Kukolja

2002-01-01

The Internet promises dramatic changes in the way we learn and teach, the way we interact as a society. Networked technologies introduce interactivity and multimedia into the educational process. The student of the 21st century will use his/her PC as a learning station, as a tutoring system, as an information provider and as a communication center. Therefore the passive classroom (teacher-centered teaching) will evolve into active studio learning (student-centered learning). This will be achieved by new teaching techniques and standards of quality. The role of the new generation of educators is to create exploratory learning environments that offer a wide range of views on many subject areas and encourage active lifelong learning. This will be achieved by 1) placing courseware on the web where it can be accessed by remote students and by 2) finding and reviewing teaching materials obtained from www for possible integration into the local lecture material. The paper suggests strategies for introducing medical educators to networked teaching.

Medical Record Documentation Among Interns: A Prospective Quality Improvement Study.

PubMed

Owen, Jm; Conway, R; Silke, B; O'Riordan, D

2015-06-01

Comprehensive record keeping is a key aspect of medical practice. The National Hospitals Office (NHO) and Irish Medical Council (IMC) have published guidelines in this area. A prospective audit of 100 patients assessed by interns was performed to quantify adherence with these guidelines followed by an educational session and email reminders. Adherence was reassessed in an incidental manner. Compliance was recorded in a number of areas including the reason for review and documentation of a plan both 98 (98%). However less than half of interns recorded the patient's name, background history or their impression of the case. Only 31(31%) noted the patient's MRN and only 1(1%) the information they gave to the patient. Significant improvements following the intervention were found, however significant deficits remained in a number of areas including the noting of an impression of the case 62(62%) and information given to patients 18(18%). Suboptimal documentation can be improved through education and clinical auditing.

Anticipatory ethics for a future Internet: analyzing values during the design of an Internet infrastructure.

PubMed

Shilton, Katie

2015-02-01

The technical details of Internet architecture affect social debates about privacy and autonomy, intellectual property, cybersecurity, and the basic performance and reliability of Internet services. This paper explores one method for practicing anticipatory ethics in order to understand how a new infrastructure for the Internet might impact these social debates. This paper systematically examines values expressed by an Internet architecture engineering team-the Named Data Networking project-based on data gathered from publications and internal documents. Networking engineers making technical choices also weigh non-technical values when working on Internet infrastructure. Analysis of the team's documents reveals both values invoked in response to technical constraints and possibilities, such as efficiency and dynamism, as well as values, including privacy, security and anonymity, which stem from a concern for personal liberties. More peripheral communitarian values espoused by the engineers include democratization and trust. The paper considers the contextual and social origins of these values, and then uses them as a method of practicing anticipatory ethics: considering the impact such priorities may have on a future Internet.

Sustains--direct access for the patient to the medical record over the Internet.

PubMed

Eklund, Benny; Joustra-Enquist, Ingrid

2004-01-01

The basic idea of Sustains III is to emulate the Internet banking for Health Care. Instead of an "Internet Bank Account" the user has a "Health Care Account". The user logs in using a One Time Password which is sent to the user's mobile phone as an SMS, three seconds after the PIN code is entered. Thus personal information can be transferred both ways in a secure way, with acceptable privacy. The user can then explore the medical record in detail. Also get full and complete list of prescriptions, lab-result etc. It's also an easy way of exchange written information between the doctor and the patient. So far Sustains has showed that patients are very satisfied and is also beneficial for the physicians.

Perspective: Whither the problem list? Organ-based documentation and deficient synthesis by medical trainees.

PubMed

Kaplan, Daniel M

2010-10-01

The author argues that the well-formulated problem list is essential for both organizing and evaluating diagnostic thinking. He considers evidence of deficiencies in problem lists in the medical record. He observes a trend among medical trainees toward organizing notes in the medical record according to lists of organ systems or medical subspecialties and hypothesizes that system-based documentation may undermine the art of problem formulation and diagnostic synthesis. Citing research linking more sophisticated problem representation with diagnostic success, he suggests that documentation style and clinical reasoning are closely connected and that organ-based documentation may predispose trainees to several varieties of cognitive diagnostic error and deficient synthesis. These include framing error, premature or absent closure, failure to integrate related findings, and failure to recognize the level of diagnostic resolution attained for a given problem. He acknowledges the pitfalls of higher-order diagnostic resolution, including the application of labels unsupported by firm evidence, while maintaining that diagnostic resolution as far as evidence permits is essential to both rational care of patients and rigorous education of learners. He proposes further research, including comparison of diagnostic efficiency between organ- and problem-oriented thinkers. He hypothesizes that the subspecialty-based structure of academic medical services helps perpetuate organ-system-based thinking, and calls on clinical educators to renew their emphasis on the formulation and documentation of complete and precise problem lists and progressively refined diagnoses by trainees.

The development of MML (Medical Markup Language) version 3.0 as a medical document exchange format for HL7 messages.

PubMed

Guo, Jinqiu; Takada, Akira; Tanaka, Koji; Sato, Junzo; Suzuki, Muneou; Suzuki, Toshiaki; Nakashima, Yusei; Araki, Kenji; Yoshihara, Hiroyuki

2004-12-01

Medical Markup Language (MML), as a set of standards, has been developed over the last 8 years to allow the exchange of medical data between different medical information providers. MML Version 2.21 used XML as a metalanguage and was announced in 1999. In 2001, MML was updated to Version 2.3, which contained 12 modules. The latest version--Version 3.0--is based on the HL7 Clinical Document Architecture (CDA). During the development of this new version, the structure of MML Version 2.3 was analyzed, subdivided into several categories, and redefined so the information defined in MML could be described in HL7 CDA Level One. As a result of this development, it has become possible to exchange MML Version 3.0 medical documents via HL7 messages.

42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

Validity of the Malay version of the Internet Addiction Test: a study on a group of medical students in Malaysia.

PubMed

Guan, Ng Chong; Isa, Saramah Mohammed; Hashim, Aili Hanim; Pillai, Subash Kumar; Harbajan Singh, Manveen Kaur

2015-03-01

The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P < .001), and concurrent validity with the Compulsive Internet Use Scale (Pearson's correlation = .84, P < .001). Receiver operating characteristic analysis showed that 43 was the optimal cutoff score to discriminate students with and without Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students. © 2012 APJPH.

The internet

PubMed Central

Al-Shahi, R; Sadler, M; Rees, G; Bateman, D

2002-01-01

The growing use of email and the world wide web (WWW), by the public, academics, and clinicians—as well as the increasing availability of high quality information on the WWW—make a working knowledge of the internet important. Although this article aims to enhance readers' existing use of the internet and medical resources on the WWW, it is also intelligible to someone unfamiliar with the internet. A web browser is one of the central pieces of software in modern computing: it is a window on the WWW, file transfer protocol sites, networked newsgroups, and your own computer's files. Effective use of the internet for professional purposes requires an understanding of the best strategies to search the WWW and the mechanisms for ensuring secure data transfer, as well as a compendium of online resources including journals, textbooks, medical portals, and sites providing high quality patient information. This article summarises these resources, available to incorporate into your web browser as downloadable "Favorites" or "Bookmarks" from www.jnnp.com, where there are also freely accessible hypertext links to the recommended sites. PMID:12438460

Use of internet by the teaching faculty of Peshawar Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan.

PubMed

Jan, Saeedullah; Hussain, Abid; Ibrahim, Muhammad; Saeed, Sarah

2018-03-01

This study was planned to examine the hard and soft form of learning resources available on the internet accessed by the teaching faculty. This study was conducted at the Peshawar Medical College, Peshawar, Pakistan from January 2to April 2017. As the target population was not too large, no sampling technique was employed and census-based approach was adopted. For data collection, the pre-tested questionnaire was distributed among 115 faculty members of both basic and clinical sciences groups with a response rate of 66(57.39%). Data was analysed using SPSS. Among the respondents, 38(57.6%) were males and 28(42.4%) were females. A majority 51 (77.27%) of the respondents used the internet for teaching and research. Library was the most frequently 22 (33.33%) used place for the internet use. Low internet speed, virus on computers and a lack of modern trainings were the major barriers. E-journals, e-books, online databases and theses and dissertations were the major sources consulted by the participants.

76 FR 60754 - Preserving the Open Internet

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-30

...-201] Preserving the Open Internet AGENCY: Federal Communications Commission. ACTION: Final rule..., 2011, a document establishing rules to preserve the open Internet. Inadvertently the wrong paragraph... alleging violations of the open Internet rules. Federal Communications Commission. Matt Warner, Attorney...

Using Internet Search Engines to Obtain Medical Information: A Comparative Study

PubMed Central

Wang, Liupu; Wang, Juexin; Wang, Michael; Li, Yong; Liang, Yanchun

2012-01-01

Background The Internet has become one of the most important means to obtain health and medical information. It is often the first step in checking for basic information about a disease and its treatment. The search results are often useful to general users. Various search engines such as Google, Yahoo!, Bing, and Ask.com can play an important role in obtaining medical information for both medical professionals and lay people. However, the usability and effectiveness of various search engines for medical information have not been comprehensively compared and evaluated. Objective To compare major Internet search engines in their usability of obtaining medical and health information. Methods We applied usability testing as a software engineering technique and a standard industry practice to compare the four major search engines (Google, Yahoo!, Bing, and Ask.com) in obtaining health and medical information. For this purpose, we searched the keyword breast cancer in Google, Yahoo!, Bing, and Ask.com and saved the results of the top 200 links from each search engine. We combined nonredundant links from the four search engines and gave them to volunteer users in an alphabetical order. The volunteer users evaluated the websites and scored each website from 0 to 10 (lowest to highest) based on the usefulness of the content relevant to breast cancer. A medical expert identified six well-known websites related to breast cancer in advance as standards. We also used five keywords associated with breast cancer defined in the latest release of Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) and analyzed their occurrence in the websites. Results Each search engine provided rich information related to breast cancer in the search results. All six standard websites were among the top 30 in search results of all four search engines. Google had the best search validity (in terms of whether a website could be opened), followed by Bing, Ask.com, and Yahoo!. The search

Using Internet search engines to obtain medical information: a comparative study.

PubMed

Wang, Liupu; Wang, Juexin; Wang, Michael; Li, Yong; Liang, Yanchun; Xu, Dong

2012-05-16

The Internet has become one of the most important means to obtain health and medical information. It is often the first step in checking for basic information about a disease and its treatment. The search results are often useful to general users. Various search engines such as Google, Yahoo!, Bing, and Ask.com can play an important role in obtaining medical information for both medical professionals and lay people. However, the usability and effectiveness of various search engines for medical information have not been comprehensively compared and evaluated. To compare major Internet search engines in their usability of obtaining medical and health information. We applied usability testing as a software engineering technique and a standard industry practice to compare the four major search engines (Google, Yahoo!, Bing, and Ask.com) in obtaining health and medical information. For this purpose, we searched the keyword breast cancer in Google, Yahoo!, Bing, and Ask.com and saved the results of the top 200 links from each search engine. We combined nonredundant links from the four search engines and gave them to volunteer users in an alphabetical order. The volunteer users evaluated the websites and scored each website from 0 to 10 (lowest to highest) based on the usefulness of the content relevant to breast cancer. A medical expert identified six well-known websites related to breast cancer in advance as standards. We also used five keywords associated with breast cancer defined in the latest release of Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) and analyzed their occurrence in the websites. Each search engine provided rich information related to breast cancer in the search results. All six standard websites were among the top 30 in search results of all four search engines. Google had the best search validity (in terms of whether a website could be opened), followed by Bing, Ask.com, and Yahoo!. The search results highly overlapped between the

Electronic Medical Record Documentation of Driving Safety for Veterans with Diagnosed Dementia.

PubMed

Vair, Christina L; King, Paul R; Gass, Julie; Eaker, April; Kusche, Anna; Wray, Laura O

2018-01-01

Many older adults continue to drive following dementia diagnosis, with medical providers increasingly likely to be involved in addressing such safety concerns. This study examined electronic medical record (EMR) documentation of driving safety for veterans with dementia (N = 118) seen in Veterans Affairs primary care and interdisciplinary geriatrics clinics in one geographic region over a 10-year period. Qualitative directed content analysis of retrospective EMR data. Assessment of known risk factors or subjective concerns for unsafe driving were documented in fewer than half of observed cases; specific recommendations for driving safety were evident for a minority of patients, with formal driving evaluation the most frequently documented recommendation by providers. Utilizing data from actual clinical encounters provides a unique snapshot of how driving risk and safety concerns are addressed for veterans with dementia. This information provides a meaningful frame of reference for understanding potential strengths and possible gaps in how this important topic area is being addressed in the course of clinical care. The EMR is an important forum for interprofessional communication, with documentation of driving risk and safety concerns an essential element for continuity of care and ensuring consistency of information delivered to patients and caregivers.

Health professionals' use of documents obtained through the Regional Medical Library Network.

PubMed

Lovas, I; Graham, E; Flack, V

1991-01-01

The Pacific Southwest Regional Medical Library Service (PSRMLS) studied how health professionals use documents obtained through the regional medical library (RML) network and how various factors, such as delivery time, affected that use. A random sample of libraries in Region 7 of the RML network was selected to survey health professionals who had received documents through the interlibrary loan (ILL) network. The survey provided data about the purposes for which health professionals requested documents, how the immediacy of need for the items affected their usefulness, what effect the obtained information had on the health professionals' work, and whether the illustrations represented an important part of the information content of the items. Survey results provided a positive assessment of the ILL network. Results also verified the basic value of the materials provided to health professionals through ILL and identified some areas for consideration in future network development. Users of the documents indicated that the network works efficiently and effectively to provide timely and useful information needed by health professionals. Technological developments in electronic information transmission and imaging will further enhance network operation in the future.

NILDE, Network Inter Library Document Exchange: An Italian Document Delivery System

NASA Astrophysics Data System (ADS)

Brunetti, F.; Gasperini, A.; Mangiaracina, S.

2007-10-01

This poster presents NILDE, a document delivery system supporting the exchange of documents via the internet. The system has been set up by the Central Library of the National Research Council of Bologna (Italy) in order to make use of new internet technology, to promote cooperation between Italian university libraries and research libraries, and to achieve quick response times in satisfying DD requests. The Arcetri Astrophysical Observatory Library was the first astronomical library to join the NILDE project from its earliest days in 2002. Many were the reasons for this choice: automation of the DD processes, security and reliability of the network, creation of usage statistics and reports, reduction of DD System management costs and so on. This work describes the benefits of NILDE and discusses the role of an organized document delivery system as an important tool to cope with the difficult constraints of the publishing market.

Schizophrenia, drug companies and the internet.

PubMed

Read, John

2008-01-01

To investigate differences in the content of websites funded, and not funded, by drug companies, the top 50 websites about 'schizophrenia' in Google and Yahoo were analysed in relation to five variables: three scales relating to causes, treatments and violence, and two categorical variables about the condition being extremely severe and about linking coming off medication to violence. Fifty eight percent of the websites analysed received funding from drug companies. Drug company funded websites were significantly more likely to espouse bio-genetic rather than psycho-social causal explanations, to emphasise medication rather than psycho-social treatments, to portray 'schizophrenia' as a debilitating, devastating and long-term illness, and to link violence to coming off medication. They were neither more nor less likely to describe 'schizophrenics' as violent. These results suggest that the documented influence of the pharmaceutical industry over research, professional organisations, teaching institutions, clinical practice and regulatory bodies may now extend to public promotion, via the internet, of perspectives conducive to maximisation of sales.

Internet-based versus traditional teaching and learning methods.

PubMed

Guarino, Salvatore; Leopardi, Eleonora; Sorrenti, Salvatore; De Antoni, Enrico; Catania, Antonio; Alagaratnam, Swethan

2014-10-01

The rapid and dramatic incursion of the Internet and social networks in everyday life has revolutionised the methods of exchanging data. Web 2.0 represents the evolution of the Internet as we know it. Internet users are no longer passive receivers, and actively participate in the delivery of information. Medical education cannot evade this process. Increasingly, students are using tablets and smartphones to instantly retrieve medical information on the web or are exchanging materials on their Facebook pages. Medical educators cannot ignore this continuing revolution, and therefore the traditional academic schedules and didactic schemes should be questioned. Analysing opinions collected from medical students regarding old and new teaching methods and tools has become mandatory, with a view towards renovating the process of medical education. A cross-sectional online survey was created with Google® docs and administrated to all students of our medical school. Students were asked to express their opinion on their favourite teaching methods, learning tools, Internet websites and Internet delivery devices. Data analysis was performed using spss. The online survey was completed by 368 students. Although textbooks remain a cornerstone for training, students also identified Internet websites, multimedia non-online material, such as the Encyclopaedia on CD-ROM, and other non-online computer resources as being useful. The Internet represented an important aid to support students' learning needs, but textbooks are still their resource of choice. Among the websites noted, Google and Wikipedia significantly surpassed the peer-reviewed medical databases, and access to the Internet was primarily through personal computers in preference to other Internet access devices, such as mobile phones and tablet computers. Increasingly, students are using tablets and smartphones to instantly retrieve medical information. © 2014 John Wiley & Sons Ltd.

Analysis of Documentation Speed Using Web-Based Medical Speech Recognition Technology: Randomized Controlled Trial.

PubMed

Vogel, Markus; Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan

2015-11-03

Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted

Wearable Devices in Medical Internet of Things: Scientific Research and Commercially Available Devices

PubMed Central

Thurow, Kerstin; Stoll, Regina

2017-01-01

Objectives Wearable devices are currently at the heart of just about every discussion related to the Internet of Things. The requirement for self-health monitoring and preventive medicine is increasing due to the projected dramatic increase in the number of elderly people until 2020. Developed technologies are truly able to reduce the overall costs for prevention and monitoring. This is possible by constantly monitoring health indicators in various areas, and in particular, wearable devices are considered to carry this task out. These wearable devices and mobile apps now have been integrated with telemedicine and telehealth efficiently, to structure the medical Internet of Things. This paper reviews wearable health care devices both in scientific papers and commercial efforts. Methods MIoT is demonstrated through a defined architecture design, including hardware and software dealing with wearable devices, sensors, smart phones, medical application, and medical station analyzers for further diagnosis and data storage. Results Wearables, with the help of improved technology have been developed greatly and are considered reliable tools for long-term health monitoring systems. These are applied in the observation of a large variety of health monitoring indicators in the environment, vital signs, and fitness. Conclusions Wearable devices are now used for a wide range of healthcare observation. One of the most important elements essential in data collection is the sensor. During recent years with improvement in semiconductor technology, sensors have made investigation of a full range of parameters closer to realization. PMID:28261526

Wearable Devices in Medical Internet of Things: Scientific Research and Commercially Available Devices.

PubMed

Haghi, Mostafa; Thurow, Kerstin; Stoll, Regina

2017-01-01

Wearable devices are currently at the heart of just about every discussion related to the Internet of Things. The requirement for self-health monitoring and preventive medicine is increasing due to the projected dramatic increase in the number of elderly people until 2020. Developed technologies are truly able to reduce the overall costs for prevention and monitoring. This is possible by constantly monitoring health indicators in various areas, and in particular, wearable devices are considered to carry this task out. These wearable devices and mobile apps now have been integrated with telemedicine and telehealth efficiently, to structure the medical Internet of Things. This paper reviews wearable health care devices both in scientific papers and commercial efforts. MIoT is demonstrated through a defined architecture design, including hardware and software dealing with wearable devices, sensors, smart phones, medical application, and medical station analyzers for further diagnosis and data storage. Wearables, with the help of improved technology have been developed greatly and are considered reliable tools for long-term health monitoring systems. These are applied in the observation of a large variety of health monitoring indicators in the environment, vital signs, and fitness. Wearable devices are now used for a wide range of healthcare observation. One of the most important elements essential in data collection is the sensor. During recent years with improvement in semiconductor technology, sensors have made investigation of a full range of parameters closer to realization.

Computer program and user documentation medical data tape retrieval system

NASA Technical Reports Server (NTRS)

Anderson, J.

1971-01-01

This volume provides several levels of documentation for the program module of the NASA medical directorate mini-computer storage and retrieval system. A biomedical information system overview describes some of the reasons for the development of the mini-computer storage and retrieval system. It briefly outlines all of the program modules which constitute the system.

Ethical Challenges of Medicine and Health on the Internet: A Review

PubMed Central

2001-01-01

Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role

Ethical challenges of medicine and health on the Internet: a review.

PubMed

Dyer, K A

2001-01-01

Knowledge and capabilities, particularly of a new technology or in a new area of study, frequently develop faster than the guidelines and principles needed for practitioners to practice ethically in the new arena; this is particularly true in medicine. The blending of medicine and healthcare with e-commerce and the Internet raises many questions involving what sort of ethical conduct should be expected by practitioners and developers of the medical Internet. Some of the early pioneers in medical and healthcare Web sites pushed the ethical boundaries with questionable, even unethical, practices. Many involved with the medical Internet are now working to reestablish patient and consumer trust by establishing guidelines to determine how the fundamentals of the medical code of ethical conduct can best be adapted for the medical/healthcare Internet. Ultimately, all those involved in the creation, maintenance, and marketing of medical and healthcare Web sites should be required to adhere to a strict code of ethical conduct, one that has been fairly determined by an impartial international organization with reasonable power to regulate the code. This code could also serve as a desirable, recognizable label-of-distinction for ethical Web sites within the medical and healthcare Internet community. One challenge for those involved with the medical and healthcare Internet will be to determine what constitutes "Medical Internet Ethics" or "Healthcare Internet Ethics," since the definition of medical ethics can vary from country to country. Therefore, the emerging field of Medical/ Healthcare Internet Ethics will require careful thought and insights from an international collection of ethicists in many contributing areas. This paper is a review of the current status of the evolving field of Medical/Healthcare Internet Ethics, including proposed definitions and identification of many diverse areas that may ultimately contribute to this multidisciplinary field. The current role

A model for indexing medical documents combining statistical and symbolic knowledge.

PubMed

Avillach, Paul; Joubert, Michel; Fieschi, Marius

2007-10-11

To develop and evaluate an information processing method based on terminologies, in order to index medical documents in any given documentary context. We designed a model using both symbolic general knowledge extracted from the Unified Medical Language System (UMLS) and statistical knowledge extracted from a domain of application. Using statistical knowledge allowed us to contextualize the general knowledge for every particular situation. For each document studied, the extracted terms are ranked to highlight the most significant ones. The model was tested on a set of 17,079 French standardized discharge summaries (SDSs). The most important ICD-10 term of each SDS was ranked 1st or 2nd by the method in nearly 90% of the cases. The use of several terminologies leads to more precise indexing. The improvement achieved in the models implementation performances as a result of using semantic relationships is encouraging.

A Model for Indexing Medical Documents Combining Statistical and Symbolic Knowledge.

PubMed Central

Avillach, Paul; Joubert, Michel; Fieschi, Marius

2007-01-01

OBJECTIVES: To develop and evaluate an information processing method based on terminologies, in order to index medical documents in any given documentary context. METHODS: We designed a model using both symbolic general knowledge extracted from the Unified Medical Language System (UMLS) and statistical knowledge extracted from a domain of application. Using statistical knowledge allowed us to contextualize the general knowledge for every particular situation. For each document studied, the extracted terms are ranked to highlight the most significant ones. The model was tested on a set of 17,079 French standardized discharge summaries (SDSs). RESULTS: The most important ICD-10 term of each SDS was ranked 1st or 2nd by the method in nearly 90% of the cases. CONCLUSIONS: The use of several terminologies leads to more precise indexing. The improvement achieved in the model’s implementation performances as a result of using semantic relationships is encouraging. PMID:18693792

Documentation of Nursing Practice Using a Computerized Medical Information System

PubMed Central

Romano, Carol

1981-01-01

This paper discusses a definition of the content of the computerized nursing data base developed by the Nursing Department for the Clinical Center Medical Information System at the National Institutes of Health in Bethesda, Maryland. The author describes the theoretical framework for the content and presents a model to describe the organization of the nursing data components in relation to the process of nursing care delivery. Nursing documentation requirements of Nurse Practice Acts, American Nurses Association Standards of Practice and the Joint Commission on Accreditation of Hospitals are also addressed as they relate to this data base. The advantages and disadvantages of such an approach to computerized documentation are discussed.

Outpatients flow management and ophthalmic electronic medical records system in university hospital using Yahgee Document View.

PubMed

Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa

2010-10-01

General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system.

Review of medical discharge summaries and medical documentation in a metropolitan hospital: impact on diagnostic-related groups and Weighted Inlier Equivalent Separation.

PubMed

Chin, N; Perera, P; Roberts, A; Nagappan, R

2013-07-01

Accurate and comprehensive clinical documentation is crucial for effective ongoing patient care, follow up and to optimise case mix-based funding. Each Diagnostic Related Group (DRG) is assigned a 'weight', leading to Weighted Inlier Equivalent Separation (WIES), a system many public and private hospitals in Australia subscribe to. To identify the top DRG in a general medical inpatient service, the completeness of medical discharge documentation, commonly missed comorbidities and system-related issues and subsequent impact on DRG and WIES allocation. One hundred and fifty completed discharge summaries were randomly selected from the top 10 medical DRG in our health service. From a detailed review of the clinical documentation, principal diagnoses, associated comorbidities and complications, where appropriate, the DRG and WIES were modified. Seventy-two (48%) of the 150 reviewed admissions resulted in a revision of DRG and WIES equivalent to an increase of AUD 142,000. Respiratory-based DRG generated the largest revision of DRG and WIES, while 'Cellulitis' DRG had the largest relative change. Twenty-seven per cent of summaries reviewed necessitated a change in coding with no subsequent change in DRG allocation or WIES. Acute renal failure, anaemia and electrolyte disturbances were the most commonly underrepresented entities in clinical discharge documentation. Seven patients had their WIES downgraded. Comprehensive documentation of principal diagnosis/diagnoses, comorbidities and their complications is imperative to optimal DRG and WIES allocation. Regular meetings between clinical and coding staff improve the quality and timeliness of medical documentation, ensure adequate communication with general practitioners and lead to appropriate funding. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Using formal methods for content validation of medical procedure documents.

PubMed

Cota, Érika; Ribeiro, Leila; Bezerra, Jonas Santos; Costa, Andrei; da Silva, Rosiana Estefane; Cota, Gláucia

2017-08-01

We propose the use of a formal approach to support content validation of a standard operating procedure (SOP) for a therapeutic intervention. Such an approach provides a useful tool to identify ambiguities, omissions and inconsistencies, and improves the applicability and efficacy of documents in the health settings. We apply and evaluate a methodology originally proposed for the verification of software specification documents to a specific SOP. The verification methodology uses the graph formalism to model the document. Semi-automatic analysis identifies possible problems in the model and in the original document. The verification is an iterative process that identifies possible faults in the original text that should be revised by its authors and/or specialists. The proposed method was able to identify 23 possible issues in the original document (ambiguities, omissions, redundant information, and inaccuracies, among others). The formal verification process aided the specialists to consider a wider range of usage scenarios and to identify which instructions form the kernel of the proposed SOP and which ones represent additional or required knowledge that are mandatory for the correct application of the medical document. By using the proposed verification process, a simpler and yet more complete SOP could be produced. As consequence, during the validation process the experts received a more mature document and could focus on the technical aspects of the procedure itself. Copyright © 2017 Elsevier B.V. All rights reserved.

Internet Architecture: Lessons Learned and Looking Forward

DTIC Science & Technology

2006-12-01

Internet Architecture: Lessons Learned and Looking Forward Geoffrey G. Xie Department of Computer Science Naval Postgraduate School April 2006... Internet architecture. Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is...readers are referred there for more information about a specific protocol or concept. 2. Origin of Internet Architecture The Internet is easily

Bar-code medication administration system for anesthetics: effects on documentation and billing.

PubMed

Nolen, Agatha L; Rodes, W Dyer

2008-04-01

The effects of using a new bar-code medication administration (BCMA) system for anesthetics to automate documentation of drug administration by anesthesiologists were studied. From October 1, 2004, to September 15, 2005, all medications administered to patients undergoing cardiac surgery were documented with a BCMA system at a large acute care facility. Drug claims data for 12 targeted anesthetics in diagnosis-related groups (DRGs) 104-111 were analyzed to determine the quantity of drugs charged and the revenue generated. Those data were compared with claims data for a historical case-control group (October 1, 2003, to September 15, 2004, for the same DRGs) for which medication use was documented manually. From October 1, 2005, to October 1, 2006, anesthesiologists for cardiac surgeries either voluntarily used the automated system or completed anesthesia records manually. A total of 870 cardiac surgery cases for which the BCMA system was used were evaluated. There were 961 cardiac surgery cases in the historical control group. The BCMA system increased the quantity of drugs documented per case by 21.7% and drug revenue captured per case by 18.8%. The time needed by operating-room pharmacy staff to process an anesthesia record for billing decreased by eight minutes per case. After two years, anesthesiologists voluntarily used the new technology on 100% of cardiac surgery patients. Implementation of a BCMA system for anesthetic use in cardiac surgery increased the quantity of drugs charged by 21.7% per case and drug revenue per case by 18.8%. Anesthesiologists continued to use the automated system on a voluntary basis after conclusion of the initial study.

Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.

PubMed

Summers, Alexander; Ruderman, Carly; Leung, Fok-Han; Slater, Morgan

2017-09-22

Studies in the United States have shown that physicians commonly use brand names when documenting medications in an outpatient setting. However, the prevalence of prescribing and documenting brand name medication has not been assessed in a clinical teaching environment. The purpose of this study was to describe the use of generic versus brand names for a select number of pharmaceutical products in clinical documentation in a large, urban academic family practice centre. A retrospective chart review of the electronic medical records of the St. Michael's Hospital Academic Family Health Team (SMHAFHT). Data for twenty commonly prescribed medications were collected from the Cumulative Patient Profile as of August 1, 2014. Each medication name was classified as generic or trade. Associations between documentation patterns and physician characteristics were assessed. Among 9763 patients prescribed any of the twenty medications of interest, 45% of patient charts contained trade nomenclature exclusively. 32% of charts contained only generic nomenclature, and 23% contained a mix of generic and trade nomenclature. There was large variation in use of generic nomenclature amongst physicians, ranging from 19% to 93%. Trade names in clinical documentation, which likely reflect prescribing habits, continue to be used abundantly in the academic setting. This may become part of the informal curriculum, potentially facilitating undue bias in trainees. Further study is needed to determine characteristics which influence use of generic or trade nomenclature and the impact of this trend on trainees' clinical knowledge and decision-making.

Ethical Issues in Internet Research: International Good Practice and Irish Research Ethics Documents

ERIC Educational Resources Information Center

Felzmann, Heike

2013-01-01

This chapter discusses the main research ethical concerns that arise in internet research and reviews existing research ethical guidance in the Irish context in relation to its application to internet research. The chapter begins with a brief outline of high profile cases in the early history of the internet that highlighted specific emerging…

Use of General-purpose Negation Detection to Augment Concept Indexing of Medical Documents

PubMed Central

Mutalik, Pradeep G.; Deshpande, Aniruddha; Nadkarni, Prakash M.

2001-01-01

Objectives: To test the hypothesis that most instances of negated concepts in dictated medical documents can be detected by a strategy that relies on tools developed for the parsing of formal (computer) languages—specifically, a lexical scanner (“lexer”) that uses regular expressions to generate a finite state machine, and a parser that relies on a restricted subset of context-free grammars, known as LALR(1) grammars. Methods: A diverse training set of 40 medical documents from a variety of specialties was manually inspected and used to develop a program (Negfinder) that contained rules to recognize a large set of negated patterns occurring in the text. Negfinder's lexer and parser were developed using tools normally used to generate programming language compilers. The input to Negfinder consisted of medical narrative that was preprocessed to recognize UMLS concepts: the text of a recognized concept had been replaced with a coded representation that included its UMLS concept ID. The program generated an index with one entry per instance of a concept in the document, where the presence or absence of negation of that concept was recorded. This information was used to mark up the text of each document by color-coding it to make it easier to inspect. The parser was then evaluated in two ways: 1) a test set of 60 documents (30 discharge summaries, 30 surgical notes) marked-up by Negfinder was inspected visually to quantify false-positive and false-negative results; and 2) a different test set of 10 documents was independently examined for negatives by a human observer and by Negfinder, and the results were compared. Results: In the first evaluation using marked-up documents, 8,358 instances of UMLS concepts were detected in the 60 documents, of which 544 were negations detected by the program and verified by human observation (true-positive results, or TPs). Thirteen instances were wrongly flagged as negated (false-positive results, or FPs), and the program missed

Medical Device Integration Model Based on the Internet of Things

PubMed Central

Hao, Aiyu; Wang, Ling

2015-01-01

At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

Medical Device Integration Model Based on the Internet of Things.

PubMed

Hao, Aiyu; Wang, Ling

2015-01-01

At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

A generic framework for internet-based interactive applications of high-resolution 3-D medical image data.

PubMed

Liu, Danzhou; Hua, Kien A; Sugaya, Kiminobu

2008-09-01

With the advances in medical imaging devices, large volumes of high-resolution 3-D medical image data have been produced. These high-resolution 3-D data are very large in size, and severely stress storage systems and networks. Most existing Internet-based 3-D medical image interactive applications therefore deal with only low- or medium-resolution image data. While it is possible to download the whole 3-D high-resolution image data from the server and perform the image visualization and analysis at the client site, such an alternative is infeasible when the high-resolution data are very large, and many users concurrently access the server. In this paper, we propose a novel framework for Internet-based interactive applications of high-resolution 3-D medical image data. Specifically, we first partition the whole 3-D data into buckets, remove the duplicate buckets, and then, compress each bucket separately. We also propose an index structure for these buckets to efficiently support typical queries such as 3-D slicer and region of interest, and only the relevant buckets are transmitted instead of the whole high-resolution 3-D medical image data. Furthermore, in order to better support concurrent accesses and to improve the average response time, we also propose techniques for efficient query processing, incremental transmission, and client sharing. Our experimental study in simulated and realistic environments indicates that the proposed framework can significantly reduce storage and communication requirements, and can enable real-time interaction with remote high-resolution 3-D medical image data for many concurrent users.

Evaluating aspects of online medication safety in long-term follow-up of 136 Internet pharmacies: illegal rogue online pharmacies flourish and are long-lived.

PubMed

Fittler, Andras; Bősze, Gergely; Botz, Lajos

2013-09-10

A growing number of online pharmacies have been established worldwide. Among them are numerous illegal websites selling medicine without valid medical prescriptions or distributing substandard or counterfeit drugs. Only a limited number of studies have been published on Internet pharmacies with regard to patient safety, professionalism, long-term follow-up, and pharmaceutical legitimacy verification. In this study, we selected, evaluated, and followed 136 Internet pharmacy websites aiming to identify indicators of professional online pharmacy service and online medication safety. An Internet search was performed by simulating the needs of potential customers of online pharmacies. A total of 136 Internet pharmacy websites were assessed and followed for four years. According to the LegitScript database, relevant characteristics such as longevity, time of continuous operation, geographical location, displayed contact information, prescription requirement, medical information exchange, and pharmaceutical legitimacy verification were recorded and evaluated. The number of active Internet pharmacy websites decreased; 23 of 136 (16.9%) online pharmacies ceased operating within 12 months and only 67 monitored websites (49.3%) were accessible at the end of the four-year observation period. However, not all operated continuously, as about one-fifth (31/136) of all observed online pharmacy websites were inaccessible provisionally. Thus, only 56 (41.2%) Internet-based pharmacies were continuously operational. Thirty-one of the 136 online pharmacies (22.8%) had not provided any contact details, while only 59 (43.4%) displayed all necessary contact information on the website. We found that the declared physical location claims did not correspond to the area of domain registration (according to IP address) for most websites. Although the majority (120/136, 88.2%) of the examined Internet pharmacies distributed various prescription-only medicines, only 9 (6.6%) requested prior

Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

PubMed

Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

2012-03-01

The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

'What is not written does not exist': the importance of proper documentation of medication use history.

PubMed

Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

2017-10-01

Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

A first evaluation of a pedagogical network for medical students at the University Hospital of Rennes.

PubMed

Fresnel, A; Jarno, P; Burgun, A; Delamarre, D; Denier, P; Cleret, M; Courtin, C; Seka, L P; Pouliquen, B; Cléran, L; Riou, C; Leduff, F; Lesaux, H; Duvauferrier, R; Le Beux, P

1998-01-01

A pedagogical network has been developed at University Hospital of Rennes from 1996. The challenge is to give medical information and informatics tools to all medical students in the clinical wards of the University Hospital. At first, nine wards were connected to the medical school server which is linked to the Internet. Client software electronic mail and WWW Netscape on Macintosh computers. Sever software is set up on Unix SUN providing a local homepage with selected pedagogical resources. These documents are stored in a DBMS database ORACLE and queries can be provided by specialty, authors or disease. The students can access a set of interactive teaching programs or electronic textbooks and can explore the Internet through the library information system and search engines. The teachers can send URL and indexation of pedagogical documents and can produce clinical cases: the database updating will be done by the users. This experience of using Web tools generated enthusiasm when we first introduced it to students. The evaluation shows that if the students can use this training early on, they will adapt the resources of the Internet to their own needs.

Assessing the Readability of Medical Documents: A Ranking Approach.

PubMed

Zheng, Jiaping; Yu, Hong

2018-03-23

The use of electronic health record (EHR) systems with patient engagement capabilities, including viewing, downloading, and transmitting health information, has recently grown tremendously. However, using these resources to engage patients in managing their own health remains challenging due to the complex and technical nature of the EHR narratives. Our objective was to develop a machine learning-based system to assess readability levels of complex documents such as EHR notes. We collected difficulty ratings of EHR notes and Wikipedia articles using crowdsourcing from 90 readers. We built a supervised model to assess readability based on relative orders of text difficulty using both surface text features and word embeddings. We evaluated system performance using the Kendall coefficient of concordance against human ratings. Our system achieved significantly higher concordance (.734) with human annotators than did a baseline using the Flesch-Kincaid Grade Level, a widely adopted readability formula (.531). The improvement was also consistent across different disease topics. This method's concordance with an individual human user's ratings was also higher than the concordance between different human annotators (.658). We explored methods to automatically assess the readability levels of clinical narratives. Our ranking-based system using simple textual features and easy-to-learn word embeddings outperformed a widely used readability formula. Our ranking-based method can predict relative difficulties of medical documents. It is not constrained to a predefined set of readability levels, a common design in many machine learning-based systems. Furthermore, the feature set does not rely on complex processing of the documents. One potential application of our readability ranking is personalization, allowing patients to better accommodate their own background knowledge. ©Jiaping Zheng, Hong Yu. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 23.03.2018.

[The Offer of Medical-Diagnostic Self-Tests on German Language Websites: Results of a Systematic Internet Search].

PubMed

Kuecuekbalaban, P; Schmidt, S; Muehlan, H

2018-03-01

The aim of the current study was to provide an overview of medical-diagnostic self-tests which can be purchased without a medical prescription on German language websites. From September 2014 to March 2015, a systematic internet research was conducted with the following search terms: self-test, self-diagnosis, home test, home diagnosis, quick test, rapid test. 513 different self-tests for the diagnostics of 52 diverse diseases or health risks were identified, including chronic diseases (e. g. diabetes, chronic disease of the kidneys, liver, and lungs), sexually transmitted diseases (e. g. HIV, chlamydia, gonorrhea), infectious diseases (e. g. tuberculosis, malaria, Helicobacter pylori), allergies (e. g. house dust, cats, histamine) and cancer as well as tests for the diagnostics of 12 different psychotropic substances. These were sold by 90 companies in Germany and by other foreign companies. The number of medical-diagnostic self-tests which can be bought without a medical prescription on the Internet has increased enormously in the last 10 years. Further studies are needed for the identification of the determinants of the use of self-tests as well as the impact of the application on the experience and behavior of the user. © Georg Thieme Verlag KG Stuttgart · New York.

Oncology information on the Internet.

PubMed

Goto, Yasushi; Nagase, Takahide

2012-05-01

Owing to new developments in Internet technologies, the amount of available oncology information is growing. Both patients and caregivers are increasingly using the Internet to obtain medical information. However, while it is easy to provide information, ensuring its quality is always a concern. Thus, many instruments for evaluating the quality of health information have been created, each with its own advantages and disadvantages. The increasing importance of online search engines such as Google warrants the examination of the correlation between their rankings and medical quality. The Internet also mediates the exchange of information from one individual to another. Mailing lists of advocate groups and social networking sites help spread information to patients and caregivers. While text messages are still the main medium of communication, audio and video messages are also increasing rapidly, accelerating the communication on the Internet. Future health information developments on the Internet include merging patients' personal information on the Internet with their traditional health records and facilitating the interaction among patients, caregivers and health-care providers. Through these developments, the Internet is expected to strengthen the mutually beneficial relationships among all stakeholders in the field of medicine.

Evaluating Aspects of Online Medication Safety in Long-Term Follow-Up of 136 Internet Pharmacies: Illegal Rogue Online Pharmacies Flourish and Are Long-Lived

PubMed Central

2013-01-01

Background A growing number of online pharmacies have been established worldwide. Among them are numerous illegal websites selling medicine without valid medical prescriptions or distributing substandard or counterfeit drugs. Only a limited number of studies have been published on Internet pharmacies with regard to patient safety, professionalism, long-term follow-up, and pharmaceutical legitimacy verification. Objective In this study, we selected, evaluated, and followed 136 Internet pharmacy websites aiming to identify indicators of professional online pharmacy service and online medication safety. Methods An Internet search was performed by simulating the needs of potential customers of online pharmacies. A total of 136 Internet pharmacy websites were assessed and followed for four years. According to the LegitScript database, relevant characteristics such as longevity, time of continuous operation, geographical location, displayed contact information, prescription requirement, medical information exchange, and pharmaceutical legitimacy verification were recorded and evaluated. Results The number of active Internet pharmacy websites decreased; 23 of 136 (16.9%) online pharmacies ceased operating within 12 months and only 67 monitored websites (49.3%) were accessible at the end of the four-year observation period. However, not all operated continuously, as about one-fifth (31/136) of all observed online pharmacy websites were inaccessible provisionally. Thus, only 56 (41.2%) Internet-based pharmacies were continuously operational. Thirty-one of the 136 online pharmacies (22.8%) had not provided any contact details, while only 59 (43.4%) displayed all necessary contact information on the website. We found that the declared physical location claims did not correspond to the area of domain registration (according to IP address) for most websites. Although the majority (120/136, 88.2%) of the examined Internet pharmacies distributed various prescription

Use of internet resources by patients awaiting gastroenterology consultation.

PubMed

Teriaky, Anouar; Tangri, Vikram; Chande, Nilesh

2015-01-01

The purpose of this study is to understand how outpatients awaiting initial gastroenterology consultation seek medical information on the Internet and how wait times affect Internet usage. A cross-sectional survey of 87 gastroenterology outpatients awaiting consultation was performed at a tertiary care center. Fifty-two patients (60%) utilized the Internet for medical information. The mean age of patients using the Internet was 41 years, whereas the mean age of those not using the Internet was 60 years (p<0.0001). The Internet was used by 71% of females and 47% of males (p<0.05). Regarding the educational level, the Internet was sought by 33% of the patients possessing less than secondary school education, 59% possessing secondary school education, 66% with an undergraduate degree, and 100% with a postgraduate degree (p=0.14). The mean wait time for consultation for patients who utilized the Internet was 158 days, and for patients who did not was 147 days (p=0.60). The most common websites searched were medical, 71%. The most common medical information sought was symptoms and diagnosis by 85% of patients. The reasons for Internet use were wait times for 36% of patients and recommendation by a physician for 10%. Eighty seven percent of the patients who utilized the Internet believed that they suffered from an unidentified disease, whereas 46% of patients who did not utilize the Internet believed the same (p=0.0001). Younger patients and females were more likely to use the Internet, but wait times did not affect Internet usage. The Internet is a powerful patient resource; however, further physician guidance is required to help patients identify reliable resources.

Use of the Internet by patients before and after cardiac surgery: telephone survey.

PubMed

Murero, M; D'Ancona, G; Karamanoukian, H

2001-01-01

Little is known about to what extent patients who underwent medical treatment access the Internet and whether they benefit from consulting the Internet. To understand if cardiopathic patients use the Internet for health-related information and whether they find retrieved information understandable and useful. Telephone interviews, using a semi-structured questionnaire, were conducted with 82 patients who had undergone off-pump coronary-artery bypass grafting at the Center for Less Invasive and Robotic Heart Surgery in Buffalo, New York, USA. Study design was multidisciplinary, combining expertise of medical and communication science. Sources of medical information were identified (doctor, Internet, magazines, newspapers, television, radio, family members). Accessibility, quality, and readability of Internet medical information from the patients point of view were investigated. Out of 82 patients, 35 (35/82, 42.7%) were Internet users. Internet users had a significantly higher education level than Internet non-users (college education: 42.9% of users, 10.6% of non-users; P <.001). Among the Internet users, 18 (18/35, 51.4%) had used the Internet for retrieving medical information; 17 (17/35, 48.6%) had not. No statistically significant differences in demographic data were found when comparing these 2 sub-groups of patients. Family-members involvement was high (15/18, 83.3%). Internet medical information was rated helpful in most cases; readability was acceptable for only 3 patients (3/18, 16.7%). To improve on-line medical information, all patients interviewed suggested sites designed by their physicians. Although 1 in 5 patients in our sample has used the Internet to retrieve medical information, the majority of them experiences difficulties comprehending the information retrieved. Health-care providers should provide Internet medical information that is adequate for the non-medical public's needs.

Usage experience with the document archiving and communication system for the storage and retrieval of medical records.

PubMed

Takeda, Toshihiro; Ueda, Kanayo; Manabe, Shiro; Teramoto, Kei; Mihara, Naoki; Matsumura, Yasushi

2013-01-01

Standard Japanese electronic medical record (EMR) systems are associated with major shortcomings. For example, they do not assure lifelong readability of records because each document requires its own viewing software program, a system that is difficult to maintain over long periods of time. It can also be difficult for users to comprehend a patient's clinical history because different classes of documents can only be accessed from their own window. To address these problems, we developed a document-based electronic medical record that aggregates all documents for a patient in a PDF or DocuWorks format. We call this system the Document Archiving and Communication System (DACS). There are two types of viewers in the DACS: the Matrix View, which provides a time line of a patient's history, and the Tree View, which stores the documents in hierarchical document classes. We placed 2,734 document classes into 11 categories. A total of 22,3972 documents were entered per month. The frequency of use of the DACS viewer was 268,644 instances per month. The DACS viewer was used to assess a patient's clinical history.

Gender Difference in Internet Use and Internet Problems among Quebec High School Students.

PubMed

Dufour, Magali; Brunelle, Natacha; Tremblay, Joel; Leclerc, Danielle; Cousineau, Marie-Marthe; Khazaal, Yasser; Légaré, Andrée-Anne; Rousseau, Michel; Berbiche, Djamal

2016-10-01

There are presently no data available concerning Internet addiction (IA) problems among adolescents in Canada and the province of Quebec. The goal of this study is thus to document and compare the influence of gender on Internet use and addiction. The study data were collected from a larger research project on gambling among adolescents. Activities conducted online (applications used and time spent) as well as answers to the Internet Addiction Test (IAT) were collected from 3938 adolescents from grades 9 to 11. The two most often employed cut-off points for the IAT in the literature were documented: (40-69 and 70+) and (50+). Boys spent significantly more time on the Internet than did girls. A greater proportion of the girls made intense use of social networks, whereas a greater proportion of the boys made intense use of massively multiplayer online role-playing games, online games, and adult sites. The proportion of adolescents with a potential IA problem varied according to the cut-off employed. When the cut-off was set at 70+, 1.3% of the adolescents were considered to have an IA, while 41.7% were seen to be at risk. At a 50+ cut-off, 18% of the adolescents were considered to have a problem. There was no significant difference between the genders concerning the proportion of adolescents considered to be at risk or presenting IA problems. Finally, analysis of the percentile ranks would seem to show that a cut-off of 50+ better describes the category of young people at risk. The results of this study make it possible to document Internet use and IA in a large number of Quebec adolescents. © The Author(s) 2016.

Cognitive analyses of a paper medical record and electronic medical record on the documentation of two nursing tasks: patient education and adherence assessment of insulin administration.

PubMed Central

Rinkus, Susan M.; Chitwood, Ainsley

2002-01-01

The incorporation of electronic medical records into busy physician clinics has been a major development in the healthcare industry over the past decade. Documentation of key nursing activities, especially when interacting with patients who have chronic diseases, is often lacking or missing from the paper medical record. A case study of a patient with diabetes mellitus was created. Well established methods for the assessment of usability in the areas of human-computer interaction and computer supported cooperative work were employed to compare the nursing documentation of two tasks in a commercially available electronic medical record (eRecord) and in a paper medical record. Overall, the eRecord was found to improve the timeliness and quality of nursing documentation. With certain tasks, the number of steps to accomplish the same task was higher, which may result in the perception by the end user that the tool is more complex and therefore difficult to use. Recommendations for the eRecord were made to expand the documentation of patient teaching and adherence assessment and to incorporate web technology for patient access to medical records and healthcare information. PMID:12463905

A Comparison of Internet-Based Learning and Traditional Classroom Lecture to Learn CPR for Continuing Medical Education

ERIC Educational Resources Information Center

Hemmati, Nima; Omrani, Soghra; Hemmati, Naser

2013-01-01

The purpose of this study was to compare the satisfaction and effectiveness of Internet-based learning (IBL) and traditional classroom lecture (TCL) for continuing medical education (CME) programs by comparing final resuscitation exam results of physicians who received the newest cardiopulmonary resuscitation (CPR) curriculum guidelines training…

Computer Program and User Documentation Medical Data Input System

NASA Technical Reports Server (NTRS)

Anderson, J.

1971-01-01

Several levels of documentation are presented for the program module of the NASA medical directorate minicomputer storage and retrieval system. The biomedical information system overview gives reasons for the development of the minicomputer storage and retrieval system. It briefly describes all of the program modules which constitute the system. A technical discussion oriented to the programmer is given. Each subroutine is described in enough detail to permit in-depth understanding of the routines and to facilitate program modifications. The program utilization section may be used as a users guide.

Chaplain Documentation and the Electronic Medical Record: A Survey of ACPE Residency Programs.

PubMed

Tartaglia, Alexander; Dodd-McCue, Diane; Ford, Timothy; Demm, Charles; Hassell, Alma

2016-01-01

This study explores the extent to which chaplaincy departments at ACPE-accredited residency programs make use of the electronic medical record (EMR) for documentation and training. Survey data solicited from 219 programs with a 45% response rate and interview findings from 11 centers demonstrate a high level of usage of the EMR as well as an expectation that CPE residents document each patient/family encounter. Centers provided considerable initial training, but less ongoing monitoring of chaplain documentation. Centers used multiple sources to develop documentation tools for the EMR. One center was verified as having created the spiritual assessment component of the documentation tool from a peer reviewed published model. Interviews found intermittent use of the student chart notes for educational purposes. One center verified a structured manner of monitoring chart notes as a performance improvement activity. Findings suggested potential for the development of a standard documentation tool for chaplain charting and training.

17 CFR 250.21 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20549. Except as otherwise provided by the rules, such documents shall be deemed to have been filed with... direct transmission, via dial-up modem or Internet. (2) The date of filing of documents shall be...

17 CFR 250.21 - Filing of documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20549. Except as otherwise provided by the rules, such documents shall be deemed to have been filed with... direct transmission, via dial-up modem or Internet. (2) The date of filing of documents shall be...

Home Computer and Internet User Security

DTIC Science & Technology

2005-01-01

Information Security Model © 2005 Carnegie Mellon University (Lawrence R. Rogers, Author) Home Computer and Internet User Security...Carnegie Mellon University (Lawrence R. Rogers, Author) Home Computer and Internet User Security Version 1.0.4 – slide 50 Contact Information Lawrence R. Rogers • Email: cert@cert.org CERT website: http://www.cert.org/ ...U.S. Patent and Trademark Office Home Computer and Internet User Security Report Documentation Page Form ApprovedOMB

78 FR 57371 - Agency Information Collection Activities; Comment Request; Student Aid Internet Gateway (SAIG...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-18

...; Comment Request; Student Aid Internet Gateway (SAIG) Enrollment Document AGENCY: Federal Student Aid (FSA... Internet Gateway (SAIG) Enrollment Document. OMB Control Number: 1845-0002. Type of Review: A revision of... Internet Gateway (SAIG) allows eligible entities to securely exchange Title IV, Higher Education Act (HEA...

A standardized, uniform and universal dental chart for documenting state of dentition before anaesthesia.

PubMed

Gatt, S P; Aurisch, J; Wong, K

2001-02-01

It is vital to have adequate and precise documentation of the condition of a patient's dentition before commencing an anaesthetic. The incidence of dental damage during anaesthesia is not low. To the authors' knowledge, there is no standardized method used by anaesthetists to document the state of a patient's dentition. We propose the introduction of a standardized uniform dental chart to enable anaesthetists to accurately document the condition of their patients' teeth. This vital information can be easily obtained during the preanaesthetic assessment. With the increase in medical litigation and demands for adequate documentation, we believe this chart can become an invaluable part of every hospital's preanaesthetic assessment form. The dental chart is to be offered as a service to anaesthetists in the form of a copyright-free "Freeware" computer diskette or adhesive sticker and will be downloadable from the internet.

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... in Washington, DC. Documents may be filed either on paper or by electronic means using the process set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... below the space provided for signature. Electronic filers need only submit one copy of the document...

The commerce of ideas: Internets and Intranets.

PubMed

Frisse, M E

1996-07-01

Academic physicians pride themselves on their intelligent use of medical technology, their innovativeness, and their ability to market their excellence to the public. Although this pride is extraordinarily justified in the areas of clinical medicine, biomedical research, and health sciences education, academic physicians have less reason to be proud of their accomplishments in the area of information management. In years past, a lack of attention to coherent information management had few consequences so long as there were foci of excellence in clinical disciplines, libraries, core research laboratories, and selected training programs. But the widespread adoption of network-based communications has changed both the priorities of faculty and the information infrastructure necessary to maintain a competitive advantage. In the arena of health care information technology, many medical centers have chosen indiscriminate consumption over focused leadership. This essay speculates on how technologies based on the World Wide Web (WWW) may affect academic medicine through both the greater penetration of the Internet and a wider use of internal "intranets." The Internet is transforming the landscape of biomedical publishing, biomedical education, and the hospital library. The intranet is becoming a vital means of providing documents to support the administration of academic medicine and, in many circumstances, the delivery of patient-specific information. Although there is great potential for transformation, many academic medical centers have not yet fully demonstrated either the wisdom to advance a great information-technology vision or the will necessary to turn a vision into a coherent plan of action.

Internet Usage by Parents Prior to Seeking Care at a Pediatric Emergency Department: Observational Study

PubMed Central

2017-01-01

Background Little is known about how parents utilize medical information on the Internet prior to an emergency department (ED) visit. Objective The objective of the study was to determine the proportion of parents who accessed the Internet for medical information related to their child’s illness in the 24 hours prior to an ED visit (IPED), to identify the websites used, and to understand how the content contributed to the decision to visit the ED. Methods A 40-question interview was conducted with parents presenting to an ED within a freestanding children’s hospital. If parents reported IPED, the number and names of websites were documented. Parents indicated the helpfulness of Web-based content using a 100-mm visual analog scale and the degree to which it contributed to the decision to visit the ED using 5-point Likert-type responses. Results About 11.8 % (31/262) reported IPED (95% CI 7.3-5.3). Parents who reported IPED were more likely to have at least some college education (P=.04), higher annual household income (P=.001), and older children (P=.04) than those who did not report IPED. About 35% (11/31) could not name any websites used. Mean level of helpfulness of Web-based content was 62 mm (standard deviation, SD=25 mm). After Internet use, some parents (29%, 9/31) were more certain they needed to visit the ED, whereas 19% (6/31) were less certain. A majority (87%, 195/224) of parents who used the Internet stated that they would be somewhat likely or very likely to visit a website recommended by a physician. Conclusions Nearly 1 out of 8 parents presenting to an urban pediatric ED reported using the Internet in the 24 hours prior to the ED visit. Among privately insured, at least one in 5 parents reported using the Internet prior to visiting the ED. Web-based medical information often influences decision making regarding ED utilization. Pediatric providers should provide parents with recommendations for high-quality sources of health information available

Exploration of the perceptions of emergency physicians and interns regarding the medical documentation practices of interns.

PubMed

Isoardi, Jonathon; Spencer, Lyndall; Sinnott, Michael; Nicholls, Kim; O'Connor, Angela; Jones, Fleur

2013-08-01

The primary objective of the present study was to learn the factors that influence the documentation practices of ED interns. A second objective was to identify the expectations of emergency physicians (EPs) towards the medical record documentation of ED interns. A qualitative design was adopted using semi-structured interviews in convenience samples drawn from both groups. Eighteen interviews were conducted with intern volunteers and 10 with EP volunteers. One (5%) intern and two (20%) EPs had received medical documentation training. Factors that encouraged interns' documentation included: patient acuity (the more critical the condition, the more comprehensive the documentation) and the support of senior colleagues. Inhibiting factors included uncertainty about how much to write, and the shift being worked (interns indicated they wrote less at night). Factors of consequence to senior personnel included the apparent reluctance of interns to document management plans. They noted that interns frequently confine their notes to assessment, investigations and treatments, whereas EPs preferred records that demonstrated intern thought processes and included such matters as future actions to follow immediate treatment. A positive theme that emerged included the high level of support interns received from their senior colleagues. Another theme, the influence of patient acuity, held both positive and negative implications for intern writing practices. The lack of formal training is an impediment to the production of useful medical records by ED interns. One solution proposed by both interns and senior personnel was the introduction of the subject into intern education programmes. © 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

MorphoSaurus--design and evaluation of an interlingua-based, cross-language document retrieval engine for the medical domain.

PubMed

Markó, K; Schulz, S; Hahn, U

2005-01-01

We propose an interlingua-based indexing approach to account for the particular challenges that arise in the design and implementation of cross-language document retrieval systems for the medical domain. Documents, as well as queries, are mapped to a language-independent conceptual layer on which retrieval operations are performed. We contrast this approach with the direct translation of German queries to English ones which, subsequently, are matched against English documents. We evaluate both approaches, interlingua-based and direct translation, on a large medical document collection, the OHSUMED corpus. A substantial benefit for interlingua-based document retrieval using German queries on English texts is found, which amounts to 93% of the (monolingual) English baseline. Most state-of-the-art cross-language information retrieval systems translate user queries to the language(s) of the target documents. In contra-distinction to this approach, translating both documents and user queries into a language-independent, concept-like representation format is more beneficial to enhance cross-language retrieval performance.

Medical Internet of Things and Big Data in Healthcare

PubMed Central

2016-01-01

Objectives A number of technologies can reduce overall costs for the prevention or management of chronic illnesses. These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real-time health data when a patient self-administers a therapy. Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs. These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT). This paper reviews mIoT and big data in healthcare fields. Methods mIoT is a critical piece of the digital transformation of healthcare, as it allows new business models to emerge and enables changes in work processes, productivity improvements, cost containment and enhanced customer experiences. Results Wearables and mobile apps today support fitness, health education, symptom tracking, and collaborative disease management and care coordination. All those platform analytics can raise the relevancy of data interpretations, reducing the amount of time that end users spend piecing together data outputs. Insights gained from big data analysis will drive the digital disruption of the healthcare world, business processes and real-time decision-making. Conclusions A new category of "personalised preventative health coaches" (Digital Health Advisors) will emerge. These workers will possess the skills and the ability to interpret and understand health and well-being data. They will help their clients avoid chronic and diet-related illness, improve cognitive function, achieve improved mental health and achieve improved lifestyles overall. As the global population ages, such roles will become increasingly important. PMID:27525156

Medical Internet of Things and Big Data in Healthcare.

PubMed

Dimitrov, Dimiter V

2016-07-01

A number of technologies can reduce overall costs for the prevention or management of chronic illnesses. These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real-time health data when a patient self-administers a therapy. Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs. These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT). This paper reviews mIoT and big data in healthcare fields. mIoT is a critical piece of the digital transformation of healthcare, as it allows new business models to emerge and enables changes in work processes, productivity improvements, cost containment and enhanced customer experiences. Wearables and mobile apps today support fitness, health education, symptom tracking, and collaborative disease management and care coordination. All those platform analytics can raise the relevancy of data interpretations, reducing the amount of time that end users spend piecing together data outputs. Insights gained from big data analysis will drive the digital disruption of the healthcare world, business processes and real-time decision-making. A new category of "personalised preventative health coaches" (Digital Health Advisors) will emerge. These workers will possess the skills and the ability to interpret and understand health and well-being data. They will help their clients avoid chronic and diet-related illness, improve cognitive function, achieve improved mental health and achieve improved lifestyles overall. As the global population ages, such roles will become increasingly important.

Asia-Pacific POPIN workshop on Internet.

PubMed

1996-01-01

This brief article announces the accomplishments of the ESCAP Population Division of the Department of Economic and Social Information and Policy Analysis (DESIPA) in conjunction with the Asia-Pacific POPIN Internet (Information Superhighway) Training Workshop in popularizing useful new computer information technologies. A successful workshop was held in Bangkok in November 1996 for 18 people from 8 countries in the Asian and Pacific region, many of whom were from population information centers. Participants were taught some techniques for disseminating population data and information through use of the Internet computer facility. Participants learned 1) how to use Windows software in the ESCAP local area network (LAN), 2) about concepts such as HTML (hypertext mark-up language), and 3) detailed information about computer language. Computer practices involved "surfing the Net (Internet)" and linking with the global POPIN site on the Internet. Participants learned about computer programs for information handling and learned how to prepare documents using HTML, how to mount information on the World Wide Web (WWW) of the Internet, how to convert existing documents into "HTML-style" files, and how to scan graphics, such as logos, photographs, and maps, for visual display on the Internet. The Workshop and the three training modules was funded by the UN Population Fund (UNFPA). The POPIN Coordinator was pleased that competency was accomplished in such a short period of time.

The role of industry in Internet education.

PubMed

Wieting, Mark W; Mevis, Howard; Zuckerman, Joseph D

2003-07-01

Each year hundreds of accredited continuing medical education conferences and meetings receive industry support through unrestricted educational grants. Many of these programs might not occur without this funding support. With the explosive growth of continuing medical education on the Internet, industry again is being asked to provide assistance through unrestricted educational grants and in some instances educational content. At the same time, industry is using the Internet to provide orthopaedic surgeons with education and information about their products and services. Education and information do not require continuing medical education accreditation to be valuable. Although some people in continuing medical education voice ethical concerns regarding the nature of industry's involvement in education, meeting the needs of orthopaedic surgeons remains the top priority. As demands on the orthopaedic surgeons' time continue to impact participation in educational meetings, industry will continue to play a critical role in helping educational organizations such as medical specialty societies develop new, innovative educational programs for presentation via the Internet.

Use of the Internet by Patients Before and After Cardiac Surgery: An Interdisciplinary Telephone Survey

PubMed Central

D'Ancona, Giuseppe; Karamanoukian, Hratch

2001-01-01

Background Little is known about to what extent patients who underwent medical treatment access the Internet and whether they benefit from consulting the Internet. Objective To understand if cardiopathic patients use the Internet for health-related information and whether they find retrieved information understandable and useful. Methods Telephone interviews, using a semi-structured questionnaire, were conducted with 82 patients who had undergone off-pump coronary-artery bypass grafting at the Center for Less Invasive and Robotic Heart Surgery in Buffalo, New York, USA. Study design was multidisciplinary, combining expertise of medical and communication science. Sources of medical information were identified (doctor, Internet, magazines, newspapers, television, radio, family members). Accessibility, quality, and readability of Internet medical information from the patients' point of view were investigated. Results Out of 82 patients, 35 (35/82, 42.7%) were Internet users. Internet users had a significantly higher education level than Internet non-users (college education: 42.9% of users, 10.6% of non-users; P < .001). Among the Internet users, 18 (18/35, 51.4%) had used the Internet for retrieving medical information; 17 (17/35, 48.6%) had not. No statistically significant differences in demographic data were found when comparing these 2 sub-groups of patients. Family-members' involvement was high (15/18, 83.3%). Internet medical information was rated helpful in most cases; readability was acceptable for only 3 patients (3/18, 16.7%). To improve on-line medical information, all patients interviewed suggested sites designed by their physicians. Conclusions Although 1 in 5 patients in our sample has used the Internet to retrieve medical information, the majority of them experiences difficulties comprehending the information retrieved. Health-care providers' should provide Internet medical information that is adequate for the non-medical public's needs. PMID:11720969

Internet-based learning and applications for critical care medicine.

PubMed

Wolbrink, Traci A; Burns, Jeffrey P

2012-01-01

Recent changes in duty hour allowances and economic constraints are forcing a paradigm shift in graduate medical education in the United States. Internet-based learning is a rapidly growing component of postgraduate medical education, including the field of critical care medicine. Here, we define the key concepts of Internet-based learning, summarize the current literature, and describe how Internet-based learning may be uniquely suited for the critical care provider. A MEDLINE/PubMed search from January 2000 to July 2011 using the search terms: "e-learning," "Web-based learning," "computer-aided instruction," "adult learning," "knowledge retention," "intensive care," and "critical care." The growth of the Internet is marked by the development of new technologies, including more user-derived tools. Nonmedical fields have embraced Internet-based learning as a valuable teaching tool. A recent meta-analysis described Internet-based learning in the medical field as being more effective than no intervention and likely as efficacious as traditional teaching methods. Web sites containing interactive features are aptly suited for the adult learner, complementing the paradigm shift to more learner-centered education. Interactive cases, simulators, and games may allow for improvement in clinical care. The total time spent utilizing Internet-based resources, as well as the frequency of returning to those sites, may influence educational gains. Internet-based learning may provide an opportunity for assistance in the transformation of medical education. Many features of Web-based learning, including interactivity, make it advantageous for the adult medical learner, especially in the field of critical care medicine, and further work is necessary to develop a robust learning platform incorporating a variety of learning modalities for critical care providers.

Surfing the Internet.

PubMed

Clay, A T

1995-08-01

More physicians are surfing the Internet than ever before, thanks to the recent launch of MSMSNET, the Michigan State Medical Society's new online service for physician members. If words like World Wide Web, E-mail, and Hypertext links send you into a state of confusion, then read on. This month's cover story discusses MSMS's launch into the information superhighway and training programs MSMS has in store for physician members. Also included is an examination of the Internet--past, present and future--by the president of Voyager Information Networks, Inc., a Michigan corporation specializing in Internet services for Michigan trade groups and other organizations, including MSMS. This cover story marks the beginning of a series of articles on the Internet which will appear in future issues of Michigan Medicine. Hop on board and enjoy the ride!

Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review.

PubMed

Tsai, H-H; Lin, H-W; Simon Pickard, A; Tsai, H-Y; Mahady, G B

2012-11-01

The use of herbs and dietary supplements (HDS) alone or concomitantly with medications can potentially increase the risk of adverse events experienced by the patients. This review aims to evaluate the documented HDS-drug interactions and contraindications. A structured literature review was conducted on PubMed, EMBASE, Cochrane Library, tertiary literature and Internet. While 85 primary literatures, six books and two web sites were reviewed for a total of 1,491 unique pairs of HDS-drug interactions, 213 HDS entities and 509 medications were involved. HDS products containing St. John's Wort, magnesium, calcium, iron, ginkgo had the greatest number of documented interactions with medications. Warfarin, insulin, aspirin, digoxin, and ticlopidine had the greatest number of reported interactions with HDS. Medications affecting the central nervous system or cardiovascular system had more documented interactions with HDS. Of the 882 HDS-drug interactions being described its mechanism and severity, 42.3% were due to altered pharmacokinetics and 240 were described as major interactions. Of the 152 identified HDS contraindications, the most frequent involved gastrointestinal (16.4%), neurological (14.5%), and renal/genitourinary diseases (12.5%). Flaxseed, echinacea, and yohimbe had the largest number of documented contraindications. Although HDS-drug interactions and contraindications primarily concerned a relatively small subset of commonly used medications and HDS entities, this review provides the summary to identify patients, HDS products, and medications that are more susceptible to HDS-drug interactions and contraindications. The findings would facilitate the health-care professionals to communicate these documented interactions and contraindications to their patients and/or caregivers thereby preventing serious adverse events and improving desired therapeutic outcomes. © 2012 Blackwell Publishing Ltd.

The prevalence of obesity documentation in Primary Care Electronic Medical Records

PubMed Central

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B.

2017-01-01

Summary Background Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient’s problem list for patients with eligible body mass indexes (BMI) as contained in the patients’ electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. Method This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Results Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Conclusion Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese. PMID:28119990

Secure scalable disaster electronic medical record and tracking system.

PubMed

Demers, Gerard; Kahn, Christopher; Johansson, Per; Buono, Colleen; Chipara, Octav; Griswold, William; Chan, Theodore

2013-10-01

Electronic medical records (EMRs) are considered superior in documentation of care for medical practice. Current disaster medical response involves paper tracking systems and radio communication for mass-casualty incidents (MCIs). These systems are prone to errors, may be compromised by local conditions, and are labor intensive. Communication infrastructure may be impacted, overwhelmed by call volume, or destroyed by the disaster, making self-contained and secure EMR response a critical capability. Report As the prehospital disaster EMR allows for more robust content including protected health information (PHI), security measures must be instituted to safeguard these data. The Wireless Internet Information System for medicAl Response in Disasters (WIISARD) Research Group developed a handheld, linked, wireless EMR system utilizing current technology platforms. Smart phones connected to radio frequency identification (RFID) readers may be utilized to efficiently track casualties resulting from the incident. Medical information may be transmitted on an encrypted network to fellow prehospital team members, medical dispatch, and receiving medical centers. This system has been field tested in a number of exercises with excellent results, and future iterations will incorporate robust security measures. A secure prehospital triage EMR improves documentation quality during disaster drills.

Documentation of limitation of medical therapy at the time of a rapid response team call.

PubMed

Sundararajan, K; Flabouris, A; Keeshan, Alexander; Cramey, Tracey

2014-05-01

The aims of the present study were to: (1) describe the documentation process of limitation of medical therapy (LMT) orders at the time of a rapid response team (RRT) call; and (2) compare documented LMT orders not associated with an RRT call (control, Group 1) with LMT orders documented at the time of an RRT call (Group 2). A descriptive study, over a 6-month period (February-August 2011), involving the review of the medical records of patients prospectively identified as either Group 1 or Group 2. There were 994 RRT calls; of these, 50 patients (5%) had an LMT order documented by the RRT. A cardiac arrest was the trigger for the RRT for six patients (12%). Patients in Group 1 (n=50) and Group 2 were of similar median age (80.5 vs 78.5 years; P=0.30), LMTs were recorded at a similar time of day (15:30 vs 15:55 hours; P=0.52) and day of the week (weekend: 32% vs 35%; P=0.72). Comparing group 2 with Group 1, the RRT was less likely to document a not-for-resuscitation (NFR; 31 (62%) vs 49 (98%); P<0.01) or a not-for-ICU (NFICU; 18 (36%) vs 41 (82%); P<0.01) order, but more likely to document a not-for-RRT call (NFRRT; 31 (62%) vs 22 (44%); P=0.04) and modified RRT calling criteria (MRRT; 4 (8%) vs 0 (0%); P=0.04) orders. For Group 2 compared with Group 1 orders, involvement of the patient in the decision making process (9 (18%) vs 25 (50%); P<0.01) or the next of kin (29 (58%) vs 45 (90%); P<0.01) was documented less often. Documentation of LMT orders at the time of an RRT call is less likely to include documented involvement of patients or their next of kin, and is more likely to be an NFRRT or MRRT order. These findings have implications for overall clinical governance. What is known about the topic? RRT are not infrequently involved in documenting LMT orders. What does this paper add? This is the first study in Australasia to look into the timing and circumstances surrounding the issuing of a NFR order during an RRT call. The study findings clarify the type of LMT

Internet addiction in young people.

PubMed

Ong, Say How; Tan, Yi Ren

2014-07-01

In our technology-savvy population, mental health professionals are seeing an increasing trend of excessive Internet use or Internet addiction. Researchers in China, Taiwan and Korea have done extensive research in the field of Internet addiction. Screening instruments are available to identify the presence of Internet addiction and its extent. Internet addiction is frequently associated with mental illnesses such as anxiety, depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). Treatment modalities include individual and group therapies, cognitive behavioural therapy (CBT), family therapy and psychotropic medications. A significant proportion of Singapore adolescents engaging in excessive Internet use are also diagnosed to have concomitant Internet addiction. Despite the presence of a variety of treatment options, future research in this area is needed to address its growing trend and to minimise its negative psychological and social impact on the individuals and their families.

In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey

PubMed Central

2014-01-01

Background Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers’ actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. Objective The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals’ treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients’ health travel. Methods This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists’ written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to

In the words of the medical tourist: an analysis of Internet narratives by health travelers to Turkey.

PubMed

Ozan-Rafferty, Margaret E; Johnson, James A; Shah, Gulzar H; Kursun, Attila

2014-02-06

Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers' actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals' treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients' health travel. This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists' written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to identify characteristics and themes

The differing privacy concerns regarding exchanging electronic medical records of internet users in Taiwan.

PubMed

Hwang, Hsin-Ginn; Han, Hwai-En; Kuo, Kuang-Ming; Liu, Chung-Feng

2012-12-01

This study explores whether Internet users have different privacy concerns regarding the information contained in electronic medical records (EMRs) according to gender, age, occupation, education, and EMR awareness. Based on the Concern for Information Privacy (CFIP) scale developed by Smith and colleagues in 1996, we conducted an online survey using 15 items in four dimensions, namely, collection, unauthorized access, secondary use, and errors, to investigate Internet users' concerns regarding the privacy of EMRs under health information exchanges (HIE). We retrieved 213 valid questionnaires. The results indicate that the respondents had substantial privacy concerns regarding EMRs and their educational level and EMR awareness significantly influenced their privacy concerns regarding unauthorized access and secondary use of EMRs. This study recommends that the Taiwanese government organizes a comprehensive EMR awareness campaign, emphasizing unauthorized access and secondary use of EMRs. Additionally, to cultivate the public's understanding of EMRs, the government should employ various media, especially Internet channels, to promote EMR awareness, thereby enabling the public to accept the concept and use of EMRs. People who are highly educated and have superior EMR awareness should be given a comprehensive explanation of how hospitals protect patients' EMRs from unauthorized access and secondary use to address their concerns. Thus, the public can comprehend, trust, and accept the use of EMRs, reducing their privacy concerns, which should facilitate the future implementation of HIE.

The Impact of the Internet on Economic Education.

ERIC Educational Resources Information Center

Agarwal, Rajshree; Day, A. Edward

1998-01-01

Presents the results of a class experiment that documented the significance of use of the Internet on learning and retention of economic concepts. The results offer evidence of the positive effects of Internet use on both academic performance and students' attitudes toward economics. (MJP)

Everything you might want to know about the Internet but are afraid to ask!. A new users resource

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thiel, E.

This document is a guide to accessing the Internet and the services available on Internet. The document contains a short explanation of the Internet by E. Kroll and E. Hoffman, brief descriptions of the primary access tools, a glossary, answers to frequently asked questions about the Internet, J. Martin`s `Search for Internet Treasure` and other helpful information. The data access tools discussed in this document include Gopher, World Wide Web, WAIS, ASTRA, ARCHIE, WHOIS, NETSERV, and TRICKLE. The file transfer tool discussed is BITFTP. The two communication services discussed are NETNEWS and LISTSERV.

Internet addiction: a new disorder enters the medical lexicon.

PubMed

OReilly, M

1996-06-15

The latest consequence of the information age may be addiction to the Internet. A psychologist who has established the Centre for Online Addiction in the US says the disorder causes the same type of social problems as other established addictions. Michael OReilly went on line to find physicians interested in discussing potential problems posed by the Internet.

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment

PubMed Central

Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun

2015-01-01

Objectives Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. Methods This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. Results The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. Conclusions The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment.

PubMed

Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun; Cha, Hyo Soung

2015-10-01

Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.

Internet embeddedness: links with online health information seeking, expectancy value/quality of health information websites, and Internet usage patterns.

PubMed

Leung, Louis

2008-10-01

To see how the Internet is actually embedded in our lives, this exploratory study examines how Internet users search the Web for important information, especially health or medical information, to make critical decisions, and the perception of how intimately our lives are embedded in the Internet intersects with patterns of health information seeking online and the expected quality of health information websites. Data from a probability sample of 569 Internet users found four types of commonly sought health information clusters online which included information on (a) health improvement, (b) medical treatment, (c) family health, and (d) health issues that are difficult to talk about. Results also show that behavior or behavioral intentions in health information seeking are in fact either a function of value expectancy or the evaluation of health information websites. More importantly, people who often go to the Internet for health information and have high expectations of the value and quality of health information websites (especially in terms of reliability, relevance/context, and interaction) tend to be those who are more likely to perceive the Internet as playing an important role in life decisions or rate the Internet as more embedded in their lives.

Disparities in internet use among orthopedic outpatients.

PubMed

Walsh, Kenneth P; Rehman, Saqib; Goldhirsh, Jessie

2014-02-01

Internet access has lagged behind for patients with lower incomes and from certain ethnic groups. This study investigated the possible improvement of access to health-related information on the Internet for all patients in an urban outpatient setting, regardless of socioeconomic background. A 28-question survey was completed by 100 orthopedic outpatients evaluating associations between their age, ethnicity, income, or education level and their access to the Internet. The survey also examined how patients used the Internet to obtain information about their medical condition, their privacy concerns when conducting online research, and their use of mobile phones as a primary means of Internet access. The Internet was used by 57% of orthopedic outpatients in this urban setting. Internet access decreased with advancing age but increased with increasing income and education, findings consistent with similar studies. Despite the inability to identify an association between ethnicity and Internet access in this patient population, fewer Latinos (33%) than whites (67%) or African Americans (77%) sought information about their medical condition. Among patients who used a mobile phone as the primary method for online access, 74% were African American or Latino and 26% were white. This difference in mobile phone use for online access suggests that mobile phones have provided ethnic minorities with greater Internet access and thus may have narrowed the digital divide among the races. Copyright 2014, SLACK Incorporated.

Internet marketing of bariatric surgery: contemporary trends in the medicalization of obesity.

PubMed

Salant, Talya; Santry, Heena P

2006-05-01

In the context of political, economic, and scientific anxiety around the 'epidemic' rise in obesity in the US, the social and historical forces engendering the medicalization of obesity have been widely discussed. However, the recent growth of bariatric-weight loss-surgery and the expanding presence of advertising for bariatric surgery on the Internet suggest the possible emergence of new loci and languages of medicalization. We sought to identify the nature and extent to which web advertising of bariatric surgery contributes to the medicalization of obesity by examining the design and textual content of 100 bariatric surgery center websites. We found that websites, through strategic use of text and images, consistently describe obesity as a serious disease that requires professional ascertainment and supervision, entails substantial individual suffering, and is remedied through the transformative yet low risk effects of bariatric surgery. In the process, social normalcy and risk reduction come to replace physical criteria as the basis for determining health. Further, websites draw upon contradictory discourses of medicalization; that is, they insist upon 'external' (e.g. genetics, environment) causes of obesity to legitimize surgical intervention while implicating individual behaviors in surgical failure. From this, we suggest that the economic and professional motivations underlying website advertisements for bariatric surgery may result in confusing messages being sent to prospective patients as well as the perpetuation of gendered notions of obesity and the entrenchment of health disparities.

Experiential curriculum improves medical students' ability to answer clinical questions using the internet.

PubMed

Alper, Brian S; Vinson, Daniel C

2005-09-01

Teaching about evidence-based medicine (EBM) is widespread, yet physicians still use rapid references preferentially over EBM techniques such as literature searching and appraisal of original research. The Internet now provides rapid access to preappraised evidence. We provided clinically integrated teaching of using the Internet to answer clinical questions for third-year medical students and assessed the change in their search skills. The curriculum included two 90-minute computer lab sessions with teaching of search skills related to clinical questions. Immediately before the first and after the second session, students recorded sites searched, time needed for searching, and answers found for three standardized questions. Pretest and posttest questions were matched and reversed with each block. Eighty-six students completed pretests and posttests. For two questions about conventional medical care, posttest answer quality was significantly higher, and posttest search times were significantly shorter, by 1.6 minutes for question 1 (mean pretest search time 6.3 minutes, mean posttest search time 4.7 minutes) and 1.9 minutes for question 2 (mean pretest search time 8 minutes, mean posttest search time 6.1 minutes). For a question about herbal medicine, results were similar, but there were smaller differences that did not reach statistical significance. Students used or found significantly fewer sites on the posttest than on the pretest to find answers for all three question types (absolute difference=0.3 sites for each question). CONCLUSIONS Introducing students to useful Web sites, practicing answering clinical questions, and integrating this process with clinical rotation experiences can reduce the effort that students need to find answers and improve the quality of answers they find.

Internet use by colorectal surgery patients: a surgeon's tool for education and marketing.

PubMed

Lake, Jeffrey P; Ortega, Adrian; Vukasin, Petar; Kaiser, Andreas M; Kaufman, Howard S; Beart, Robert W

2004-06-01

The goal of this study is to understand the role of the Internet in the education and recruitment of patients within colorectal surgery practices. Surveys of Internet use were completed by 298 patients visiting five outpatient colorectal surgery clinics affiliated with the University of Southern California. Data collected included the patient's age, gender, level of education, zip code at home, type of clinic visited, and information on the respondent's Internet use. Overall, 20 per cent of the respondent patients visiting our clinics had used the Internet to research the medical condition that prompted their visit. Highest grade level completed (P < 0.001), age (P < 0.01), type of clinic (P < 0.001), and household income (P < 0.001) were all found to be associated with any prior use of the Internet whereas gender was not (P = 0.58). Among Internet users, only household income and frequent use of the Internet were associated with searching the Internet for medical information (P < 0.001). Ultimately, all of the Internet-using patients surveyed felt the medical information they found was "some what" or "very helpful." Understanding which patients "go online" to search for medical information is essential for surgeons who wish to use the Internet for marketing their practices and educating their patients.

Secure Internet video conferencing for assessing acute medical problems in a nursing facility.

PubMed Central

Weiner, M.; Schadow, G.; Lindbergh, D.; Warvel, J.; Abernathy, G.; Dexter, P.; McDonald, C. J.

2001-01-01

Although video-based teleconferencing is becoming more widespread in the medical profession, especially for scheduled consultations, applications for rapid assessment of acute medical problems are rare. Use of such a video system in a nursing facility may be especially beneficial, because physicians are often not immediately available to evaluate patients. We have assembled and tested a portable, wireless conferencing system to prepare for a randomized trial of the system s influence on resource utilization and satisfaction. The system includes a rolling cart with video conferencing hardware and software, a remotely controllable digital camera, light, wireless network, and battery. A semi-automated paging system informs physicians of patient s study status and indications for conferencing. Data transmission occurs wirelessly in the nursing home and then through Internet cables to the physician s home. This provides sufficient bandwidth to support quality motion images. IPsec secures communications. Despite human and technical challenges, this system is affordable and functional. Images Figure 1 PMID:11825286

The Use of Smartphones in Different Phases of Medical School and its Relationship to Internet Addiction and Learning Approaches.

PubMed

Loredo E Silva, Mathias Paulo; de Souza Matos, Brenda Dutra; da Silva Ezequiel, Oscarina; Lucchetti, Alessandra Lamas Granero; Lucchetti, Giancarlo

2018-04-26

The use of smartphones is revolutionizing the way information is acquired, leading to profound modifications in teaching medicine. Nevertheless, inadvertent use can negatively affect student learning. The present study aims to evaluate smartphone use in the educational context as well as Internet addiction and its repercussions on surface and deep learning and to compare them during the different phases of medical students' education. This is a cross-sectional study involving medical students in all phases of education. Sociodemographic data, type and frequency of smartphone use, degree of digital addiction (Internet Addiction Test - IAT), and surface and deep approaches to learning (Biggs) were analyzed. A total of 710 students were included. Almost all students had a smartphone and a total of 96.8% used it during lectures, classes, and meetings. Less than half of the students (47.3%) reported using a smartphone for more than 10 min for educational purposes, a usage that is higher among clerkship students. At least 95% reported using a smartphone in the classroom for activities not related to medicine (social media and searching for general information) and 68.2% were considered problematic Internet users according to the IAT. The most common reasons for noneducational use were that the class was uninteresting, students needed to receive or make an important call, and the educational strategy was not stimulating. The "frequency of smartphone use" and higher "internet addiction" were correlated to both higher levels of surface learning and lower levels of deep learning. Educators should advise and educate their students about conscientious use of this tool to avoid detrimental impact on the learning process.

The Internet School of Medicine: use of electronic resources by medical trainees and the reliability of those resources.

PubMed

Egle, Jonathan P; Smeenge, David M; Kassem, Kamal M; Mittal, Vijay K

2015-01-01

Electronic sources of medical information are plentiful, and numerous studies have demonstrated the use of the Internet by patients and the variable reliability of these sources. Studies have investigated neither the use of web-based resources by residents, nor the reliability of the information available on these websites. A web-based survey was distributed to surgical residents in Michigan and third- and fourth-year medical students at an American allopathic and osteopathic medical school and a Caribbean allopathic school regarding their preferred sources of medical information in various situations. A set of 254 queries simulating those faced by medical trainees on rounds, on a written examination, or during patient care was developed. The top 5 electronic resources cited by the trainees were evaluated for their ability to answer these questions accurately, using standard textbooks as the point of reference. The respondents reported a wide variety of overall preferred resources. Most of the 73 responding medical trainees favored textbooks or board review books for prolonged studying, but electronic resources are frequently used for quick studying, clinical decision-making questions, and medication queries. The most commonly used electronic resources were UpToDate, Google, Medscape, Wikipedia, and Epocrates. UpToDate and Epocrates had the highest percentage of correct answers (47%) and Wikipedia had the lowest (26%). Epocrates also had the highest percentage of wrong answers (30%), whereas Google had the lowest percentage (18%). All resources had a significant number of questions that they were unable to answer. Though hardcopy books have not been completely replaced by electronic resources, more than half of medical students and nearly half of residents prefer web-based sources of information. For quick questions and studying, both groups prefer Internet sources. However, the most commonly used electronic resources fail to answer clinical queries more than half

21 CFR 316.50 - Guidance documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... USE ORPHAN DRUGS Availability of Information § 316.50 Guidance documents. FDA's Office of Orphan... the regulations in this part. The list is maintained on the Internet and is published annually in the...

Documentation of psychotropic PRN medication administration: An evaluation of electronic health records compared with paper charts and verbal reports.

PubMed

Martin, Krystle; Ham, Elke; Hilton, Zoe

2018-05-12

To describe the documentation of pro re nata (PRN) medication for anxiety, and to compare documentation at two hospitals providing similar psychiatric services, one that used paper charts and another that used an electronic health record (EHR). We also assessed congruence between nursing documentation and verbal reports from staff about the PRN administration process. The ability to accurately document patients' symptoms and the care given is considered a core competency of the nursing profession (Wilkinson, 2007); however, researchers have found poor concordance between nursing notes and verbal reports or observations of events (e.g., De Marinis, Piredda, Pascarella et al., 2009) and considerable information missing (e.g., Marinis et al., 2010). Additionally, the administration of PRN medication has consistently been noted to be poorly documented (e.g., Baker, Lovell, & Harris, 2008). The project was a mixed method, two-phase study that collected data from two sites. In phase 1, nursing documentation of PRN medication administrations was reviewed in patient charts; phase 2 included verbal reports from staff about this practice. Nurses using EHR documented more information than those using paper charts, including the reason for PRN administration, who initiated the administration, and effectiveness. There were some differences between written and verbal reports, including whether potential side effects were explained to patients prior to PRN administration. We continue the calls for attention to be paid to improving the quality of nursing documentation. Our results support the shift to using EHR, yet not relying on this method completely to ensure comprehensiveness of documentation. Efforts to address the quality of documentation, particularly for PRN administration, are needed. This could be done through training, using structured report templates, and switching to electronic databases. This article is protected by copyright. All rights reserved. This article is

Online database for documenting clinical pathology resident education.

PubMed

Hoofnagle, Andrew N; Chou, David; Astion, Michael L

2007-01-01

Training of clinical pathologists is evolving and must now address the 6 core competencies described by the Accreditation Council for Graduate Medical Education (ACGME), which include patient care. A substantial portion of the patient care performed by the clinical pathology resident takes place while the resident is on call for the laboratory, a practice that provides the resident with clinical experience and assists the laboratory in providing quality service to clinicians in the hospital and surrounding community. Documenting the educational value of these on-call experiences and providing evidence of competence is difficult for residency directors. An online database of these calls, entered by residents and reviewed by faculty, would provide a mechanism for documenting and improving the education of clinical pathology residents. With Microsoft Access we developed an online database that uses active server pages and secure sockets layer encryption to document calls to the clinical pathology resident. Using the data collected, we evaluated the efficacy of 3 interventions aimed at improving resident education. The database facilitated the documentation of more than 4 700 calls in the first 21 months it was online, provided archived resident-generated data to assist in serving clients, and demonstrated that 2 interventions aimed at improving resident education were successful. We have developed a secure online database, accessible from any computer with Internet access, that can be used to easily document clinical pathology resident education and competency.

Building Networks of Leaders through the Internet.

ERIC Educational Resources Information Center

Gabbard, Glenn

2001-01-01

This bulletin brings together the concepts of parent networking and the Internet. The document highlights key free or low cost features of the Internet which have proven to be useful tools in linking together networks of parents. It addresses the following six questions: (1) What if I don't have a computer? (2) How can I get Web access? (3) How do…

Current Internet use and preferences of IVF and ICSI patients.

PubMed

Haagen, E C; Tuil, W; Hendriks, J; de Bruijn, R P J; Braat, D D M; Kremer, J A M

2003-10-01

Nowadays, the Internet has a tremendous impact on modern society, including healthcare practice. The study aim was to characterize current Internet use by IVF and ICSI patients and to identify their preferences regarding Internet applications in fertility care. A total of 163 couples with fertility problems awaiting an IVF or ICSI procedure in the University Medical Centre Nijmegen, The Netherlands, was asked to complete a written questionnaire on Internet use in general, and also for fertility-related problems, preferences regarding Internet applications in fertility care and demographic characteristics. The response rate was 82%. In total, 81% of infertile couples used the Internet. Multivariate logistic regression analysis showed ethnic background and annual family income to be significant predictors of Internet use. Some 66% of Internet users and 54% of the total study population used the Internet for fertility-related problems. The female partners were the main Internet users with regard to fertility-related issues. In terms of preferences of the study participants, the majority favoured personal medical information online. Most infertile couples used the Internet with respect to fertility-related problems and were interested in implementation of Internet applications in fertility care. Healthcare providers should actively participate in the development and implementation of Internet applications in fertility care.

10 CFR 55.27 - Documentation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Documentation. 55.27 Section 55.27 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.27 Documentation. The facility licensee shall document and maintain the results of medical qualifications data, test results, and...

A Framework for an Institutional High Level Security Policy for the Processing of Medical Data and their Transmission through the Internet

PubMed Central

Pangalos, George

2001-01-01

Background The Internet provides many advantages when used for interaction and data sharing among health care providers, patients, and researchers. However, the advantages provided by the Internet come with a significantly greater element of risk to the confidentiality, integrity, and availability of information. It is therefore essential that Health Care Establishments processing and exchanging medical data use an appropriate security policy. Objective To develop a High Level Security Policy for the processing of medical data and their transmission through the Internet, which is a set of high-level statements intended to guide Health Care Establishment personnel who process and manage sensitive health care information. Methods We developed the policy based on a detailed study of the existing framework in the EU countries, USA, and Canada, and on consultations with users in the context of the Intranet Health Clinic project. More specifically, this paper has taken into account the major directives, technical reports, law, and recommendations that are related to the protection of individuals with regard to the processing of personal data, and the protection of privacy and medical data on the Internet. Results We present a High Level Security Policy for Health Care Establishments, which includes a set of 7 principles and 45 guidelines detailed in this paper. The proposed principles and guidelines have been made as generic and open to specific implementations as possible, to provide for maximum flexibility and adaptability to local environments. The High Level Security Policy establishes the basic security requirements that must be addressed to use the Internet to safely transmit patient and other sensitive health care information. Conclusions The High Level Security Policy is primarily intended for large Health Care Establishments in Europe, USA, and Canada. It is clear however that the general framework presented here can only serve as reference material for

A framework for an institutional high level security policy for the processing of medical data and their transmission through the Internet.

PubMed

Ilioudis, C; Pangalos, G

2001-01-01

The Internet provides many advantages when used for interaction and data sharing among health care providers, patients, and researchers. However, the advantages provided by the Internet come with a significantly greater element of risk to the confidentiality, integrity, and availability of information. It is therefore essential that Health Care Establishments processing and exchanging medical data use an appropriate security policy. To develop a High Level Security Policy for the processing of medical data and their transmission through the Internet, which is a set of high-level statements intended to guide Health Care Establishment personnel who process and manage sensitive health care information. We developed the policy based on a detailed study of the existing framework in the EU countries, USA, and Canada, and on consultations with users in the context of the Intranet Health Clinic project. More specifically, this paper has taken into account the major directives, technical reports, law, and recommendations that are related to the protection of individuals with regard to the processing of personal data, and the protection of privacy and medical data on the Internet. We present a High Level Security Policy for Health Care Establishments, which includes a set of 7 principles and 45 guidelines detailed in this paper. The proposed principles and guidelines have been made as generic and open to specific implementations as possible, to provide for maximum flexibility and adaptability to local environments. The High Level Security Policy establishes the basic security requirements that must be addressed to use the Internet to safely transmit patient and other sensitive health care information. The High Level Security Policy is primarily intended for large Health Care Establishments in Europe, USA, and Canada. It is clear however that the general framework presented here can only serve as reference material for developing an appropriate High Level Security Policy in a

Medical teleconference about thoracic surgery using free Internet software.

PubMed

Obuchi, Toshiro; Shiono, Hiroyuki; Shimada, Junichi; Kaga, Kichizo; Kurihara, Masatoshi; Iwasaki, Akinori

2011-11-01

Surgical teleconferences using advanced academic networks are becoming common; however, reports regarding Internet teleconferencing using free software packages such as Skype, USTREAM, and Dropbox are very rare. Teleconferences concerning mainly surgical techniques were held five times between Fukuoka University Hospital and other institutions from April to September 2010. These teleconferences used Skype and USTREAM as videophones to establish communication. Both PowerPoint presentations and surgical videos were made. These presentation files were previously sent to all stations via mail, e-mail, or Dropbox, and shared. A slide-show was simultaneously performed following the presenter's cue in each station. All teleconferences were successfully completed, even though there were minor instances of the Skype link being broken for unknown reasons during the telecommunication. Internet surgical teleconferences using ordinary software are therefore considered to be sufficiently feasible. This method will become more convenient and common as the Internet environments advance.

[Development and integration of the Oncological Documentation System ODS].

PubMed

Raab, G; van Den Bergh, M

2001-08-01

To simplify clinical routine and to improve medical quality without exceeding the existing resources. Intensifying communication and cooperation between all institutions of patients' health care. The huge amount of documentation work of physicians can no longer be done without modern tools of paperless data processing. The development of ODS was a tight cooperation between physician and technician which resulted in a mutual understanding and led to a high level of user convenience. - At present all cases of gynecology, especially gynecologic oncology can be documented and processed by ODS. Users easily will adopt the system as data entry within different program areas follows the same rules. In addition users can choose between an individual input of data and assistants guiding them through highly specific areas of documentation. ODS is a modern, modular structured and very fast multiuser database environment for in- and outpatient documentation. It automatically generates a lot of reports for clinical day to day business. Statistical routines will help the user reflecting his work and its quality. Documentation of clinical trials according to the GCP guidelines can be done by ODS using the internet or offline datasharing. As ODS is the synthesis of a computer based patient administration system and an oncological documentation database, it represents the basis for the construction of the electronical patient chart as well as the digital documentation of clinical trials. The introduction of this new technology to physicians and nurses has to be done slowly and carefully, in order to increase motivation and to improve the results.

Medical Individualism or Medical Familism? A Critical Analysis of China's New Guidelines for Informed Consent: The Basic Norms of the Documentation of the Medical Record.

PubMed

Bian, Lin

2015-08-01

Modern Western medical individualism has had a significant impact on health care in China. This essay demonstrates the ways in which such Western-style individualism has been explicitly endorsed in China's 2010 directive: The Basic Norms of the Documentation of the Medical Record. The Norms require that the patient himself, rather than a member of his family, sign each informed consent form. This change in clinical practice indicates a shift toward medical individualism in Chinese healthcare legislation. Such individualism, however, is incompatible with the character of Chinese familism that is deeply rooted in the Chinese ethical tradition. It also contradicts family-based patterns of health care in China. Moreover, the requirement for individual informed consent is incompatible with numerous medical regulations promulgated in the past two decades. This essay argues that while Chinese medical legislation should learn from relevant Western ideas, it should not simply copy such practices by importing medical individualism into Chinese health care. Chinese healthcare policy is properly based on Chinese medical familist resources. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Internet in medicine--development and perspectives].

PubMed

Dezelić, Gjuro

2002-01-01

Internet is one of information technologies marking the transition from the second to the third millennium. The present role and expansion of Internet in medicine and healthcare is reviewed together with the perspective of further development. The beginning and initial expansion of the use of Internet in medicine are described. The World Wide Web (WWW or Web) is recognized as a major reason for this expansion, reaching a state described as a Web-pandemic. The rapid increase of the number of papers dealing with Internet in medical literature is presented as well as the appearance of several journals dedicated to Internet in medicine. First specialized symposia, among them MEDNET world conferences, are noted. First uses of Internet in medicine comprised databases, discussion groups, electronic newsletters, software archives and online public access catalogues. The appearance of the Web has led to a significant improvement of the Internet use in medicine, which is reflected in an exponential increase in the number of publications. It is noted that Internet allows "to do old things in new ways", but also "to do new things". It has become clear that the information revolution evoked by the internet shall leave a deep trace in medicine, as health information has become accessible to the public and ceased to be in exclusive control of health professionals. New medical fields--telemedicine and cybermedicine--appeared as the result of the development and global expansion of information and communication technologies, with cybermedicine dealing more specifically with the use of Internet. The advantages and disadvantages of cybermedicine are discussed, and major problems related to the quality of health information are highlighted. Several systems for quality criteria of health related Web-sites are described, indicating that Websites have to conform with the quality criteria such as transparency and honesty, accountability, privacy and data protection, currency

[A security protocol for the exchange of personal medical data via Internet: monitoring treatment and drug effects].

PubMed

Viviani, R; Fischer, J; Spitzer, M; Freudenmann, R W

2004-04-01

We present a security protocol for the exchange of medical data via the Internet, based on the type/domain model. We discuss two applications of the protocol: in a system for the exchange of data for quality assurance, and in an on-line database of adverse reactions to drug use. We state that a type/domain security protocol can successfully comply with the complex requirements for data privacy and accessibility typical of such applications.

Medical information on the Internet: Quality assessment of lumbar puncture and neuroaxial block techniques on YouTube.

PubMed

Rössler, Bernhard; Lahner, Daniel; Schebesta, Karl; Chiari, Astrid; Plöchl, Walter

2012-07-01

The Internet has become the largest, most up-to-date source for medical information. Besides enhancing patients' knowledge, the freely accessible audio-visual files have an impact on medical education. However little is known about their characteristics. In this manuscript the quality of lumbar puncture (LP) and spinal anaesthesia (SA) videos available on YouTube is assessed. This retrospective analysis was based on a search for LP and SA on YouTube. Videos were evaluated using essential key points (5 in SA, 4 in LP) and 3 safety indicators. Furthermore, violation of sterile working techniques and a rating whether the video must be regarded as dangerously misleading was performed. From 2321 hits matching the keywords, 38 videos were eligible for evaluation. In LP videos, 14% contained information on all, 4.5% on 3 and 4.5% on 2 key points, 59% on 1 and 18% on no key point. Regarding SA, no video contained information on all 5 key points, 56% on 2-4 and 25% on 1 key point, 19% did not contain any essential information. A sterility violation occurred in 11%, and 13% were classified as dangerously misleading. Even though high quality videos are available, the quality of video clips is generally low. The fraction of videos that were not performed in an aseptic manner is low, but these pose a substantial risk to patients. Consequently, more high-quality, institutional medical learning videos must be made available in the light of the increased utilization on the Internet. Copyright © 2012 Elsevier B.V. All rights reserved.

Internet trials: participant experiences and perspectives.

PubMed

Mathieu, Erin; Barratt, Alexandra; Carter, Stacy M; Jamtvedt, Gro

2012-10-23

Use of the Internet to conduct randomised controlled trials is increasing, and provides potential to increase equity of access to medical research, increase the generalisability of trial results and decrease the costs involved in conducting large scale trials. Several studies have compared response rates, completeness of data, and reliability of surveys using the Internet and traditional methods, but very little is known about participants' attitudes towards Internet-based randomised trials or their experience of participating in an Internet-based trial. To obtain insights into the experiences and perspectives of participants in an Internet-based randomised controlled trial, their attitudes to the use of the Internet to conduct medical research, and their intentions regarding future participation in Internet research. All English speaking participants in a recently completed Internet randomised controlled trial were invited to participate in an online survey. 1246 invitations were emailed. 416 participants completed the survey between May and October 2009 (33% response rate). Reasons given for participating in the Internet RCT fell into 4 main areas: personal interest in the research question and outcome, ease of participation, an appreciation of the importance of research and altruistic reasons. Participants' comments and reflections on their experience of participating in a fully online trial were positive and less than half of participants would have participated in the trial had it been conducted using other means of data collection. However participants identified trade-offs between the benefits and downsides of participating in Internet-based trials. The main trade-off was between flexibility and convenience - a perceived benefit - and a lack connectedness and understanding - a perceived disadvantage. The other tradeoffs were in the areas of: ease or difficulty in use of the Internet; security, privacy and confidentiality issues; perceived benefits and

[English translation of the title of ancient Chinese medical books and documents].

PubMed

Zeng, Fang; Shao, Xin; Zhang, Pei-Hai

2008-11-01

The title of a book is, generally, the high concentration of the writer's intention and the theme of content. Translate the title of an ancient Chinese medical book or document accurately and plainly is meaningful for exhibiting the style of the book, also for promoting the international communication of TCM. The principle should be followed is to choose the translating terms accurately to reveal the theme of content and express the cultural connotation of the book perfectly.

Simple prescribing errors and allergy documentation in medical hospital admissions in Australia and New Zealand.

PubMed

Barton, Lorna; Futtermenger, Judith; Gaddi, Yash; Kang, Angela; Rivers, Jon; Spriggs, David; Jenkins, Paul F; Thompson, Campbell H; Thomas, Josephine S

2012-04-01

This study aimed to quantify and compare the prevalence of simple prescribing errors made by clinicians in the first 24 hours of a general medical patient's hospital admission. Four public or private acute care hospitals across Australia and New Zealand each audited 200 patients' drug charts. Patient demographics, pharmacist review and pre-defined prescribing errors were recorded. At least one simple error was present on the medication charts of 672/715 patients, with a linear relationship between the number of medications prescribed and the number of errors (r = 0.571, p < 0.001). The four sites differed significantly in the prevalence of different types of simple prescribing errors. Pharmacists were more likely to review patients aged > or = 75 years (39.9% vs 26.0%; p < 0.001) and those with more than 10 drug prescriptions (39.4% vs 25.7%; p < 0.001). Patients reviewed by a pharmacist were less likely to have inadequate documentation of allergies (13.5% vs 29.4%, p < 0.001). Simple prescribing errors are common, although their nature differs from site to site. Clinical pharmacists target patients with the most complex health situations, and their involvement leads to improved documentation.

Extent, accuracy, and credibility of breastfeeding information on the Internet.

PubMed

Shaikh, Ulfat; Scott, Barbara J

2005-05-01

Our objective was to test and describe a model for evaluating Websites related to breastfeeding. Forty Websites most likely to be accessed by the public were evaluated for extent, accuracy, credibility, presentation, ease of use, and adherence to ethical and medical Internet publishing standards. Extent and accuracy of Website content were determined by a checklist of critical information. The majority of Websites reviewed provided accurate information and complied with the International Code of Marketing of Breast-milk Substitutes. Approximately half the Websites complied with standards of medical Internet publishing. While much information on breastfeeding on the Internet is accurate, there is wide variability in the extent of information, usability of Websites, and compliance with standards of medical Internet publishing. Results of this study may be helpful to health care professionals as a model for evaluating breastfeeding-related Websites and to highlight considerations when recommending or designing Websites.

Electronic Document Management Using Inverted Files System

NASA Astrophysics Data System (ADS)

Suhartono, Derwin; Setiawan, Erwin; Irwanto, Djon

2014-03-01

The amount of documents increases so fast. Those documents exist not only in a paper based but also in an electronic based. It can be seen from the data sample taken by the SpringerLink publisher in 2010, which showed an increase in the number of digital document collections from 2003 to mid of 2010. Then, how to manage them well becomes an important need. This paper describes a new method in managing documents called as inverted files system. Related with the electronic based document, the inverted files system will closely used in term of its usage to document so that it can be searched over the Internet using the Search Engine. It can improve document search mechanism and document save mechanism.

Dermatology Internet Yellow Page advertising.

PubMed

Francis, Shayla; Kozak, Katarzyna Z; Heilig, Lauren; Lundahl, Kristy; Bowland, Terri; Hester, Eric; Best, Arthur; Dellavalle, Robert P

2006-07-01

Patients may use Internet Yellow Pages to help select a physician. We sought to describe dermatology Internet Yellow Page advertising. Dermatology advertisements in Colorado, California, New York, and Texas at 3 Yellow Page World Wide Web sites were systematically examined. Most advertisements (76%; 223/292) listed only one provider, 56 listed more than one provider, and 13 listed no practitioner names. Five advertisements listed provider names without any credentialing letters, 265 listed at least one doctor of medicine or osteopathy, and 9 listed only providers with other credentials (6 doctors of podiatric medicine and 3 registered nurses). Most advertisements (61%; 179/292) listed a doctor of medicine or osteopathy claiming board certification, 78% (139/179) in dermatology and 22% (40/179) in other medical specialties. Four (1%; 4/292) claims of board certification could not be verified (one each in dermatology, family practice, dermatologic/cosmetologic surgery, and laser surgery). Board certification could be verified for most doctors of medicine and osteopathy not advertising claims of board certification (68%; 41/60; 32 dermatology, 9 other specialties). A total of 50 advertisements (17%) contained unverifiable or no board certification information, and 47 (16%) listed a physician with verifiable board certification in a field other than dermatology. All Internet Yellow Page World Wide Web sites and all US states were not examined. Nonphysicians, physicians board certified in medical specialties other than dermatology, and individuals without verifiable board certification in any medical specialty are advertising in dermatology Internet Yellow Pages. Many board-certified dermatologists are not advertising this certification.

[Research and implementation of a real-time monitoring system for running status of medical monitors based on the internet of things].

PubMed

Li, Yiming; Qian, Mingli; Li, Long; Li, Bin

2014-07-01

This paper proposed a real-time monitoring system for running status of medical monitors based on the internet of things. In the aspect of hardware, a solution of ZigBee networks plus 470 MHz networks is proposed. In the aspect of software, graphical display of monitoring interface and real-time equipment failure alarm is implemented. The system has the function of remote equipment failure detection and wireless localization, which provides a practical and effective method for medical equipment management.

Internet-ordered viagra (sildenafil citrate) is rarely genuine.

PubMed

Campbell, Neil; Clark, John P; Stecher, Vera J; Goldstein, Irwin

2012-11-01

Counterfeit medication is a growing problem. This study assessed the requirement for prescription, cost, origin, and content of medications sold via the Internet and purporting to be the phosphodiesterase type 5 inhibitor Viagra (sildenafil citrate). Pfizer monitored top search results for the query "buy Viagra" on the two leading Internet search engines in March 2011. Orders were placed from 22 unique Web sites claiming to sell Viagra manufactured by Pfizer. Tablets received were assessed for chemical composition. No Web site examined required a prescription for purchase or a health screening survey; 90% offered illegal "generic Viagra." Cost per tablet ranged from $3.28-$33.00. Shipment origins of purchases were Hong Kong (N = 11), the United States (N = 6), and the United Kingdom (N = 2) as well as Canada, China, and India (N = 1 each). Notably, the four Internet pharmacies claiming to be Canadian did not ship medication from a Canadian address. Of 22 sample tablets examined, 17 (77%) were counterfeit, 4 (18%) were authentic, and 1 (5%) was an illegal generic. Counterfeit tablets were analyzed for sildenafil citrate, the active pharmaceutical ingredient (API) of Viagra, and contents varied between 30% and 50% of the label claim. Counterfeits lacked product information leaflets, including appropriate safety warnings, and genuine Viagra formulations. Internet sites claiming to sell authentic Viagra shipped counterfeit medication 77% of the time; counterfeits usually came from non-U.S. addresses and had 30% to 50% of the labeled API claim. Caution is warranted when purchasing Viagra via the Internet. © 2012 International Society for Sexual Medicine.

Using the Internet To Create Primary Source Teaching Packets.

ERIC Educational Resources Information Center

VanFossen, Phillip J.; Shiveley, James M.

2000-01-01

Describes strategies and guidelines for creating age- and content-appropriate primary source documents using the Internet. Discusses the value of using topic-specific primary source teaching packets, or jackdaws. Provides three Internet generated jackdaws: New Deal/FDR, Home Front during World War II, and the Gilded Age. Addresses fair use issues.…

Professional use of the internet among Saudi Arabian dermatologists: a cross-sectional survey

PubMed Central

AlGhamdi, Khalid M

2009-01-01

Background The internet is an increasingly important tool for physicians, but the extent to which it is used by dermatologists is unknown. We aimed to investigate the utilization of the internet by dermatologists in Saudi Arabia for medical purposes during their daily practice and to clarify the reasons for its use and non-use. Methods A self-administered questionnaire was distributed to all 160 dermatologists attending the National Dermatology conference in 2007. Results A total of 107 questionnaires were completed. Sixty-two percent of respondents had access to the internet in the workplace. The use of the internet to update medical knowledge was reported by 91%. Only 27% had internet access in consultation rooms. The majority of information retrieval occurred outside patient consultation hours (91%). Only 13% reported using the internet during patient consultation. Possible reasons included: lack of access (54%), time pressure (37%), possible interference with the physician-patient relationship (30%), and that use of the internet was too time-consuming (10%). The mean searching time used to solve a clinical problem was 34 ± 3 minutes. Fifty-eight percent used Pubmed; however, 77% of the dermatologists had no training at all in how to use this tool. Conclusion Professional medical use of the internet is widespread among dermatologists in Saudi Arabia. Providing access to the internet in the workplace and training of dermatologists to perform effective electronic searches are badly needed to improve the professional medical use of internet, which is expected to lead to better delivery of patient care. PMID:19835598

Internet Hospitals in China: Cross-Sectional Survey.

PubMed

Xie, Xiaoxu; Zhou, Weimin; Lin, Lingyan; Fan, Si; Lin, Fen; Wang, Long; Guo, Tongjun; Ma, Chuyang; Zhang, Jingkun; He, Yuan; Chen, Yixin

2017-07-04

The Internet hospital, an innovative approach to providing health care, is rapidly developing in China because it has the potential to provide widely accessible outpatient service delivery via Internet technologies. To date, China's Internet hospitals have not been systematically investigated. The aim of this study was to describe the characteristics of China's Internet hospitals, and to assess their health service capacity. We searched Baidu, the popular Chinese search engine, to identify Internet hospitals, using search terms such as "Internet hospital," "web hospital," or "cloud hospital." All Internet hospitals in mainland China were eligible for inclusion if they were officially registered. Our search was carried out until March 31, 2017. We identified 68 Internet hospitals, of which 43 have been put into use and 25 were under construction. Of the 43 established Internet hospitals, 13 (30%) were in the hospital informatization stage, 24 (56%) were in the Web ward stage, and 6 (14%) were in full Internet hospital stage. Patients accessed outpatient service delivery via website (74%, 32/43), app (42%, 18/43), or offline medical consultation facility (37%, 16/43) from the Internet hospital. Furthermore, 25 (58%) of the Internet hospitals asked doctors to deliver health services at a specific Web clinic, whereas 18 (42%) did not. The consulting methods included video chat (60%, 26/43), telephone (19%, 8/43), and graphic message (28%, 12/43); 13 (30%) Internet hospitals cannot be consulted online any more. Only 6 Internet hospitals were included in the coverage of health insurance. The median number of doctors available online was zero (interquartile range [IQR] 0 to 5; max 16,492). The median consultation fee per time was ¥20 (approximately US $2.90, IQR ¥0 to ¥200). Internet hospitals provide convenient outpatient service delivery. However, many of the Internet hospitals are not yet mature and are faced with various issues such as online doctor scarcity and

Guiding users to quality information about osteoarthritis on the Internet: a pilot study.

PubMed

Ilic, Dragan; Maloney, Stephen; Green, Sally

2005-12-01

This pilot study explored the feasibility of and user satisfaction with an Internet User's Guide (IUG) to assist patients in sourcing relevant, valid information about osteoarthritis on the Internet. Twelve people with osteoarthritis participated in focus groups that involved searching the Internet for information relating to their condition with the aid of the IUG. Participants were asked to perform an initial search of the Internet for information on osteoarthritis, followed by a second search with the aid of the IUG. User satisfaction with the IUG and subsequent online searches was obtained during and following the Internet simulations. A total of 92% of all participants had previously used the Internet to search for health information in the past. However, only a third used the Internet to further source information on their condition. Prior to using the IUG, participants cited efficiently searching the Internet for relevant and credible information as the primary obstacle in their continued use of the Internet. All participants reported that the use of the IUG increased their ability to source quality online medical information. The provision of an IUG may support and increase user awareness about searching for relevant, quality medical information on the Internet. Further quantitative and qualitative research is required to identify how best to empower consumers who wish to use the Internet as a medical resource.

Internet use for prediagnosis symptom appraisal by colorectal cancer patients.

PubMed

Thomson, Maria D; Siminoff, Laura A; Longo, Daniel R

2012-10-01

This study explored the characteristics of colorectal cancer (CRC) patients who accessed Internet-based health information as part of their symptom appraisal process prior to consulting a health care provider. Newly diagnosed CRC patients who experienced symptoms prior to diagnosis were interviewed. Brief COPE was used to measure patient coping. Logistic and linear regressions were used to assess Internet use and appraisal delay. Twenty-five percent of the sample (61/242) consulted the Internet prior to visiting a health care provider. Internet use was associated with having private health insurance (odds ratio [OR] = 2.55; 95% confidence interval [CI] = 1.20-5.43) and experiencing elimination symptoms (OR = 1.43; 95% CI = 1.14-1.80) and was marginally associated with age (OR = 0.96; 95% CI = 0.93-0.99). Internet use was not related to delayed medical care seeking. Internet use did not influence decisions to seek medical care. The Internet provided a preliminary information resource for individuals who experienced embarrassing CRC symptoms, had private health insurance, and were younger.

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... as to the contents and style of briefs. (2) Papers may be reproduced by any duplicating process...

Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

PubMed

Laws, A; Patsalides, B

1997-01-01

Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

Health Information Obtained From the Internet and Changes in Medical Decision Making: Questionnaire Development and Cross-Sectional Survey.

PubMed

Chen, Yen-Yuan; Li, Chia-Ming; Liang, Jyh-Chong; Tsai, Chin-Chung

2018-02-12

The increasing utilization of the internet has provided a better opportunity for people to search online for health information, which was not easily available to them in the past. Studies reported that searching on the internet for health information may potentially influence an individual's decision making to change her health-seeking behaviors. The objectives of this study were to (1) develop and validate 2 questionnaires to estimate the strategies of problem-solving in medicine and utilization of online health information, (2) determine the association between searching online for health information and utilization of online health information, and (3) determine the association between online medical help-seeking and utilization of online health information. The Problem Solving in Medicine and Online Health Information Utilization questionnaires were developed and implemented in this study. We conducted confirmatory factor analysis to examine the structure of the factor loadings and intercorrelations for all the items and dimensions. We employed Pearson correlation coefficients for examining the correlations between each dimension of the Problem Solving in Medicine questionnaire and each dimension of the Online Health Information Utilization questionnaire. Furthermore, we conducted structure equation modeling for examining the possible linkage between each of the 6 dimensions of the Problem Solving in Medicine questionnaire and each of the 3 dimensions of the Online Health Information Utilization questionnaire. A total of 457 patients participated in this study. Pearson correlation coefficients ranged from .12 to .41, all with statistical significance, implying that each dimension of the Problem Solving in Medicine questionnaire was significantly associated with each dimension of the Online Health Information Utilization questionnaire. Patients with the strategy of online health information search for solving medical problems positively predicted changes in

On the Ottoman consent documents for medical interventions and the modern concept of informed consent.

PubMed

Kara, Mahmut A; Aksoy, Sahin

2006-09-01

Information for patients prior to medical intervention is one of the principles of modern medical practice. In this study, we looked at an earlier practice of this principle. Ottoman judges had record books called sicil. One of the categories in sicils was the consent documents called riza senedi, which was a patient-physician contract approved by the courts. These contracts were especially for the protection of physicians from punishment if the patient dies. It is not clear whether patients were informed properly or not. Consent for minors was obtained from parents. However, a situation where an adult does not have the capacity to consent, was not clear in these documents. Any sign of free withdrawal of consent was not found in these records. Due to the legal system of Ottoman State, these contracts were related to Islamic law rather than modern civil law. We aim, in this paper, to present a legal practice, which is possible to consider as an early example of the informed consent practice.

Exploring the feasibility of obtaining mifepristone and misoprostol from the internet.

PubMed

Murtagh, Chloe; Wells, Elisa; Raymond, Elizabeth G; Coeytaux, Francine; Winikoff, Beverly

2018-04-01

We aimed to document the experience of buying abortion pills from online vendors that do not require a prescription and to evaluate the active ingredient content of the pills received. We searched the internet to identify a convenience sample of websites that sold mifepristone and misoprostol to purchasers in the United States and attempted to order these products. We documented price, shipping time and other aspects of ordering. We sent the samples received to a testing laboratory that measured the amount of active ingredient in individual tablets. We identified 18 websites and ordered 22 products: 20 mifepristone-misoprostol combination products and 2 that contained only misoprostol. We received 18 combination products and the 2 misoprostol products from 16 different sites. No site required a prescription or any relevant medical information. The time between order and receipt of the 20 products ranged from 3 to 21 business days (median 9.5 days). The price for the 18 combination products ranged from $110 to $360, including shipping and fees; the products without mifepristone cost less. Chemical assays found that the 18 tablets labeled 200 mg mifepristone contained between 184.3 mg and 204.1 mg mifepristone, while the 20 tablets labeled 200 mcg misoprostol contained between 34.1 mcg and 201.4 mcg of the active ingredient. Obtaining abortion medications from online pharmaceutical websites is feasible in the United States. The mifepristone tablets received contained within 8% of the labeled amount of active agent. The misoprostol tablets all contained that compound but usually less than labeled. Given our findings, we expect that some people for whom clinic-based abortion is not easily available or acceptable may consider self-sourcing pills from the internet to be a rational option. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Computer and internet use in a community health clinic population.

PubMed

Peterson, Neeraja B; Dwyer, Kathleen A; Mulvaney, Shelagh A

2009-01-01

To determine if patients from a community health clinic have access to computers and/or the Internet and if they believe a computer is useful in their medical care. A convenience sample of 100 subjects, aged 50 years and older, from a community health clinic in Nashville, Tennessee, completed a structured interview and a health literacy assessment. Of the 100 participants, 40 did not have any computer access, 27 had computer but not Internet access, and 33 had Internet access. Participants with computer access (with or without Internet) had higher incomes, higher educational status, and higher literacy status than those without computer access. Of participants reporting current computer use (n = 54), 33% reported never using their computer to look up health and medical information. Of those who "never'' used their computer for this activity, 54% reported they did not have Internet connectivity, whereas 31% reported they did not know how to use the Internet. Although this group of individuals reported that they were comfortable using a computer (77%), they reported being uncomfortable with accessing the Internet (53%). Not only does access to computers and the Internet need to be improved before widespread use by patients, but computer users will need to be instructed on how to navigate the Internet.

Adult Literacy, the Internet, and NCAL: An Introduction.

ERIC Educational Resources Information Center

Rethemeyer, R. Karl

This document provides information on two services established on the Internet by the National Center on Adult Literacy (NCAL): electronic mail (e-mail) communication with NCAL and a Gopher server that makes it possible to access and download information, documents, and software relevant to adult literacy. A recent "NCAL Connections" article,…

Internet trials: participant experiences and perspectives

PubMed Central

2012-01-01

Background Use of the Internet to conduct randomised controlled trials is increasing, and provides potential to increase equity of access to medical research, increase the generalisability of trial results and decrease the costs involved in conducting large scale trials. Several studies have compared response rates, completeness of data, and reliability of surveys using the Internet and traditional methods, but very little is known about participants’ attitudes towards Internet-based randomised trials or their experience of participating in an Internet-based trial. Objective To obtain insights into the experiences and perspectives of participants in an Internet-based randomised controlled trial, their attitudes to the use of the Internet to conduct medical research, and their intentions regarding future participation in Internet research. Methods All English speaking participants in a recently completed Internet randomised controlled trial were invited to participate in an online survey. Results 1246 invitations were emailed. 416 participants completed the survey between May and October 2009 (33% response rate). Reasons given for participating in the Internet RCT fell into 4 main areas: personal interest in the research question and outcome, ease of participation, an appreciation of the importance of research and altruistic reasons. Participants’ comments and reflections on their experience of participating in a fully online trial were positive and less than half of participants would have participated in the trial had it been conducted using other means of data collection. However participants identified trade-offs between the benefits and downsides of participating in Internet-based trials. The main trade-off was between flexibility and convenience – a perceived benefit – and a lack connectedness and understanding – a perceived disadvantage. The other tradeoffs were in the areas of: ease or difficulty in use of the Internet; security, privacy and

Patterns of computer usage among medical practitioners in rural and remote Queensland.

PubMed

White, Col; Sheedy, Vicki; Lawrence, Nicola

2002-06-01

As part of a more detailed needs analysis, patterns of computer usage among medical practitioners in rural and remote Queensland were investigated. Utilising a questionnaire approach, a response rate of 23.82% (n = 131) was obtained. Results suggest that medical practitioners in rural and remote Queensland are relatively sophisticated in their use of computer and information technologies and have embraced computerisation to a substantially higher extent compared with their urban counterparts and previously published estimates. Findings also indicate that a substantial number of rural and remote practitioners are utilising computer and information technologies for clinical purposes such as pathology, patient information sheets, prescribing, education, patient records and patient recalls. Despite barriers such as bandwidth limitations, cost and the sometimes unreliable quality of Internet service providers, a majority of rural and remote respondents rated an Internet site with continuing medical education information and services as being important or very important. Suggestions that "rural doctors are slow to adapt to new technologies" are questioned, with findings indicating that rural and remote medical practitioners in Queensland have adapted to, and utilise, information technology to a far higher extent than has been previously documented.

The Documentation of Health Problems in Relation to Prescribed Medication in People with Profound Intellectual and Multiple Disabilities

ERIC Educational Resources Information Center

van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

2009-01-01

Background: Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed. Method: Persons with PIMD with an…

The Role and Implications of the Internet in Healthcare Delivery

NASA Astrophysics Data System (ADS)

Broom, Alex

Drawing on a study of the Internet usage of Australian men with prostate cancer, this chapter investigates how access to information and online support affects men’s experiences of disease and, in particular, the possible implications of Internet-informed patients for the doctor/patient relationship. The data reveal that accessing information and/or support online can have a profound effect on men’s experiences of prostate cancer, providing a method of taking some control over their disease and limiting inhibitions experienced in face-to-face encounters. However, it is also clear that some medical specialists view Internet-informed patients as a challenge to their power within medical encounters and, as a result, employ disciplinary strategies that reinforce traditional patient roles and alienate patients who use the Internet.

The Internet and the therapeutic education of patients: A systematic review of the literature.

PubMed

Gremeaux, V; Coudeyre, E

2010-12-01

To evaluate from a review of the literature the interest of using the Internet as a tool for the therapeutic education of patients. A systematic review of Pubmed was carried out using the key words: the Internet, or World Wide Web and patient education, or patient preference, or self-care. The search was restricted to articles in English published between 1990 and 2009. References to the selected articles were also analyzed. Only randomized controlled studies were retained. Thirty-nine articles concerning 20 different diseases met the inclusion criteria and were analyzed. Different types of programs were proposed: informative, interactive, cognitive-behavioral and programs concerning self-management of the disease and the treatment. These different approaches were sometimes compared. The use of quality Internet sites made it possible to induce beneficial changes in lifestyle habits, and to diminish subjective and/or objective symptom severity in chronic invalidating diseases when used as a complement to traditional management. By using the Internet, patients were also able to improve decision-making skills to a degree that was at least as good as that obtained using traditional paper documents. The Internet is an effective complementary tool that can contribute to improving therapeutic education. Nonetheless, healthcare professionals should work with patients to create quality sites that correspond more closely to their expectations. It is also essential for learned societies such as the SOFMER to invest in therapeutic education on the Internet to make quality therapeutic education modules based on factual medical data and complying with good practices available on line. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Techniques of Document Management: A Review of Text Retrieval and Related Technologies.

ERIC Educational Resources Information Center

Veal, D. C.

2001-01-01

Reviews present and possible future developments in the techniques of electronic document management, the major ones being text retrieval and scanning and OCR (optical character recognition). Also addresses document acquisition, indexing and thesauri, publishing and dissemination standards, impact of the Internet, and the document management…

Internet Searches About Therapies Do Not Impact Willingness to Accept Prescribed Therapy in Inflammatory Bowel Disease Patients.

PubMed

Feathers, Alexandra; Yen, Tommy; Yun, Laura; Strizich, Garrett; Swaminath, Arun

2016-04-01

A significant majority of patients with inflammatory bowel disease (IBD) search the Internet for information about their disease. While patients who search the Internet for disease or treatment information are believed to be more resistant to accepting medical therapy, no studies have tested this hypothesis. All IBD patients over a 3-month period across three gastroenterology practices were surveyed about their disease, treatments, websites visited, attitudes toward medications, and their willingness to accept prescribed therapies after disease-related Internet searches. Of 142 total patients, 91 % of respondents searched the Internet for IBD information. The vast majority (82 %) reported taking medication upon their doctor's recommendation and cited the desire to acquire additional information about their disease and prescribed therapies as their most important search motivator (77 %). Internet usage did not affect the willingness of 52 % of our cohort to accept prescribed medication. The majority of IBD patients who searched the Internet for disease and treatment-related information were not affected in their willingness to accept prescribed medical therapy.

[Internet addiction: a different kind of addiction?].

PubMed

Dejoie, J F

2001-07-01

The concept of Internet addiction, also called Internet addictive disorder or pathological Internet use, entered the medical dictionary in 1995. More and more authors have been preoccupied with it lately, and the majority conclude that this condition, on which some people cast doubt a few years ago, well and truly exists. Several forms of Internet addiction appear to exist, categorised according to the type of misuse it is subjected to: "cybersex", "chat rooms", "net gaming", the pathological search for information or video games being the most frequent. Psychiatric disorders most usually associated with Internet addiction seem to be bipolar disorders. As a consequence, efficient drugs would be those that act as thymo-stabilisers, undoubtedly because they are also effective against those bipolar disorders. Psychotherapeutic treatments as discussion groups on the Internet or group therapies have not yet been evaluated.

Beyond access: barriers to internet health information seeking among the urban poor.

PubMed

McCloud, Rachel F; Okechukwu, Cassandra A; Sorensen, Glorian; Viswanath, K

2016-11-01

Communication inequalities deepen health disparities even when internet access is achieved. The goal of this study is to understand how a range of barriers may inhibit individuals from low socioeconomic position (SEP) from engaging with online health information even when it is freely available. Detailed data were collected from 118 low-SEP individuals from a randomized controlled trial providing internet access. Measures triangulated the health-seeking experience through internet use tracked in real-time, call log data, and self-reported barriers. Negative binomial regression models were fitted with technology and perceived predictors, and our outcome, health information seeking, and then stratified by medical status. Participants experienced a median of two computer issues (median 6 days) and two internet issues (median 6.5 days). Duration of internet problems was associated with a decrease in the rate of internet health information seeking by a factor of 0.990 (P = .03) for each additional day. Participants with a medical problem who were frustrated in their search for health information had half the rate of health information seeking of those who were not frustrated (incidence rate ratio = 0.395, P = .030). Despite IT support, participants still experienced internet connectivity issues that negatively impacted their health information seeking. Frustration in their search to find information may serve as an additional barrier to those who have medical issues. After initial internet access, a second-level digital divide emerged due to connectivity issues, highlighting the need to understand the complex network of barriers experienced by low-SEP internet users. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Real world use of an Internet intervention for pediatric encopresis.

PubMed

Ritterband, Lee M; Ardalan, Kaveh; Thorndike, Frances P; Magee, Joshua C; Saylor, Drew K; Cox, Daniel J; Sutphen, James L; Borowitz, Stephen M

2008-06-30

The Internet is a significant source of medical information and is now being shown to be an important conduit for delivering various health-related interventions. This paper aimed to examine the utility and impact of an Internet intervention for childhood encopresis as part of standard medical care in a "real world" setting. Patients diagnosed with encopresis were given a Web-based information prescription to use an Internet intervention for pediatric encopresis. A total of 22 families utilized the intervention between July 2004 and June 2006. A chart review and phone interview were undertaken to collect user characteristics; defecation-related information, including frequency of soiling, bowel movements (BMs) in the toilet, and amount of pain associated with defecation; and information on computer/Internet usage. Three questionnaires were used to examine the utility of, impact of, and adherence to the Internet intervention. Program utilization was obtained from a data tracking system that monitored usage in real time. Overall, parents rated the Internet intervention as enjoyable, understandable, and easy to use. They indicated that the Internet intervention positively affected their children, decreasing overall accidents and increasing child comfort on the toilet at home. Of the 20 children who initially reported fecal accidents, 19 (95%) experienced at least a 50% improvement, with a reduction of accident frequency from one fecal accident per day to one accident per week. Although it is not clear whether this improvement is directly related to the use of the Internet intervention, patient feedback suggests that the program was an important element, further establishing Internet interventions as a viable and desirable addition to standard medical care for pediatric encopresis. To our knowledge, this is the first time a pediatric Internet intervention has been examined as part of a "real world" setting. This is an important step toward establishing Internet

Real World Use of an Internet Intervention for Pediatric Encopresis

PubMed Central

Ardalan, Kaveh; Thorndike, Frances P; Magee, Joshua C; Saylor, Drew K; Cox, Daniel J; Sutphen, James L; Borowitz, Stephen M

2008-01-01

Background The Internet is a significant source of medical information and is now being shown to be an important conduit for delivering various health-related interventions. Objective This paper aimed to examine the utility and impact of an Internet intervention for childhood encopresis as part of standard medical care in a “real world” setting. Methods Patients diagnosed with encopresis were given a Web-based information prescription to use an Internet intervention for pediatric encopresis. A total of 22 families utilized the intervention between July 2004 and June 2006. A chart review and phone interview were undertaken to collect user characteristics; defecation-related information, including frequency of soiling, bowel movements (BMs) in the toilet, and amount of pain associated with defecation; and information on computer/Internet usage. Three questionnaires were used to examine the utility of, impact of, and adherence to the Internet intervention. Program utilization was obtained from a data tracking system that monitored usage in real time. Results Overall, parents rated the Internet intervention as enjoyable, understandable, and easy to use. They indicated that the Internet intervention positively affected their children, decreasing overall accidents and increasing child comfort on the toilet at home. Of the 20 children who initially reported fecal accidents, 19 (95%) experienced at least a 50% improvement, with a reduction of accident frequency from one fecal accident per day to one accident per week. Although it is not clear whether this improvement is directly related to the use of the Internet intervention, patient feedback suggests that the program was an important element, further establishing Internet interventions as a viable and desirable addition to standard medical care for pediatric encopresis. Conclusions To our knowledge, this is the first time a pediatric Internet intervention has been examined as part of a “real world” setting. This

Use of the internet for health information among primary care patients in rural West Texas.

PubMed

Zhang, Yan; Jones, Betsy; Spalding, Mary; Young, Rodney; Ragain, Mike

2009-06-01

Little is known about how primary care patients in rural, remote or border areas use the internet for their health information. This study examined the factors related to internet use for medical information among primary care clinic patients in such areas of West Texas. A convenience sample was drawn from nine clinics that serve low-income rural area populations. Surveys were distributed to the patients during a 6-week period in the winter of 2006. The analytical sample included 1890 participants. Logistic regressions were conducted. Of 1890 subjects, 699 (37%) reported having used the internet for medical information. Among those who reported using the internet for health information, respondents' primary usage pattern was to request more health information (29.9%), followed by the purchase of health supplies (13.4%). Most internet users (78.8%) agreed that the online medical/health information had improved their understanding of a specific condition, disease, or treatment. Almost 60% of the internet users thought the information was reliable. The correlates of internet use included health insurance, self-rated health, health confidence, and number of worried days as well as age, education level, ethnicity, and language. Our findings showed a much lower rate of internet use for medical/health information compared with a 2006 nationwide survey. This finding suggests that promoting health/medical information through websites or other on-line resources might not be the most effective way to reach a majority of patients in remote, rural or border areas.

Taking note of the perceived value and impact of medical student chart documentation on education and patient care.

PubMed

Friedman, Erica; Sainte, Michelle; Fallar, Robert

2010-09-01

To determine the extent of restrictions to medical student documentation in patients' records and the opinions of medical education leaders about such restrictions' impact on medical student education and patient care. Education deans (n = 126) of medical schools in the United States and Canada were surveyed to determine policies regarding placement of medical student notes in the patient record, the value of medical students' documentation in the medical record, and the use of electronic medical records (EMRs) for patient notes. The instrument was a 23-item anonymous Web survey. Seventy-nine deans responded. Over 90% believed student notes belong in medical records, but only 42% had a policy regarding this. Ninety-three percent indicated that without student notes, student education would be negatively affected. Fewer (56%) indicated that patient care would be negatively affected. Most thought limiting students' notes would negatively affect several other issues: feeling a part of the team (96%), preparation for internship (95%), and students' sense of involvement (94%). Half (52%) reported that fourth-year students could place notes in paper charts at "all" affiliated hospitals, and 6% reported that fourth-year students could do so at "no" hospitals. Although students' ability to enter notes in patients' records is believed to be important for student education, only about half of all hospitals allow all students' notes in the EMR. Policies regarding placement of student notes should be implemented to ensure students' competency in note writing and their value as members of the patient care team.

Use of the internet for health information: United States, 2009.

PubMed

Cohen, Robin A; Adams, Patricia F

2011-07-01

Research has shown that 74% of all U.S. adults use the Internet, and 61% have looked for health or medical information on the Internet. Additionally, 49% have accessed a website that provides information about a specific medical condition or problem. In 2009, the National Health Interview Survey (NHIS) became the first nationally representative household survey to collect data on the use of health information technology when the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation sponsored 10 questions that asked about use of the Internet to look up health information, refill a prescription, schedule a medical appointment, learn about health topics in online chat groups, and e-mail a health care provider. This report provides estimates, using 2009 NHIS data, about adult use of the Internet for health information in the past 12 months, by selected sociodemographic characteristics. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

The Internet and medicine: past, present, and future.

PubMed

Doyle, D J; Ruskin, K J; Engel, T P

1996-01-01

The enormous growth of the Internet and the World Wide Web has made these two technologies an important potential adjunct to cost-effective health care research and delivery. This article surveys some recent developments in telecommunications, networking and artificial intelligence that are likely to have a significant impact on improving the efficiency and quality of future health care. Issues discussed include: clinical record keeping on the Internet, Internet-assisted medical diagnosis, privacy and security matters, financial transactions, digital money, bandwidth concerns, multimedia (music, audio and video) information delivery via the Internet, intellectual property, and the concept of Information Philanthropy.

The Internet and medicine: past, present, and future.

PubMed Central

Doyle, D. J.; Ruskin, K. J.; Engel, T. P.

1996-01-01

The enormous growth of the Internet and the World Wide Web has made these two technologies an important potential adjunct to cost-effective health care research and delivery. This article surveys some recent developments in telecommunications, networking and artificial intelligence that are likely to have a significant impact on improving the efficiency and quality of future health care. Issues discussed include: clinical record keeping on the Internet, Internet-assisted medical diagnosis, privacy and security matters, financial transactions, digital money, bandwidth concerns, multimedia (music, audio and video) information delivery via the Internet, intellectual property, and the concept of Information Philanthropy. PMID:9381738

[Osteosarcoma: reliability and quality of the information in the internet].

PubMed

Schippinger, Michael; Ruckenstuhl, Paul; Friesenbichler, Jörg; Leithner, Andreas

2014-09-01

The World Wide Web has grown during the last years to a considerable source of medical information for experts as well as for laymen and patients. The quality of this information is subjected to some limitation linked with the structure of the Internet and the management of Internet pages. The cross- sectional study presented evaluates and compares quality and reliability of information with respect of osteosarcoma in the most common German-language Internet pages for medical information. As both, one of the most common primary malignant bone tumors and its peak of incidence at the age of childhood and youth, osteosarcoma is considered of significant importance in orthopedic oncology.

Falls documentation in nursing homes: agreement between the minimum data set and chart abstractions of medical and nursing documentation.

PubMed

Hill-Westmoreland, Elizabeth E; Gruber-Baldini, Ann L

2005-02-01

To assess the agreement between falls as recorded in the Minimum Data Set (MDS) and fall events abstracted from chart documentation of elderly nursing home (NH) residents. Secondary analysis of data from a longitudinal panel study. Fifty-six randomly selected NHs in Maryland stratified by facility size and geographic region. Four hundred sixty-two NH residents, aged 65 and older, in NHs for 1 year. Falls were abstracted from resident charts and compared with MDS fall variables. Fall events data obtained from other sources of chart documentation were matched for the corresponding periods of 30 and 180 days before the 1-year MDS assessment date. For a 30-day period, concordance between the MDS and chart abstractions of falls occurred in 65% of cases, with a kappa coefficient of 0.29 (P<.001), indicating fair agreement. Concordance occurred between the sources for 75% of cases for a 180-day period, with a kappa of 0.50 (P<.001), indicating moderate agreement. During the 180-day period, chart abstractions showed that 49% of the sample fell, whereas the MDS revealed that only 28% fell. An analysis of residents whose falls the MDS missed indicated that these residents had significantly more activity of daily living impairment and significantly less unsteady gait and cane/walker use. The MDS underreported falls. Nurses completing MDS assessments must carefully review residents' medical records for falls documentation. Future studies should use caution when employing MDS data as the only indicator of falls.

Marketing your practice on the Internet.

PubMed

Rothschild, Michael A

2002-12-01

The Internet provides a unique opportunity for marketing a medical practice. By demonstrating a commitment to good doctor-patient communication, by providing helpful background information, and by facilitating office workflow, a Web site can be a cost-effective way to enhance any practice. This chapter examines the basics of implementing an Internet presence; the issues related to online communication with patients; and the ongoing utilization, promotion, and maintenance of a Web site.

mJustice: Preliminary Development of a Mobile App for Medical-Forensic Documentation of Sexual Violence in Low-Resource Environments and Conflict Zones

PubMed Central

Mishori, Ranit; Anastario, Michael; Naimer, Karen; Varanasi, Sucharita; Ferdowsian, Hope; Abel, Dori; Chugh, Kevin

2017-01-01

ABSTRACT Digital health development and use has been expansive and operationalized in a variety of settings and modalities around the world, including in low- and middle-income countries. Mobile applications have been developed for a variety of health professionals and frontline health workers including physicians, midwives, nurses, and community health workers. However, there are no published studies on the development and use of digital health related to human rights fieldwork and to our knowledge no mobile health platforms exist specifically for use by frontline health workers to forensically and clinically document sexual violence. We describe a participatory development and user design process with Congolese end-users of a novel human rights app for clinicians intended to standardize the documentation of sexual violence evidence for forensic and legal purposes, called MediCapt. The app, yet to be launched and still in the future proofing phase, has included several development phases: (1) initial needs assessment conducted in 2011, (2) prototype development and field-testing in 2014 with 8 Congolese physicians, (3) prototype refinement and field-testing in 2015 with 9 clinicians. Feedback from the first field-testing phase was incorporated into the design of the second prototype; key features that were added to MediCapt include the ability for users to take photographs and draw on a pictogram to include as part of the evidence package, as well as the ability to print a form with the completed data. Questionnaires and key-informant interviews during the second and third field-testing phases revealed overall positive attitudes about MediCapt, but multiple perceived and actual barriers to implementation were identified, from personal behaviors, such as individual clinicians' comfort with new technology, to more systemic and infrastructure factors, such as strong cultural preferences for print documentation of evidence and limited Internet connectivity. Next

Beyond access: barriers to internet health information seeking among the urban poor

PubMed Central

Okechukwu, Cassandra A; Sorensen, Glorian; Viswanath, K

2016-01-01

Objective Communication inequalities deepen health disparities even when internet access is achieved. The goal of this study is to understand how a range of barriers may inhibit individuals from low socioeconomic position (SEP) from engaging with online health information even when it is freely available. Materials and methods Detailed data were collected from 118 low-SEP individuals from a randomized controlled trial providing internet access. Measures triangulated the health-seeking experience through internet use tracked in real-time, call log data, and self-reported barriers. Negative binomial regression models were fitted with technology and perceived predictors, and our outcome, health information seeking, and then stratified by medical status. Results Participants experienced a median of two computer issues (median 6 days) and two internet issues (median 6.5 days). Duration of internet problems was associated with a decrease in the rate of internet health information seeking by a factor of 0.990 (P = .03) for each additional day. Participants with a medical problem who were frustrated in their search for health information had half the rate of health information seeking of those who were not frustrated (incidence rate ratio = 0.395, P = .030). Discussion Despite IT support, participants still experienced internet connectivity issues that negatively impacted their health information seeking. Frustration in their search to find information may serve as an additional barrier to those who have medical issues. Conclusion After initial internet access, a second-level digital divide emerged due to connectivity issues, highlighting the need to understand the complex network of barriers experienced by low-SEP internet users. PMID:27206459

Efficiently finding information on the Internet.

PubMed

Underberger, D

2000-01-01

The Internet: a vast frontier of endless information. Despite this gold mine of knowledge, most users remain lost in cyberspace with little knowledge of what is available, where or how to find these treasures. Popular communities such as America Online have emerged because they help to organize the content into manageable pieces. But once you venture outside these confines, you get lost. This article will enable you to efficiently find general information and medically-related content on the Internet.

WEBCAP: Web Scheduler for Distance Learning Multimedia Documents with Web Workload Considerations

ERIC Educational Resources Information Center

Habib, Sami; Safar, Maytham

2008-01-01

In many web applications, such as the distance learning, the frequency of refreshing multimedia web documents places a heavy burden on the WWW resources. Moreover, the updated web documents may encounter inordinate delays, which make it difficult to retrieve web documents in time. Here, we present an Internet tool called WEBCAP that can schedule…

Darknet and bitcoin, the obscure and anonymous side of the internet in healthcare.

PubMed

Masoni, Marco; Guelfi, Maria Renza; Gensini, Gian Franco

2016-11-14

Illegal activities prosecutable by law in the real life can be committed on the internet alike. In the healthcare domain, we refer mainly to selling of illegal and counterfeit drugs, exchange of pedo-pornographic material and marketing of stolen medical records. These illegal activities are made easier by recent developments of the Internet that medical community must be aware of: darknet and bitcoin. The first allows anonymous surfing and the last anonymous financial transactions. After discussing which healthcare areas are affected by these technological developments of the Internet and the deriving consequences, then the Authors express their opinion on what actions can be taken to protect internet community.

The Future of the Internet in Science

NASA Technical Reports Server (NTRS)

Guice, Jon; Duffy, Robert

2000-01-01

How are scientists going to make use of the Internet several years from now? This is a case study of a leading-edge experiment in building a 'virtual institute'-- using electronic communication tools to foster collaboration among geographically dispersed scientists. Our experience suggests: Scientists will want to use web-based document management systems. There will be a demand for Internet-enabled meeting support tools. While internet videoconferencing will have limited value for scientists, webcams will be in great demand as a tool for transmitting pictures of objects and settings, rather than "talking heads." and a significant share of scientists who do fieldwork will embrace mobile voice, data and video communication tools. The setting for these findings is a research consortium called the NASA Astrobiology Institute.

Computer and internet use by first year clinical and nursing students in a Nigerian teaching hospital.

PubMed

Ajuwon, Grace Ada

2003-09-18

The internet is an important source of up-to-date medical information. Although several studies in different countries have explored the extent to which health science students use the computer and the internet, few researches are available on this subject in Nigeria. The aim of this study was to assess the uptake of computer and internet by health science students studying in the country. One hundred and eighty three first year medical and nursing students of the University College Hospital, Ibadan, Nigeria, completed a-25 item questionnaire during routine Library Orientation Program in the medical library. The EPI-Info software was used for data analysis. The mean ages for medical students and the student nurses were 22 and 24.6 years respectively. Overall, 42.6% of the entire sample could use the computer, 57.4% could not. While more than half (58%) of the medical students are computer literate, majority (75.9%) of the student nurses are not. Slightly more than two thirds (60.7%) of the entire students had ever used the internet, 33. 9% had not. E-mail was the most popular of internet services used by the students (76.4%) and the cyber café was the common place where students had accessed these services. The students' mean scores on a 15-point perceived self-efficacy scale for internet-related tasks was 3.8 for medical and 0.7 for nursing students (p = 0.00). Students who are computer literate had superior mean scores (4.8) than those without (0.6) (p = 0.000). First year clinical and nursing students in Ibadan Nigeria have not fully utilised the opportunity that the use of computer and internet offer for medical education. Improved efforts such as inclusion of computer education in medical and nursing curricular and establishment of computer laboratories are required to increase the student's access to computers and internet.

Computer and internet use by first year clinical and nursing students in a Nigerian teaching hospital

PubMed Central

Ajuwon, Grace Ada

2003-01-01

Background The internet is an important source of up-to-date medical information. Although several studies in different countries have explored the extent to which health science students use the computer and the internet, few researches are available on this subject in Nigeria. The aim of this study was to assess the uptake of computer and internet by health science students studying in the country. Methods One hundred and eighty three first year medical and nursing students of the University College Hospital, Ibadan, Nigeria, completed a-25 item questionnaire during routine Library Orientation Program in the medical library. The EPI-Info software was used for data analysis. Results The mean ages for medical students and the student nurses were 22 and 24.6 years respectively. Overall, 42.6% of the entire sample could use the computer, 57.4% could not. While more than half (58%) of the medical students are computer literate, majority (75.9%) of the student nurses are not. Slightly more than two thirds (60.7%) of the entire students had ever used the internet, 33. 9% had not. E-mail was the most popular of internet services used by the students (76.4%) and the cyber café was the common place where students had accessed these services. The students' mean scores on a 15-point perceived self-efficacy scale for internet-related tasks was 3.8 for medical and 0.7 for nursing students (p = 0.00). Students who are computer literate had superior mean scores (4.8) than those without (0.6) (p = 0.000). Conclusion First year clinical and nursing students in Ibadan Nigeria have not fully utilised the opportunity that the use of computer and internet offer for medical education. Improved efforts such as inclusion of computer education in medical and nursing curricular and establishment of computer laboratories are required to increase the student's access to computers and internet. PMID:14498997

Enabling Joint Commission Medication Reconciliation Objectives with the HL7 / ASTM Continuity of Care Document Standard

PubMed Central

Dolin, Robert H.; Giannone, Gay; Schadow, Gunther

2007-01-01

We sought to determine how well the HL7 / ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common source of medication errors. These transition points are the focus of communication standards, suggesting that CCD can support and enable medication related patient safety initiatives. Data elements needed to support the Joint Commission recommendations were identified and mapped to CCD, and a detailed clinical scenario was constructed. The mapping identified minor gaps, and identified fields present in CCD not specifically identified by Joint Commission, but useful nonetheless when managing medications across transitions of care, suggesting that a closer collaboration between the Joint Commission and standards organizations will be mutually beneficial. The nationally recognized CCD specification provides a standards-based solution for enabling Joint Commission medication reconciliation objectives. PMID:18693823

Enabling joint commission medication reconciliation objectives with the HL7 / ASTM Continuity of Care Document standard.

PubMed

Dolin, Robert H; Giannone, Gay; Schadow, Gunther

2007-10-11

We sought to determine how well the HL7/ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common source of medication errors. These transition points are the focus of communication standards, suggesting that CCD can support and enable medication related patient safety initiatives. Data elements needed to support the Joint Commission recommendations were identified and mapped to CCD, and a detailed clinical scenario was constructed. The mapping identified minor gaps, and identified fields present in CCD not specifically identified by Joint Commission, but useful nonetheless when managing medications across transitions of care, suggesting that a closer collaboration between the Joint Commission and standards organizations will be mutually beneficial. The nationally recognized CCD specification provides a standards-based solution for enabling Joint Commission medication reconciliation objectives.

A Forest Landowner's Guide to Internet Resources: States of the Northeast

Treesearch

USDA Forest Service

2000-01-01

This listing of internet resources was developed to provide you, the Non-Industrial Private Forest (NIPF) landowner, with a better understanding of the information and resources available on the internet relating to forest stewardship. In browsing the document, you'll hopefully find links to areas you're already interested in, and perhaps also find your...

Developing a medical emergency team running sheet to improve clinical handoff and documentation.

PubMed

Mardegan, Karen; Heland, Melodie; Whitelock, Tifany; Millar, Robert; Jones, Daryl

2013-12-01

During medical emergency team (MET) and cardiac arrest calls, a scribe usually records events on a running sheet. There is more agreement on what data should be recorded in cardiac arrest calls than for MET calls. In addition, handoff (handover) from ward staff to the arriving MET may be variable. In a quality improvement project, a novel MET running sheet was developed to document events and therapies administered during MET calls. Key characteristics of the form were improved form layout, increased space for event documentation, and prompts to assist handoff to the arriving MET using the Identity Situation, Background, Assessment, Request (ISBAR) format. Ward nurses commonly involved in MET activation were surveyed to assess their perceptions of the new MET running sheet. Files of 100 consecutive MET calls were reviewed to assess compliance. Of 109 nurses invited to complete the survey, 103 did so (94.5% response rate). Overall, 87 (84.5%) of the 103 respondents agreed or strongly agreed that the new MET running sheet was better than the previous form for documenting MET management, and 58 (57.4%) of 101 respondents agreed or strongly agreed that it assisted handoff. The form was completed in 91 of a sample of 100 consecutive MET calls. Areas of less complete documentation included aspects of the ISBAR handover to the arriving MET and notification of the next of kin and usual clinicians at the completion of the call. The MET running sheet, tailored to the clinical events that occur during episodes of MET review, may assist handoff from ward nurses to the arriving MET and event documentation.

Relevance of Web Documents:Ghosts Consensus Method.

ERIC Educational Resources Information Center

Gorbunov, Andrey L.

2002-01-01

Discusses how to improve the quality of Internet search systems and introduces the Ghosts Consensus Method which is free from the drawbacks of digital democracy algorithms and is based on linear programming tasks. Highlights include vector space models; determining relevant documents; and enriching query terms. (LRW)

[Security aspects on the Internet].

PubMed

Seibel, R M; Kocher, K; Landsberg, P

2000-04-01

Is it possible to use the Internet as a secure media for transport of telemedicine? Which risks exist for routine use? In this article state of the art methods of security were analysed. Telemedicine in the Internet has severe risks, because patient data and hospital data of a secure Intranet can be manipulated by connecting it to the Web. Establishing of a firewall and the introduction of HPC (Health Professional Card) are minimizing the risk of un-authorized access to the hospital server. HPC allows good safety with digital signature and authentication of host and client of medical data. For secure e-mail PGP (Pretty Good Privacy) is easy to use as a standard protocol. Planning all activities exactly as well as following legal regulations are important requisites for reduction of safety risks in Internet.

Electronic Journals, the Internet, and Scholarly Communication.

ERIC Educational Resources Information Center

Kling, Rob; Callahan, Ewa

2003-01-01

Examines the role of the Internet in supporting scholarly communication via electronic journals. Topics include scholarly electronic communication; a typology of electronic journals; models of electronic documents and scholarly communication forums; publication speed; costs; pricing; access and searching; citations; interactivity; archiving and…

77 FR 43538 - Misuse of Internet Protocol (IP) Relay Service; Telecommunications Relay Services and Speech-to...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-25

... the Internet, this service has become subject to abuse. Among other things, persons have been using IP...] Misuse of Internet Protocol (IP) Relay Service; Telecommunications Relay Services and Speech-to-Speech.... ACTION: Final rule. SUMMARY: In this document, the Commission adopts a measure that prohibits Internet...

Off the Charts: Medical documentation and selective redaction in the age of transparency.

PubMed

McCarthy, Matthew William; de Asua, Diego Real; Gabbay, Ezra; Fins, Joseph J

2018-01-01

A growing demand for transparency in medicine has the potential to strain the doctor-patient relationship. While information can empower patients, unrestricted patient access to the electronic medical record may have unintended consequences. Medical documentation is often written in language that is inaccessible to people without medical training, and without guidance, patients have no way to interpret the constellation of acronyms, diagnoses, treatments, impressions, and arguments that appear throughout their own chart. Additionally, full transparency may not allow physicians the intellectual or clinical freedom they need to authentically express questions, problematic impressions, and concerns about the patient's clinical and psychosocial issues. This article examines the ethical challenges of transparency in the digital era and suggests that selective redaction may serve as a means to maintain transparency, affirm physician's discretion, and uphold the core values of the doctor-patient relationship amidst disruptive technological change.

EFFECTS OF MEDICAL DISPUTES ON INTERNET COMMUNICATIONS OF NEGATIVE EMOTIONS AND NEGATIVE ONLINE WORD-OF-MOUTH.

PubMed

Lee, Yi-Chih; Wu, Wei-Li

2015-08-01

Emotions play an important role in human behavior. Negative emotions resulting from medical disputes are problems for medical personnel to solve but also have a significant impact on a hospital's reputation and people's trust in the hospital. One medical dispute case was chosen from an Internet news source to assess the correlation between people's negative emotions and negative online word-of-mouth. Convenience sampling was used in school faculties and university students who had shared their medical treatment experiences online were the research participants. A total of 221 Taiwanese participants volunteered (158 women, 63 men; ages: 26.7% under 19, 22.6% 20-29, 30.8% 30-39,19.9% over 40). Four negative emotions were measured using rating scales: uncertainty, anger, disappointment, and sadness. Four negative online word-of-mouth measures were: venting, advice search, helping receiver, and revenge. A modeled relationship was assessed by partial least square method (PLS). Then, people's positive emotions were further analyzed to assess changes after spreading negative word-of-mouth. The results showed that uncertainty had a positive effect on venting and advice search. People who felt anger or regret spread word-of-mouth in order to help the receiver. Disappointment may trigger the revenge behavior of negative word-of-mouth. Negative emotions could be relieved after engaging in the behavior of helping the receiver.

Desktop document delivery using portable document format (PDF) files and the Web.

PubMed Central

Shipman, J P; Gembala, W L; Reeder, J M; Zick, B A; Rainwater, M J

1998-01-01

Desktop access to electronic full-text literature was rated one of the most desirable services in a client survey conducted by the University of Washington Libraries. The University of Washington Health Sciences Libraries (UW HSL) conducted a ten-month pilot test from August 1996 to May 1997 to determine the feasibility of delivering electronic journal articles via the Internet to remote faculty. Articles were scanned into Adobe Acrobat Portable Document Format (PDF) files and delivered to individuals using Multipurpose Internet Mail Extensions (MIME) standard e-mail attachments and the Web. Participants retrieved scanned articles and used the Adobe Acrobat Reader software to view and print files. The pilot test required a special programming effort to automate the client notification and file deletion processes. Test participants were satisfied with the pilot test despite some technical difficulties. Desktop delivery is now offered as a routine delivery method from the UW HSL. PMID:9681165

Desktop document delivery using portable document format (PDF) files and the Web.

PubMed

Shipman, J P; Gembala, W L; Reeder, J M; Zick, B A; Rainwater, M J

1998-07-01

Desktop access to electronic full-text literature was rated one of the most desirable services in a client survey conducted by the University of Washington Libraries. The University of Washington Health Sciences Libraries (UW HSL) conducted a ten-month pilot test from August 1996 to May 1997 to determine the feasibility of delivering electronic journal articles via the Internet to remote faculty. Articles were scanned into Adobe Acrobat Portable Document Format (PDF) files and delivered to individuals using Multipurpose Internet Mail Extensions (MIME) standard e-mail attachments and the Web. Participants retrieved scanned articles and used the Adobe Acrobat Reader software to view and print files. The pilot test required a special programming effort to automate the client notification and file deletion processes. Test participants were satisfied with the pilot test despite some technical difficulties. Desktop delivery is now offered as a routine delivery method from the UW HSL.

Comparison of handheld computer-assisted and conventional paper chart documentation of medical records. A randomized, controlled trial.

PubMed

Stengel, Dirk; Bauwens, Kai; Walter, Martin; Köpfer, Thilo; Ekkernkamp, Axel

2004-03-01

Daily documentation and maintenance of medical record quality is a crucial issue in orthopaedic surgery. The purpose of the present study was to determine whether the introduction of a handheld computer could improve both the quantitative and qualitative aspects of medical records. A series of consecutive patients who were admitted for the first time to a thirty-six-bed orthopaedic ward of an academic teaching hospital for a planned operation or any other treatment of an acute injury or chronic condition were randomized to daily documentation of their clinical charts on a handheld computer or on conventional paper forms. The electronic documentation consisted of a specially designed software package on a handheld computer for bedside use with structured decision trees for examination, obtaining a history, and coding. In the control arm, chart notes were compiled on standard paper forms and were subsequently entered into the hospital's information system. The number of documented ICD (International Classification of Diseases) diagnoses was the primary end point for sample size calculations. All patient charts were reread by an expert panel consisting of two surgeons and the surgical quality assurance manager. These experts assigned quality ratings to the different documentation systems by scrutinizing the extent and accuracy of the patient histories and the physical findings as assessed by daily chart notes. Eighty patients were randomized to one of the two documentation arms, and seventy-eight (forty-seven men and thirty-one women) of them were eligible for final analysis. Documentation with the handheld computer increased the median number of diagnoses per patients from four to nine (p < 0.0001), but it produced some overcoding for false or redundant items. Documentation quality ratings improved significantly with the introduction of the handheld device (p < 0.01) with respect to the correct assessment of a patient's progress and translation into ICD diagnoses

78 FR 14701 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and..., the information collection associated with the Commission's Misuse of Internet Protocol (IP) Captioned... Registration and Documentation of Disability for Eligibility to Use IP Captioned Telephone Service, CG Docket...

The monitoring and managing application of cloud computing based on Internet of Things.

PubMed

Luo, Shiliang; Ren, Bin

2016-07-01

Cloud computing and the Internet of Things are the two hot points in the Internet application field. The application of the two new technologies is in hot discussion and research, but quite less on the field of medical monitoring and managing application. Thus, in this paper, we study and analyze the application of cloud computing and the Internet of Things on the medical field. And we manage to make a combination of the two techniques in the medical monitoring and managing field. The model architecture for remote monitoring cloud platform of healthcare information (RMCPHI) was established firstly. Then the RMCPHI architecture was analyzed. Finally an efficient PSOSAA algorithm was proposed for the medical monitoring and managing application of cloud computing. Simulation results showed that our proposed scheme can improve the efficiency about 50%. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Embedding the shapes of regions of interest into a Clinical Document Architecture document.

PubMed

Minh, Nguyen Hai; Yi, Byoung-Kee; Kim, Il Kon; Song, Joon Hyun; Binh, Pham Viet

2015-03-01

Sharing a medical image visually annotated by a region of interest with a remotely located specialist for consultation is a good practice. It may, however, require a special-purpose (and most likely expensive) system to send and view them, which is an unfeasible solution in developing countries such as Vietnam. In this study, we design and implement interoperable methods based on the HL7 Clinical Document Architecture and the eXtensible Markup Language Stylesheet Language for Transformation standards to seamlessly exchange and visually present the shapes of regions of interest using web browsers. We also propose a new integration architecture for a Clinical Document Architecture generator that enables embedding of regions of interest and simultaneous auto-generation of corresponding style sheets. Using the Clinical Document Architecture document and style sheet, a sender can transmit clinical documents and medical images together with coordinate values of regions of interest to recipients. Recipients can easily view the documents and display embedded regions of interest by rendering them in their web browser of choice. © The Author(s) 2014.

Internet Point of Care Learning at a Community Hospital

ERIC Educational Resources Information Center

Sinusas, Keith

2009-01-01

Introduction: Internet point of care (PoC) learning is a relatively new method for obtaining continuing medical education credits. Few data are available to describe physician utilization of this CME activity. Methods: We describe the Internet point of care system we developed at a medium-sized community hospital and report on its first year of…

Dermatology education and the Internet: traditional and cutting-edge resources.

PubMed

Hanson, Anne H; Krause, L Kendall; Simmons, Rachel N; Ellis, Jeffrey I; Gamble, Ryan G; Jensen, J Daniel; Noble, Melissa N; Orser, Michael L; Suarez, Andrea L; Dellavalle, Robert P

2011-10-01

The number and variety of dermatological medical resources available online has grown exponentially over the past decade. Internet-based resources allow for immediate and easy access to information for both medical education and reference purposes. Although clinicians continue to turn to the Internet for clinical information and still images, tech-savvy medical students are currently accessing a variety of exciting new resources, including discussion boards, wikis, streaming video, podcasts, journal clubs, online communities, and interactive diagnostic experiences to augment their medical education. The objective of this study was to identify traditional and cutting-edge online dermatology resources. We present a sampling of the top dermatology Internet resources, as assessed by a group of medical students in our university dermatology research lab. These resources were ranked by using a matrix derived from the Silberg Criteria, which assessed authorship, attribution, disclosure, currency, and content. Results indicate comparable ranking and approval of cutting-edge resources as traditional online sources. The ranked resources in each category are provided with URLs for readers' use. These cutting-edge online dermatology resources represent excellent sources for continuing education for students and clinicians alike. Resources such as these likely represent the future of medical education, as they allow for self-directed and supplementary education as well as remote access. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

BRIEF REPORT: What Types of Internet Guidance Do Patients Want from Their Physicians?

PubMed Central

Diaz, Joseph A; Sciamanna, Christopher N; Evangelou, Evangelos; Stamp, Michael J; Ferguson, Tom

2005-01-01

Objectives To understand what patients expect from physicians regarding information seeking on the Internet. Design Self-administered survey. Setting/Participants Waiting rooms of 4 community-based primary care offices. Measurements/Main Results Of 494 patients invited to participate, 330 completed the survey for a response rate of 67%. Of 177 respondents who used the Internet for health information, only 15% agreed that physicians should ask them about their Internet searches. Most (62%) agreed that physicians should recommend specific web sites where patients can learn more about their health care. Conclusions Primary care physicians should recognize that many patients would like guidance as they turn to the Internet for medical information. Physicians can utilize quality assessment tools and existing resources that facilitate referring patients to authoritative, commercial-free, patient-oriented medical information on the Internet. PMID:16050874

39 CFR 3001.9 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Commission, or by direction of the presiding officer shall be made using the Internet (Filing Online...) Account holder. In order for a document to be accepted using Filing Online, it must be submitted to the Commission by a principal account holder or an agent account holder (Filing Online account holder). The...

The Internet and primary care physicians: coping with different expectations.

PubMed

van Woerkum, Cees M J

2003-04-01

The birth of the Internet is one of the most important developments in the past 2 decades. It is a new medium, especially in the sense that the initiative now rests on the information user, who is no longer just a receiver of information. In part, the use of the Internet to find answers to health-related questions (medical, but also psychological, social, financial, legal) is linked to problems within existing practices. People use the Internet for several reasons: to obtain information that they could not get from their physicians, to verify a medical opinion or treatment, or to overcome reticence in discussing personal issues. Physicians' experience is changing because their patients are using the Internet. Many patients are better informed, and they ask more questions and demand more from their physicians. As a result, there is increased interaction concerning health issues. In addition, there is greater differentiation among patients, precisely because of their different information-seeking behavior. In coping with this inequality, physicians can select among 3 approaches, each with associated costs and benefits: 1) the medical model, in which the physicians follow the "essentials" of the profession (treatment and advice); 2) the client-oriented model, in which the physicians adapt to patients' needs, approaching patients as they would any other consumers; and 3) the educational model, in which physicians promote the proper use of the Internet as a profitable and equalizing medium.

The use of interactive graphical maps for browsing medical/health Internet information resources

PubMed Central

Boulos, Maged N Kamel

2003-01-01

As online information portals accumulate metadata descriptions of Web resources, it becomes necessary to develop effective ways for visualising and navigating the resultant huge metadata repositories as well as the different semantic relationships and attributes of described Web resources. Graphical maps provide a good method to visualise, understand and navigate a world that is too large and complex to be seen directly like the Web. Several examples of maps designed as a navigational aid for Web resources are presented in this review with an emphasis on maps of medical and health-related resources. The latter include HealthCyberMap maps , which can be classified as conceptual information space maps, and the very abstract and geometric Visual Net maps of PubMed (for demos). Information resources can be also organised and navigated based on their geographic attributes. Some of the maps presented in this review use a Kohonen Self-Organising Map algorithm, and only HealthCyberMap uses a Geographic Information System to classify Web resource data and render the maps. Maps based on familiar metaphors taken from users' everyday life are much easier to understand. Associative and pictorial map icons that enable instant recognition and comprehension are preferred to geometric ones and are key to successful maps for browsing medical/health Internet information resources. PMID:12556244

Assessing Information on the Internet: Toward Providing Library Services for Computer-Mediated Communication.

ERIC Educational Resources Information Center

Dillon, Martin; And Others

1992-01-01

Describes a project that examined textual information available on the Internet and potential means of providing access to this information. Highlights include an overview of Internet resources, a profile of a document sample, description of FTP (File Transfer Protocol) sites, and an automated method of categorizing files. (MES)

Social bonds and internet pornographic exposure among adolescents.

PubMed

Mesch, Gustavo S

2009-06-01

Concern has grown regarding possible harm to the social and psychological development of children and adolescents exposed to Internet pornography. Parents, academics and researchers have documented pornography from the supply side, assuming that its availability explains consumption satisfactorily. The current paper explored the user's dimension, probing whether pornography consumers differed from other Internet users, as well as the social characteristics of adolescent frequent pornography consumers. Data from a 2004 survey of a national representative sample of the adolescent population in Israel were used (n=998). Adolescent frequent users of the Internet for pornography were found to differ in many social characteristics from the group that used the Internet for information, social communication and entertainment. Weak ties to mainstream social institutions were characteristic of the former group but not of the latter. X-rated material consumers proved to be a distinct sub-group at risk of deviant behaviour.

[How does our specialty present itself on the Internet?].

PubMed

Rechenberg, U; Josten, C; Grüner, S; Klima, S

2013-08-01

The huge amount of information on the internet about orthopaedic and trauma surgical issues is very often unclear and hard to control in reliability, autonomy and expertise. The aim of this work is to evaluate German-speaking internet sites with orthopaedic and trauma surgical contents. Over a period of two months (from May to June) in 2012 different websites about 20 common orthopaedic and trauma surgical diseases were analysed on the internet by Google search engine. The first ten search results were evaluated for the HON code principles (Health On the Net Foundation). Furthermore there was an evaluation about qualification of the first 50 websites. The best 1,000 placed websites on Google were analysed for the authoritative value: academic, commercial, media, non-medical, physicians, non-profit and miscellaneous. Only 194 from 200 websites could be evaluated by the HON code principles. Overall 188 websites complied the principle of transparency, followed by privacy with 150 sites and authoritative with 134 sites. Only 90 websites give information about financial disclosure. Medical articles of the website Wikipedia appear most frequently. In the second part of this work it is shown that non-profit sites and sites by physicians are the most frequent. The fewest results are given by academic and commercial sites with 93 and 85 online hits. In summary, it is shown that most of the websites about medical information have inadequate quality. This statement is in accord with some U. S. American publications. It is clear that Wikipedia has a top-ranking on the internet when it is about medical information. Wikipedia almost achieves all of the HON code principles. It is possible to give better medical online information about orthopaedic and trauma surgical issues published by professionals. Georg Thieme Verlag KG Stuttgart · New York.

A telemedicine system for wireless home healthcare based on Bluetooth and the Internet.

PubMed

Zhao, Xiaoming; Fei, Ding-Yu; Doarn, Charles R; Harnett, Brett; Merrell, Ronald

2004-01-01

The VitalPoll Telemedicine System (VTS) was designed and developed for wireless home healthcare. The aims of this study were: to design the architecture and communication methods for a telemedicine system; to implement a physiologic routing hub to collect data from different medical devices and sensors; and to evaluate the feasibility of this system for applications in wireless home healthcare. The VTS was built using Bluetooth wireless and Internet technologies with client/server architecture. Several medical devices, which acquire vital signs, such as real-time electrocardiogram signals, heart rate, body temperature, and activity (physical motion), were integrated into the VTS. Medical information and data were transmitted over short-range interface (USB, RS232), wireless communication, and the Internet. The medical results were stored in a database and presented using a web browser. The patient's vital signals can be collected, transmitted, and displayed in real time by the VTS. The experiments verified no data loss during Bluetooth and Internet communication. Bluetooth and the Internet provide enough bandwidth channels to tranmit these vital signs. The experimental results show that VTS may be suitable for a practical telemedicine system in home healthcare.

39 CFR 3001.9 - Filing of documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Commission, or by direction of the presiding officer shall be made using the Internet (Filing Online... 20268-0001 during regular business hours on a date no later than that specified for such filing. (b) Account holder. In order for a document to be accepted using Filing Online, it must be submitted to the...

Medical technology at home: safety-related items in technical documentation.

PubMed

Hilbers, Ellen S M; de Vries, Claudette G J C A; Geertsma, Robert E

2013-01-01

This study aimed to investigate the technical documentation of manufacturers on issues of safe use of their device in a home setting. Three categories of equipment were selected: infusion pumps, ventilators, and dialysis systems. Risk analyses, instructions for use, labels, and post market surveillance procedures were requested from manufacturers. Additionally, they were asked to fill out a questionnaire on collection of field experience, on incidents, and training activities. Specific risks of device operation by lay users in a home setting were incompletely addressed in the risk analyses. A substantial number of user manuals were designed for professionals, rather than for patients or lay carers. Risk analyses and user information often showed incomplete coherence. Post market surveillance was mainly based on passive collection of field experiences. Manufacturers of infusion pumps, ventilators, and dialysis systems pay insufficient attention to the specific risks of use by lay persons in home settings. It is expected that this conclusion is also applicable for other medical equipment for treatment at home. Manufacturers of medical equipment for home use should pay more attention to use errors, lay use and home-specific risks in design, risk analysis, and user information. Field experiences should be collected more actively. Coherence between risk analysis and user information should be improved. Notified bodies should address these aspects in their assessment. User manuals issued by institutions supervising a specific home therapy should be drawn up in consultation with the manufacturer.

A guideline to medical photography: a perspective on digital photography in an orthopaedic setting.

PubMed

de Meijer, P P G; Karlsson, J; LaPrade, R F; Verhaar, J A N; Wijdicks, C A

2012-12-01

Quality photographs are essential for clinical documentation, research, and publication in scientific journals and teaching. Oftentimes, non-ideal lighting and a sterile environment restrict the medical photographer, resulting in lower-quality photographs. This article aims to provide a clear and comprehensible guideline for medical photography in an orthopaedic setting. This article is based on extensive photographic involvement in operating and laboratory settings, in close collaboration with medical professionals from the Steadman Clinic (Vail, Colorado, USA), Gothenburg University (Göteborg, Sweden) and Erasmus MC (Rotterdam, the Netherlands). Background literature was searched through Google Scholar and PubMed. Three relevant journal articles, and one book on medical photography, were used to write this paper. Seventeen Internet articles were used for background information. A relevant, up-to-date and comprehensive guideline to medical photography for medical professionals, with or without photographic experience, is provided. Expert opinion, Level V.

Internet Resources for Civic Educators. ERIC Digest.

ERIC Educational Resources Information Center

Pinhey, Laura A.

The Internet is an important resource for K-12 citizenship education teachers. Curriculum guides, lesson plans, government documents, conference proceedings, databases, photographs, and multimedia files provide the classroom teacher with a variety of materials including many primary sources. An annotated list of 15 World Wide Web sites are…

Digital discrimination: Political bias in Internet service provision across ethnic groups.

PubMed

Weidmann, Nils B; Benitez-Baleato, Suso; Hunziker, Philipp; Glatz, Eduard; Dimitropoulos, Xenofontas

2016-09-09

The global expansion of the Internet is frequently associated with increased government transparency, political rights, and democracy. However, this assumption depends on marginalized groups getting access in the first place. Here we document a strong and persistent political bias in the allocation of Internet coverage across ethnic groups worldwide. Using estimates of Internet penetration obtained through network measurements, we show that politically excluded groups suffer from significantly lower Internet penetration rates compared with those in power, an effect that cannot be explained by economic or geographic factors. Our findings underline one of the central impediments to "liberation technology," which is that governments still play a key role in the allocation of the Internet and can, intentionally or not, sabotage its liberating effects. Copyright © 2016, American Association for the Advancement of Science.

[Evaluation of an internet site on evidence-based medicine].

PubMed

Mathys, J; Steurer, J

2000-10-19

The present study evaluated a Swiss internet provider of Evidence-based Medicine (EBM) with regard to its utilization and function for medical practitioners. The internet provider under study (www.evimed.ch) primarily provides abstracts of original articles relevant to medical practice that are presented according to the criteria of EBM and includes information about EBM itself. In March 1999 a survey was conducted to better appraise the benefits gained from the information provided from the website visitors' point of view. Around 400 persons who had entered their names in the homepage guest book were informed about the survey by e-mail. A total of 167 questionnaires were filled in online, which is equivalent to the reply rate of close to 42%. The majority of the replies (63.5%) were from private-practice physicians, 22.2% from hospital-based physicians. The average age ranged between 40 and 49 years. 67.7% of the 167 respondents had internet access at their workplace, 72.5% had private internet access. For their own practical work, 61.1% of the respondents rated the information provided by www.evimed.ch as generally useful. The clinical relevance of the studies presented in the Journal Club was rated as good by 55.7% and as very good by 26.9%. The reliability of the information provided was rated as good by 56.3% and as very good by 35.3%. The majority regarded the following homepage sites as personally important: Journal Club (55.7%), articles about EBM (46.1%), MEDLINE access (37.7%) and article citations/links (41.3%). The homepage was visited at an average frequency of 1-3 times a month. 50.3% preferred electronic media (40.1% using various internet providers, 10.2% www.evimed.ch) and 44.3% preferred print media to search for specialist information on a specific medical subject. With regard to new medical findings, 44.9% of the respondents stated that they used print media, 17.4% the www.evimed.ch homepage and 28.7% other internet sources as their primary

Sildenafil and the Internet.

PubMed

Kahan, S E; Seftel, A D; Resnick, M I

2000-03-01

The Internet is changing the way medicine is being practiced and challenging our notions of the doctor-patient relationship. We analyze the development of online prescriptions and propose guidelines for the sale of sildenafil over the Internet. Using MEDLINE, Medscape and Lexis-Nexis search engines we reviewed pertinent materials from January 1996 to July 1999 focusing on the keywords Viagra, prescription and Internet. The review included press releases, law review articles, case law, medical literature, pending litigation, proposed legislation, and federal and state statutes. Online prescriptions are an outgrowth of the mail order drug business. This development continues the historic innovations in communications and transportation that have enabled physicians to practice medicine over long distances while maintaining ties to hospitals and other specialists. While the sale of sildenafil over the Internet may be profitable and convenient, it raises a variety of legal, ethical and safety concerns. Many federal and state organizations have addressed the issue without establishing a clear standard. A clear distinction exists between online prescriptions and pharmacies. While it may be acceptable for sildenafil to be sold over the Internet given current technologies, it must be done within the confines of a traditional doctor-patient relationship. Online prescriptions must be limited to patients who live in states in which the prescribing physician is licensed. Failure to establish a doctor patient relationship in this context breeches ethical standards, and may give rise to potential civil and criminal liabilities.

Usability and Navigability of an HIV/AIDS Internet Intervention for Adolescents in a Resource Limited Setting

PubMed Central

Ybarra, Michele; Biringi, Ruth; Prescott, Tonya; Bull, Sheana S.

2012-01-01

Use of Internet is growing in Sub Saharan Africa. Evidence of computer and Internet effectiveness for reduction in risk behaviors associated with HIV shown in U.S. settings has yet to be replicated in Africa. We describe the development, usability and navigability testing of an Internet-based HIV prevention program for secondary school students in Uganda, called CyberSenga. For this work, we used four data collection activities, including observation of (a) computer skills and (b) navigation, (c) focus group discussions, and (d) field assessments to document comprehension and usability of program content. We document limited skills among students, but youth with basic computers skills were able to navigate the program after instruction. Youth were most interested in activities with more interaction. Field-testing illustrated the importance of using a stand-alone electrical source during program delivery. This work suggests delivery of Internet-based health promotion content in Africa requires attention to user preparedness and literacy, bandwidth, Internet connection, and electricity. PMID:22918136

Value of the internet in emergency response.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Herzenberg, C. L.; Newsom, D. E.; Swietlik, C. E.

1999-05-26

Can the Internet be of value in emergency response? The answer is yes, judging by its use in the Kobe earthquake in Japan in 1995, ice storms in the US and Canada in 1998, and other disasters. Current and future areas of application are numerous, including exchanging messages, documents, and data files via e-mail; accessing operational data on-line; visualizing events via photos and maps; providing backup communications in lieu of broadcast media, exchanging information between crisis managers and responders; and providing information to media and the public. However, the Internet has some drawbacks, such as hardware/software requirements, computer literacy requirements,more » traffic jams, dependence on power and communication networks, and risks to information integrity and security. This paper examines some of the advantages, drawbacks, concerns, and potential uses of the Internet for emergency response.« less

Use of the Internet by women seeking information about potentially teratogenic agents.

PubMed

De Santis, Marco; De Luca, Carmen; Quattrocchi, Tomasella; Visconti, Daniela; Cesari, Elena; Mappa, Ilenia; Nobili, Elena; Spagnuolo, Terryann; Caruso, Alessandro

2010-08-01

The aim of this study was to evaluate if the Internet provides evidence-based information to women seeking information about teratogenic risk factors and women's risk perception. Furthermore, we evaluated the possible risk related to teratogen exposure in the study sample and analysed age, gravidity, educational level, geographic location, marital status and type of exposure compared to a control group made up of women who did not use the Internet to search for teratogen-related information. Between October 2008 and June 2009, a questionnaire was administered to pregnant women calling our Teratology Information Service concerning a suspected teratogenic exposure. Fifty-seven percent (n=116) of callers had used the Internet to find medical information about their exposure, while 43% (n=87) had not. Internet users had a medium-high level of education and consulted the Internet because of its convenience, usually early in their pregnancy. We verified the accuracy of the information the women obtained from the Internet and found that 59.5% (n=69) of women received evidence-based answers; 18.1% (n=21) were informed that their exposure was dangerous when it was not; 4.3% (n=5) were wrongly reassured; and the rest (n=18) were not able to interpret the data they found or found no relevant information. Internet use during pregnancy is a widespread phenomenon as the Internet offers the opportunity to share apprehensions and doubts with other women, but it can often lead to increased and unjustified anxiety. Medical information published on websites cannot be considered a substitute for informed medical advice, and patients should not take any action before consulting with a health care professional. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Digital health care--the convergence of health care and the Internet.

PubMed

Frank, S R

2000-04-01

The author believes that interactive media (the Internet and the World Wide Web) and associated applications used to access those media (portals, browsers, specialized Web-based applications) will result in a substantial, positive, and measurable impact on medical care faster than any previous information technology or communications tool. Acknowledging the dynamic environment, the author classifies "pure" digital health care companies into three business service areas: content, connectivity, and commerce. Companies offering these services are attempting to tap into a host of different markets within the health care industry including providers, payers, pharmaceutical and medical products companies, employers, distributors, and consumers. As the fastest growing medium in history, and given the unique nature of health care information and the tremendous demand for content among industry professionals and consumers, the Internet offers a more robust and targeted direct marketing opportunity than traditional media. From the medical consumer's standpoint (i.e., the patient) the author sees the Internet as performing five critical functions: (1) Disseminate information, (2) Aid informed decision making, (3) Promote health, (4) Provide a means for information exchange and support--the community concept, and (5) Increase self-care and manage demand for health services, lowering direct medical costs. The author firmly submits the Web will provide overall benefits to the health care economy as health information consumers manage their own health problems that might not directly benefit from an encounter with a health professional. Marrying the Internet to other interactive technologies, including voice recognition systems and telephone-based triage lines among others, holds the promise of reducing unnecessary medical services.

Desiderata for product labeling of medical expert systems.

PubMed

Geissbühler, A; Miller, R A

1997-12-01

The proliferation and increasing complexity of medical expert systems raise ethical and legal concerns about the ability of practitioners to protect their patients from defective or misused software. Appropriate product labeling of expert systems can help clinical users to understand software indications and limitations. Mechanisms of action and knowledge representation schema should be explained in layperson's terminology. User qualifications and resources available for acquiring the skills necessary to understand and critique the system output should be listed. The processes used for building and maintaining the system's knowledge base are key determinants of the product's quality, and should be carefully documented. To meet these desiderata, a printed label is insufficient. The authors suggest a new, more active, model of product labeling for medical expert systems that involves embedding 'knowledge of the knowledge base', creating user-specific data, and sharing global information using the Internet.

The prevalence of obesity documentation in Primary Care Electronic Medical Records. Are we acknowledging the problem?

PubMed

Mattar, Ahmed; Carlston, David; Sariol, Glen; Yu, Tongle; Almustafa, Ahmad; Melton, Genevieve B; Ahmed, Adil

2017-01-25

Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese.

Drug related problems with Antiparkinsonian agents: consumer Internet reports versus published data.

PubMed

Schröder, Sabrina; Zöllner, York Francis; Schaefer, Marion

2007-10-01

There is currently a lack of detailed information concerning drug related problems in the outpatient treatment of Parkinson's disease. Problems associated with drug treatment communicated anonymously in Parkinson's disease online forums were therefore retrospectively searched and documented for 1 year. Based on postings concerning 12 drugs for the treatment of Parkinson's disease, a total of 238 drug related problems were identified and categorised using the Problem Intervention Documentation (PI-Doc). Of these, 153 were adverse drug reactions. Adverse drug reactions associated with the skin were relatively common, but central effects such as cognitive or psychiatric changes, effects on the sleep/waking system and other problems like headache and dizziness accounted for the highest percentage of adverse events. A comparison with data from scientific literature revealed a number of differences. This means that an analysis of online forums detected a number of drug related problems that were otherwise largely invisible. These were mainly associated with the qualitative aspects of treatment such as medication handling, dosage and individual problems concerning adverse events. In addition, the described method of identifying and classifying drug related problems in Internet forums may also be seen as a contribution to the international discussion about consumer reports and pharmacovigilance. The information about adverse drug reactions given by Internet users can be seen as a valuable adjunct to clinical trial data and as being very timely with regard to the event itself. Online forums may be considered as a suitable source of observational information to complement data from randomised clinical trials.

Internet 2 Health Sciences Initiative.

ERIC Educational Resources Information Center

Simco, Greg

2003-01-01

The Internet 2 (I2) health sciences initiative (I2HSI) involves the formulation of applications and supporting technologies, and guidelines for their use in the health sciences. Key elements of I2HSI include use of visualization, collaboration, medical informatics, telemedicine, and educational tools that support the health sciences. Specific…

History, structure, and function of the Internet.

PubMed

Glowniak, J

1998-04-01

The Internet stands at the forefront of telecommunications in medicine. This worldwide system of computers had its beginnings in networking projects in the United States and western Europe in the 1960s and 1970s. The precursor of the Internet was ARPANET, a long-distance telecommunication network funded by the Department of Defense that linked together computers throughout the United States. In the 1980s, ARPANET was superseded by NSFNET, a series of networks created by the National Science Foundation, which established the present-day structure of the Internet. The physical structure of the Internet resembles and is integrated with the telephone system. Long-distance data transport services are provided by large telecommunication companies, called network service providers (NSPs), through high-capacity, high-speed national and international fiber optic cables. These transport services are accessed through Internet service providers, ISPs. ISPs, the equivalent of regional Bell operating companies, provide the physical link to the NSPs for individuals and organizations. Telecommunications on the Internet are standardized by a set of communications protocols, the TCP/IP protocol suite, that describe routing of messages over the Internet, computer naming conventions, and commonly used Internet services such as e-mail. At present, the Internet consists of over 20 million computer worldwide and is continuing to grow at a rapid rate. Along with the growth of the Internet, higher speed access methods are offering a range of new services such as real-time video and voice communications. Medical education, teaching, and research, as well as clinical practice, will be affected in numerous different ways by these advances.

Radiation therapy and internet - what can patients expect? homepage analysis of german radiotherapy institutions.

PubMed

Janssen, Stefan; Meyer, Andreas; Vordermark, Dirk; Steinmann, Diana

2010-12-01

the internet as a source of medical information has emerged during the last years. There is a confusing amount of medical websites with a great diversity of quality. Websites of radiotherapy institutions could offer a safe and an easy-to-control way to assist patients' requests. 205 internet appearances of German radiotherapy institutions were analyzed in June 2009 (nonuniversity hospitals n = 108, medical practices n = 62, university hospitals n = 35). For the evaluation of each homepage verifiable criteria concerning basic information, service and medical issues were used. the quality of information published via internet by different radiotherapy institutions showed a large variety. Basic information like telephone numbers, operating hours, and direction guidance were provided in 96.7%, 40%, and 50.7%, respectively. 85% of the websites introduced the staff, 50.2% supplied photos and 14% further information on the attending physicians. The mean amount of continuative links to other websites was 5.4, the mean amount of articles supplying medical information for patients summed up to 4.6. Medical practices and university hospitals had statistically significant more informative articles and links to other websites than nonuniversity hospitals. No statistically significant differences could be found in most other categories like service issues and basic information. internet presences of radiotherapy institutions hold the chance to supply patients with professional and individualized medical information. While some websites are already using this opportunity, others show a lack of basic information or of user-friendliness.

The more it changes; the more it remains the same: a Foucauldian analysis of Canadian policy documents relevant to student selection for medical school.

PubMed

Razack, Saleem; Lessard, David; Hodges, Brian D; Maguire, Mary H; Steinert, Yvonne

2014-05-01

Calls to increase the demographic representativeness of medical classes to better reflect the diversity of society are part of a growing international trend. Despite this, entry into medical school remains highly competitive and exclusive of marginalized groups. To address these questions, we conducted a Foucauldian discourse analysis of 15 publically available policy documents from the websites of Canadian medical education regulatory bodies, using the concepts of "excellence" (institutional or in an applicant), "diversity," and "equity" to frame the analysis. In most documents, there were appeals to broaden definitions of institutional excellence to include concerns for greater social accountability. Equity concerns tended to be represented as needing to be dealt with by people in positions of authority in order to counter a "hidden curriculum." Diversity was represented as an object of value, situated within a discontinuous history. As a rhetorical strategy, documents invoked complex societal shifts to promote change toward a more humanistic medical education system and profession. "Social accountability" was reified as an all-encompassing solution to most issues of representation. Although the policy documents proclaimed rootedness in an ethos of improving the societal responsiveness of the medical profession, our analysis takes a more critical stance towards the discourses identified. On the basis of our research findings, we question whether these calls may contribute to the maintenance of the specific power relations they seek to address. These conclusions lead us to consider the possibility that the discourses represented in the documents might be reframed to take into account issues of power distribution and its productive and reproductive features. A reframing of discourses could potentially generate greater inclusiveness in policy development processes, and afford disadvantaged and marginalized groups more participatory roles in the discussion.

Gstruct: a system for extracting schemas from GML documents

NASA Astrophysics Data System (ADS)

Chen, Hui; Zhu, Fubao; Guan, Jihong; Zhou, Shuigeng

2008-10-01

Geography Markup Language (GML) becomes the de facto standard for geographic information representation on the internet. GML schema provides a way to define the structure, content, and semantic of GML documents. It contains useful structural information of GML documents and plays an important role in storing, querying and analyzing GML data. However, GML schema is not mandatory, and it is common that a GML document contains no schema. In this paper, we present Gstruct, a tool for GML schema extraction. Gstruct finds the features in the input GML documents, identifies geometry datatypes as well as simple datatypes, then integrates all these features and eliminates improper components to output the optimal schema. Experiments demonstrate that Gstruct is effective in extracting semantically meaningful schemas from GML documents.

Analysis of Internet information on the controversial X-Stop device.

PubMed

Anderson, Joshua T; Sullivan, T Barrett; Ahn, Uri M; Ahn, Nicholas U

2014-10-01

The Internet is frequently used by patients to aid in medical decision making. Multiple studies display the Internet's ineffectiveness in presenting high-quality information regarding surgical procedures and devices. With recent reports of unacceptably high complication rates and poor outcomes with the X-Stop device, it is important that online information is comprehensive and accurate. This study is the first to examine Internet information on the controversial X-Stop. To determine how accurately public information over the Internet portrays the existing primary literature on the X-Stop, how extensively the X-Stop is characterized online, and how patient decision making could foreseeably be affected. This cross-sectional study analyzed publicly available Internet information, including videos on the web site YouTube regarding the X-Stop device. No patients were involved in this study. No specific outcome measures were used. Search engines Google, Yahoo, and Bing were used to identify 105 web sites providing information on the X-Stop. Videos on the web site YouTube were included. Web sites were categorized based on the authorship. Each site was analyzed for the provision of appropriate patient inclusion and exclusion criteria, surgical and nonsurgical treatment alternatives, purported benefits, common complications, peer-reviewed literature citations, and descriptions/diagrams of the procedure. Data were evaluated for each authorship subgroup and the entire group of sites. Forty-three percent of sites were authored by a private medical group, 4% by an academic medical group, 16% by an insurance company, 9% by a biomedical industry, 10% by news sources, and 19% by other. Thirty-one percent of web sites and 11% of sites authored by private medical groups contained references to peer-reviewed literature. Fifty-six percent of web sites reported patient inclusion criteria, whereas 33% reported exclusion criteria. Benefits and complications were reported within 91% and

[Psychiatry and psychotherapy on the internet. Current overview].

PubMed

Seemann, O; Soyka, M

1999-01-01

The Internet is a fast growing medium, which is about to alter our all day life. Most impact is given to advantages of telemedicine to psychiatrists and psychotherapists as well as patients. After introduction of the essential features of the Internet practical aspects of medicine in Cyberspace for psychotherapists, psychiatrists and their patients are shown. Then, the general prohibition of advertisement for physicians is discussed on the bases of actual laws related to Internet activities. Relevant resources of medical information are shown with regard to the detailed facilities of using search engines. Highlighting opportunities and possible resources of medicine in cyberspace, it is made clear, that the rising interest in telemedicine on Internet is more than justified. Finally, some risks of virtual communication are visible. Important and mentioned Web-sites are listed at the end.

Internet Patient Records: new techniques

PubMed Central

Moehrs, Sascha; Anedda, Paolo; Tuveri, Massimiliano; Zanetti, Gianluigi

2001-01-01

Background The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article - XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans - may significantly reduce the complexity of the development of distributed healthcare systems. Objective The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists. Methods We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is

Healthcare organizations and the Internet: impact on federal tax exemption.

PubMed

Woods, LaVerne; Osborne, Michele

2002-01-01

Tax-exempt healthcare organizations have turned to the Internet as a powerful tool in communicating with the public, medical staff, and patients. Activities as diverse as providing links to the Web sites of other organizations, selling goods and services, soliciting contributions, and hosting forums on the Internet raise unresolved questions concerning the impact of Internet use on such organizations' tax-exempt status. The Internal Revenue Service has provided no guidance to date regarding the manner in which a nonprofit organizations' use of the Internet may affect its tax-exempt status or subject it to federal income tax on some sources of funds. This article suggests analytical approaches for applying existing law in the Internet context and identifies areas that are ripe for additional guidance.

Dysfunctional internet behaviour symptoms in association with personality traits.

PubMed

Tsiolka, E; Bergiannaki, I D; Margariti, M; Malliori, M; Papageorgiou, Ch

2017-01-01

Internet addiction is a matter of great interest for researchers, taking into consideration Internet's rapid spread and its ever growing use in children, adolescents and adults. It has been associated with multiple psychological symptoms and social difficulties, therefore raising even greater concerns for its adverse consequences. The present study that consists part of a broader research, aims to investigate the association between excessive Internet use and personality traits in an adult population. Specifically, the research examined the relation between dysfunctional internet behaviour and personality traits as neuroticism and extraversion, the two personality dimensions that have arisen as the most important ones in all relevant research. Our main hypotheses are that dysfunctional internet behaviour would be positively associated with neuroticism but negatively linked to extraversion. The 1211 participants aged over 18 years, completed the IAT (Internet Addiction Test) by Kimberly Young and the Eysenck Personality Questionnaire (EPQ) and some other questionnaires detecting psychopathology. Additionally, part of the administered questionnaires concerned socio-demographic characteristics of the participant subjects: specifically sex, age, marital status, education (educational years), place of residence -urban, semi-urban and rural-, whether they suffer from somatic or mental health disorder and if they take medication for any of the above categories. All the questionnaires have been electronically completed by each participant. Results showed that 7.7% showed dysfunctional internet behaviour that concerns both medium and severe degree of dependence by the use of Internet, as measured by the use of IAT. The univariate logistic regression analysis revealed that the individuals exhibiting symptoms of dysfunctional internet behaviour were more likely to suffer from a chronic mental health disorder, to use psychotropic medication and to score higher on neuroticism

How do eHealth Programs for Adolescents With Depression Work? A Realist Review of Persuasive System Design Components in Internet-Based Psychological Therapies.

PubMed

Wozney, Lori; Huguet, Anna; Bennett, Kathryn; Radomski, Ashley D; Hartling, Lisa; Dyson, Michele; McGrath, Patrick J; Newton, Amanda S

2017-08-09

Major depressive disorders are common among adolescents and can impact all aspects of their daily life. Traditional therapies, cognitive behavioral therapy (CBT), and interpersonal psychotherapy (IPT) have been delivered face-to-face. However, Internet-based (online) delivery of these therapies is emerging as an option for adolescents. Internet-based CBT and IPT involve therapeutic content, interaction between the user and the system, and different technological features embedded into the online program (eg, multimedia). Studies of Internet-based CBT and IPT for adolescent depression differ on all three aspects, and variable, positive therapy effects have been reported. A better understanding of the treatment conditions that influence therapy outcomes is important to designing and evaluating these novel therapies. Our aim was to examine the technological and program delivery features of Internet-based CBT and IPT for adolescent depression and to document their potential relation to treatment outcomes and program use. We performed a realist synthesis. We started with an extensive search of published and gray literature. We included intervention studies that evaluated Internet-based CBT or IPT for adolescent depression. We included mixed-methods and qualitative studies, theoretical papers, and policy/implementation documents if they included a focus on how Internet-based psychological therapy is proposed to work for adolescents with depression/depressive symptoms. We used the Mixed-Methods Appraisal Tool to assess the methodological quality of studies. We used the Persuasive System Design (PSD) model as a framework for data extraction and analysis to examine how Internet-based CBT and IPT, as technology-based systems, influence the attitudes and behaviors of system users. PSD components described for the therapies were linked to reported outcomes using a cross-case comparison method and thematic synthesis. We identified 19 Internet-based CBT programs in 59 documents

Prescription drugs purchased through the internet: who are the end users?

PubMed

Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Rosenblum, Andrew; Ahwah, Candice; Bailey, J Elise; Dart, Richard C; Burke, John J

2010-07-01

Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of "end users" of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Prescription drugs purchased through the internet: Who are the end users?

PubMed Central

Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Rosenblum, Andrew; Ahwah, Candice; Bailey, J. Elise; Dart, Richard C.; Burke, John J.

2012-01-01

Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of “end users” of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS® (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs. PMID:20227199

Evaluation of an internet-based aftercare program to improve vocational reintegration after inpatient medical rehabilitation: study protocol for a cluster-randomized controlled trial.

PubMed

Zwerenz, Rüdiger; Gerzymisch, Katharina; Edinger, Jens; Holme, Martin; Knickenberg, Rudolf J; Spörl-Dönch, Sieglinde; Kiwus, Ulrich; Beutel, Manfred E

2013-01-25

Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation. Vocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up. We expect the intervention group to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation. International Standard Randomised Controlled Trial Number Register (ISRCTN:ISRCTN33957202).

[Disease management programs in Germany: Validity of the medical documentation].

PubMed

Linder, R; Horenkamp-Sonntag, D; Engel, S; Köppel, D; Heilmann, T; Verheyen, F

2014-01-01

The specific documentation for disease management programs (DMP) in Germany with respect to § 137 Social Code Book V is the basis for evaluating the DMP. DMP run up costs of the order of a billion euro without assessing evidence-based benefit so far. Aim of this study was to question if and to which extent this documentation may be suitable for reliable quality assurance in its present form. Data of nearly 300000 insured persons of a German Statutory Health Insurance (Techniker Krankenkasse, TK) which were continuously registered from July 1st 2009 until December 31st 2010 in a DMP were analyzed. We analyzed how items which were components of claims data and of DMP documentation were matched. With regard to prescriptions there were some considerable differences. Prescription of glibenclamid was documented twice as frequently in the DMP documentation compared to prescriptions filled in pharmacies. Only a fraction of emergency hospitalizations documented in the claims data were found in the DMP documentation. Investigations of the fundus oculi for diabetics are mentioned three times more frequently in the DMP documentation than they are accounted by ophthalmologists. There are considerable differences between claims data and DMP specific documentation. The latter shows a plainly reduced validity for investigated fields in the documentation forms. Reasons for this are manifold. Former evaluations of DM Ps carried out just on the basis of DMP documentation are thus highly questionable. Therefore, the DMPs themselves and their documentation have to be reformed. © Georg Thieme Verlag KG Stuttgart · New York.

Possibilities and limits of Internet-based registers.

PubMed

Wild, Michael; Candrian, Aron; Wenda, Klaus

2009-03-01

The Internet is an inexpensive platform for the investigation of medical questions in case of low prevalence. By accessing www.ao-nailregister.org, every interested participant may participate in the English-language survey of the complications specific to the femoral nail. The address data of the participant, the anonymised key data of the patients and the medical parameters are entered. In real time, these data are checked for plausibility, evaluated and published on the Internet where they are freely accessible immediately. Because of national differences, data acquisition caused considerable difficulties at the beginning. In addition, wrong data were entered because of linguistic or contextual misunderstandings. After having reworked the questionnaire completely, facilitating data input and implementing an automated plausibility check, these difficulties could be cleared. In a next step, the automatic evaluation of the data was implemented. Only very few data still have to be checked for plausibility manually to exclude wrong entries, which cannot be verified by the computer. The effort required for data acquisition and evaluation of the Internet-based femoral nail register was reduced distinctly. The possibility of free international participation as well as the freely accessible representation of the results offers transparency.

Medical student storytelling on an institutional blog: a case study analysis.

PubMed

Becker, Katherine A; Freberg, Karen

2014-05-01

Despite the proclivity and proliferation of blogs on the Internet, the use of blogs at medical institutions is not well documented. In examining the structured stories that medical students share with the digital community, we may better understand how students use institutional blogs to discuss their medical school experiences while maintaining their role as a medical student ambassador for the program. We conducted a case study to analyze the stories within 309 medical student blogs from one medical institution in the United States. In an attempt to communicate their experiences to different benefactors, student bloggers engaged in structured and personal storytelling. Structured stories offered medical school advice to prospective students, while personal stories embodied features of a personal diary where students recounted significant milestones, talked about personal relationships and engaged in emotional reflection and disclosure. Institutional blogs may provide social marketing for medical institutions, as students strategically framed their experiences to reflect a positive attitude about the medical institution and focused on providing advice to prospective students. Although these structured stories limit complete disclosure, students may still achieve benefits by engaging in emotional disclosure and personal reflection.

Beyond the MLA handbook : documenting electronic sources on the Internet.

DOT National Transportation Integrated Search

1996-11-25

Responding to the needs of writers, teachers, students, and scholars using the MLA style of documentation, : professional organizations and researchers are in the process of creating citation conventions that seek to : demonstrate efficient and unamb...

Usability test of an internet-based informatics tool for diabetes care providers: the comprehensive diabetes management program.

PubMed

Fonda, Stephanie J; Paulsen, Christine A; Perkins, Joan; Kedziora, Richard J; Rodbard, David; Bursell, Sven-Erik

2008-02-01

Research suggests Internet-based care management tools are associated with improvements in care and patient outcomes. However, although such tools change workflow, rarely is their usability addressed and reported. This article presents a usability study of an Internet-based informatics application called the Comprehensive Diabetes Management Program (CDMP), developed by content experts and technologists. Our aim is to demonstrate a process for conducting a usability study of such a tool and to report results. We conducted the usability test with six diabetes care providers under controlled conditions. Each provider worked with the CDMP in a single session using a "think aloud" process. Providers performed standardized tasks with fictitious patient data, and we observed how they approached these tasks, documenting verbalizations and subjective ratings. The providers then completed a usability questionnaire and interviews. Overall, the scores on the usability questionnaire were neutral to favorable. For specific subdomains of the questionnaire, the providers' reported problems with the application's ease of use, performance, and support features, but were satisfied with its visual appeal and content. The results from the observational and interview data indicated areas for improvement, particularly in navigation and terminology. The usability study identified several issues for improvement, confirming the need for usability testing of Internet-based informatics applications, even those developed by experts. To our knowledge, there have been no other usability studies of an Internet-based informatics application with the functionality of the CDMP. Such studies can form the foundation for translation of Internet-based medical informatics tools into clinical practice.

Social Bonds and Internet Pornographic Exposure among Adolescents

ERIC Educational Resources Information Center

Mesch, Gustavo S.

2009-01-01

Concern has grown regarding possible harm to the social and psychological development of children and adolescents exposed to Internet pornography. Parents, academics and researchers have documented pornography from the supply side, assuming that its availability explains consumption satisfactorily. The current paper explored the user's dimension,…

A Novel Internet Based Geriatric Education Program for Emergency Medical Services Providers

PubMed Central

Shah, Manish N.; Swanson, Peter A.; Nobay, Flavia; Peterson, Lars-Kristofer N.; Caprio, Thomas V.; Karuza, Jurgis

2012-01-01

Despite caring for large numbers of older adults, prehospital emergency medical services (EMS) providers receive minimal geriatrics-specific training while obtaining their certification. Studies have shown that they desire further training to improve their comfort level and knowledge in caring for older adults. However, continuing education programs to address these needs must account for each EMS provider's specific needs, consider each provider's learning styles, and provide an engaging, interactive experience. We developed and implemented a novel, internet-based, video podcast-based geriatric continuing education program for EMS providers and evaluated their perceived value of the program. They found this resource to be highly valuable and were strongly supportive of both the modality and the specific training provided. Technical challenges were reported by some as a barrier, as well as the inability to engage in a discussion to clarify topics. Both were felt to be addressable through programmatic and technological revisions. This study demonstrates the proof of concept of video podcast training to address deficiencies in EMS education regarding the care for older patients. However, further work is needed to demonstrate the educational impact of video podcasts on the knowledge and skills of trainees. PMID:22906239

[Design and Application of High-risk Pregnancy Monitoring & Warning Internet Platform Based on Internet of Things].

PubMed

Lu, Heqing; Zhang, Xiaofeng; Li, Bin

2017-09-30

Through illustrating the designing of high-risk pregnancy maternal-fetal monitoring system based on the internet of things, this paper introduced the specific application of using wearable medical devices to provide maternal-fetal mobile medical services. With the help of big data and cloud obstetrics platform, the monitoring and warning network was further improved, the level-to-level administration of high-risk pregnancy was realized, the level of perinatal health care was enhanced and the risk of critical emergency of pregnancy decreased.

First international telemedicine trial to China using the Internet

NASA Astrophysics Data System (ADS)

So, George J.; Li, Xin; Kangarloo, Hooshang; Steckel, Richard J.; Valentino, Daniel J.

1996-05-01

Recent advances in telecommunications via the Internet have significantly improved international communication. We report a case of teleconsultation using the World Wide Web (WWW) and related technologies on the internet to facilitate the successful diagnosis and treatment of a rare illness that occurred in Beijing, China. This case report demonstrates some of the advantages and disadvantages of using such a system to gather, to retrieve medical information, and to facilitate communication among physicians in different countries. It also demonstrates international teleconsultation using the internet and WWW is possible and effective in this case which saved this young student's life.

Internet Addiction and Antisocial Internet Behavior of Adolescents

PubMed Central

Ma, Hing Keung

2011-01-01

Internet addiction and the moral implication of antisocial Internet behavior will be investigated in this paper. More and more people use the Internet in their daily life. Unfortunately the percentage of people who use the internet excessively also increases. The concept of Internet addiction or pathological use of Internet is discussed in detail, and the characteristics of Internet addicts are also delineated. The social (especially the antisocial) use of Internet is discussed. It is argued that the behavior of Internet use is similar to daily life social behavior. In other words, Internet behavior is a kind of social behavior. Kohlberg's theory of moral development is employed to delineate the moral reasoning of the antisocial Internet behavior. The following behaviors are regarded as antisocial Internet behavior: (1) the use of Internet to carry out illegal activities such as selling faked products or offensive pornographic materials, (2) the use of Internet to bully others (i.e., cyberbullying) such as distributing libelous statements against a certain person, (3) the use of Internet to cheat others, and (4) the use of Internet to do illegal gambling. The characteristics of the moral stages that are associated with these antisocial Internet behaviors are investigated in detail. PMID:22125466

Internet Hospitals in China: Cross-Sectional Survey

PubMed Central

Lin, Lingyan; Fan, Si; Lin, Fen; Wang, Long; Guo, Tongjun; Ma, Chuyang; Zhang, Jingkun; Chen, Yixin

2017-01-01

Background The Internet hospital, an innovative approach to providing health care, is rapidly developing in China because it has the potential to provide widely accessible outpatient service delivery via Internet technologies. To date, China’s Internet hospitals have not been systematically investigated. Objective The aim of this study was to describe the characteristics of China’s Internet hospitals, and to assess their health service capacity. Methods We searched Baidu, the popular Chinese search engine, to identify Internet hospitals, using search terms such as “Internet hospital,” “web hospital,” or “cloud hospital.” All Internet hospitals in mainland China were eligible for inclusion if they were officially registered. Our search was carried out until March 31, 2017. Results We identified 68 Internet hospitals, of which 43 have been put into use and 25 were under construction. Of the 43 established Internet hospitals, 13 (30%) were in the hospital informatization stage, 24 (56%) were in the Web ward stage, and 6 (14%) were in full Internet hospital stage. Patients accessed outpatient service delivery via website (74%, 32/43), app (42%, 18/43), or offline medical consultation facility (37%, 16/43) from the Internet hospital. Furthermore, 25 (58%) of the Internet hospitals asked doctors to deliver health services at a specific Web clinic, whereas 18 (42%) did not. The consulting methods included video chat (60%, 26/43), telephone (19%, 8/43), and graphic message (28%, 12/43); 13 (30%) Internet hospitals cannot be consulted online any more. Only 6 Internet hospitals were included in the coverage of health insurance. The median number of doctors available online was zero (interquartile range [IQR] 0 to 5; max 16,492). The median consultation fee per time was ¥20 (approximately US $2.90, IQR ¥0 to ¥200). Conclusions Internet hospitals provide convenient outpatient service delivery. However, many of the Internet hospitals are not yet mature and

Improving and Measuring Inpatient Documentation of Medical Care within the MS-DRG System: Education, Monitoring, and Normalized Case Mix Index

PubMed Central

Rosenbaum, Benjamin P.; Lorenz, Robert R.; Luther, Ralph B.; Knowles-Ward, Lisa; Kelly, Dianne L.; Weil, Robert J.

2014-01-01

Documentation of the care delivered to hospitalized patients is a ubiquitous and important aspect of medical care. The majority of references to documentation and coding are based on the Centers for Medicare and Medicaid Services (CMS) Medicare Severity Diagnosis Related Group (MS-DRG) inpatient prospective payment system (IPPS). We educated the members of a clinical care team in a single department (neurosurgery) at our hospital. We measured subsequent documentation improvements in a simple, meaningful, and reproducible fashion. We created a new metric to measure documentation, termed the “normalized case mix index,” that allows comparison of hospitalizations across multiple unrelated MS-DRG groups. Compared to one year earlier, the traditional case mix index, normalized case mix index, severity of illness, and risk of mortality increased one year after the educational intervention. We encourage other organizations to implement and systematically monitor documentation improvement efforts when attempting to determine the accuracy and quality of documentation achieved. PMID:25214820

Improving and measuring inpatient documentation of medical care within the MS-DRG system: education, monitoring, and normalized case mix index.

PubMed

Rosenbaum, Benjamin P; Lorenz, Robert R; Luther, Ralph B; Knowles-Ward, Lisa; Kelly, Dianne L; Weil, Robert J

2014-01-01

Documentation of the care delivered to hospitalized patients is a ubiquitous and important aspect of medical care. The majority of references to documentation and coding are based on the Centers for Medicare and Medicaid Services (CMS) Medicare Severity Diagnosis Related Group (MS-DRG) inpatient prospective payment system (IPPS). We educated the members of a clinical care team in a single department (neurosurgery) at our hospital. We measured subsequent documentation improvements in a simple, meaningful, and reproducible fashion. We created a new metric to measure documentation, termed the "normalized case mix index," that allows comparison of hospitalizations across multiple unrelated MS-DRG groups. Compared to one year earlier, the traditional case mix index, normalized case mix index, severity of illness, and risk of mortality increased one year after the educational intervention. We encourage other organizations to implement and systematically monitor documentation improvement efforts when attempting to determine the accuracy and quality of documentation achieved.

Legal examination of physician advertising on the internet.

PubMed

Carroll, Jenny

2006-02-01

The Internet provides an invaluable resource to physicians seeking to market healthcare services to consumers. No longer considered an unethical practice, physician advertising has transformed over the years into an indispensable business tool in the medical community. While the Internet creates opportunities to reach vast numbers of individuals in a timely and cost-effective manner, physicians must be vigilant in adhering to laws, rules, and regulations designed to protect the public from false and deceptive practices.

Biomedical Publishing and the Internet

PubMed Central

Jacobson, Michael W.

2000-01-01

The Internet is challenging traditional publishing patterns. In the biomedical domain, medical journals are providing more and more content online, both free and for a fee. Beyond this, however, a number of commentators believe that traditional notions of copyright and intellectual property ownership are no longer suited to the information age and that ownership of copyright to research reports should be and will be wrested from publishers and returned to authors. In this paper, it is argued that, although the Internet will indeed profoundly affect the distribution of biomedical research results, the biomedical publishing industry is too intertwined with the research establishment and too powerful to fall prey to such a copyright revolution. PMID:10833159

A Conceptual Model for Multidimensional Analysis of Documents

NASA Astrophysics Data System (ADS)

Ravat, Franck; Teste, Olivier; Tournier, Ronan; Zurlfluh, Gilles

Data warehousing and OLAP are mainly used for the analysis of transactional data. Nowadays, with the evolution of Internet, and the development of semi-structured data exchange format (such as XML), it is possible to consider entire fragments of data such as documents as analysis sources. As a consequence, an adapted multidimensional analysis framework needs to be provided. In this paper, we introduce an OLAP multidimensional conceptual model without facts. This model is based on the unique concept of dimensions and is adapted for multidimensional document analysis. We also provide a set of manipulation operations.

Sale of prescription drugs over the Internet.

PubMed

Armstrong, K; Bloom, B S

1999-01-01

Online drugstores represent one of the hottest categories in electronic commerce. The Internet offers great promise in expanding access to prescription drugs for the disabled, the elderly, and people living in rural areas. But with this promise comes the danger of eliminating the safeguards that protect consumers from inappropriate use of medications and adverse drug events. This Issue Brief highlights two studies that investigate the availability of prescription drugs over the Internet, and focuses on the alarming ease with which consumers can obtain drugs without seeing a physician or a pharmacist.

14 CFR 302.4 - General requirements as to documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., along with the telephone and facsimile numbers and, if available, electronic mail address of that person... website. (3) All documents filed under this part consisting of twenty (20) or more pages must contain a... subscription requirements shall be those specified at the DOT DMS internet website. ...

14 CFR 302.4 - General requirements as to documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., along with the telephone and facsimile numbers and, if available, electronic mail address of that person... website. (3) All documents filed under this part consisting of twenty (20) or more pages must contain a... subscription requirements shall be those specified at the DOT DMS internet website. ...

14 CFR 302.4 - General requirements as to documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., along with the telephone and facsimile numbers and, if available, electronic mail address of that person... website. (3) All documents filed under this part consisting of twenty (20) or more pages must contain a... subscription requirements shall be those specified at the DOT DMS internet website. ...

Use of a secure Internet Web site for collaborative medical research.

PubMed

Marshall, W W; Haley, R W

2000-10-11

Researchers who collaborate on clinical research studies from diffuse locations need a convenient, inexpensive, secure way to record and manage data. The Internet, with its World Wide Web, provides a vast network that enables researchers with diverse types of computers and operating systems anywhere in the world to log data through a common interface. Development of a Web site for scientific data collection can be organized into 10 steps, including planning the scientific database, choosing a database management software system, setting up database tables for each collaborator's variables, developing the Web site's screen layout, choosing a middleware software system to tie the database software to the Web site interface, embedding data editing and calculation routines, setting up the database on the central server computer, obtaining a unique Internet address and name for the Web site, applying security measures to the site, and training staff who enter data. Ensuring the security of an Internet database requires limiting the number of people who have access to the server, setting up the server on a stand-alone computer, requiring user-name and password authentication for server and Web site access, installing a firewall computer to prevent break-ins and block bogus information from reaching the server, verifying the identity of the server and client computers with certification from a certificate authority, encrypting information sent between server and client computers to avoid eavesdropping, establishing audit trails to record all accesses into the Web site, and educating Web site users about security techniques. When these measures are carefully undertaken, in our experience, information for scientific studies can be collected and maintained on Internet databases more efficiently and securely than through conventional systems of paper records protected by filing cabinets and locked doors. JAMA. 2000;284:1843-1849.

Managing the life cycle of electronic clinical documents.

PubMed

Payne, Thomas H; Graham, Gail

2006-01-01

To develop a model of the life cycle of clinical documents from inception to use in a person's medical record, including workflow requirements from clinical practice, local policy, and regulation. We propose a model for the life cycle of clinical documents as a framework for research on documentation within electronic medical record (EMR) systems. Our proposed model includes three axes: the stages of the document, the roles of those involved with the document, and the actions those involved may take on the document at each stage. The model includes the rules to describe who (in what role) can perform what actions on the document, and at what stages they can perform them. Rules are derived from needs of clinicians, and requirements of hospital bylaws and regulators. Our model encompasses current practices for paper medical records and workflow in some EMR systems. Commercial EMR systems include methods for implementing document workflow rules. Workflow rules that are part of this model mirror functionality in the Department of Veterans Affairs (VA) EMR system where the Authorization/ Subscription Utility permits document life cycle rules to be written in English-like fashion. Creating a model of the life cycle of clinical documents serves as a framework for discussion of document workflow, how rules governing workflow can be implemented in EMR systems, and future research of electronic documentation.