Science.gov

Sample records for medication management system

  1. Medical Information Management System

    NASA Technical Reports Server (NTRS)

    Alterescu, S.; Hipkins, K. R.; Friedman, C. A.

    1979-01-01

    On-line interactive information processing system easily and rapidly handles all aspects of data management related to patient care. General purpose system is flexible enough to be applied to other data management situations found in areas such as occupational safety data, judicial information, or personnel records.

  2. Medical-Information-Management System

    NASA Technical Reports Server (NTRS)

    Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

    1989-01-01

    Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

  3. MIMS - MEDICAL INFORMATION MANAGEMENT SYSTEM

    NASA Technical Reports Server (NTRS)

    Frankowski, J. W.

    1994-01-01

    MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.

  4. [A medical consumable material management information system].

    PubMed

    Tang, Guoping; Hu, Liang

    2014-05-01

    Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process. PMID:25241525

  5. Purchasing a decentralized medication management system.

    PubMed

    2006-03-01

    Decentralized medication management systems (DMMSs) are used in hospitals, long-term care facilities, prisons, outpatient clinics, surgery centers, and other places to manage the distribution of drugs. DMMSs consist of storage compartments for medications, with an internal computer that controls and records the administration of drugs. Some DMMSs are stationary cabinets and others are mobile carts. There have been important advances in DMMS technology since we evaluated these products in 1996, including enhanced computer memory and processing power, wider adoption of wireless networking, better user interfaces, and greater integration with other hospital information systems. To get the most out of a DMMS purchase or upgrade, facilities will need careful planning that involves assessing their own needs, selecting hardware and software configurations that meet those needs, and then choosing the right vendor and model. A properly selected DMMS can help to enforce medication distribution policies, prevent errors, and streamline processes. PMID:16610453

  6. Managing Medical System Development Through Documentation

    PubMed Central

    Hanmer, Jean

    1980-01-01

    Health Care administrators managing a computer system development project need tools to control the project. This paper describes the concept of management control, its purpose and techniques for exercising it. Preparation of system documentation provides a vehicle for management control which can guide the behavior of the contractor, the institution's managers and staff. Techniques for managing and reviewing documentation in a management control framework are presented.

  7. A Smartwatch-Driven Medication Management System Compliant to the German Medication Plan.

    PubMed

    Keil, Andreas; Gegier, Konstantin; Pobiruchin, Monika; Wiesner, Martin

    2016-01-01

    Medication adherence is an important factor for the outcome of medical therapies. To support high adherence levels, smartwatches can be used to assist the patient. However, a successful integration of such devices into clinicians' or general practitioners' information systems requires the use of standards. In this paper, a medication management system supplied with smartwatch generated feedback events is presented. It allows physicians to manage their patients' medications and track their adherence in real time. Moreover, it fosters interoperability via a ISO/IEC 16022 data matrix which encodes related medication data in compliance with the German Medication Plan specification. PMID:27577368

  8. 21 CFR 880.6315 - Remote Medication Management System.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous Devices § 880.6315...

  9. 21 CFR 880.6315 - Remote Medication Management System.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315 Section 880.6315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous Devices § 880.6315...

  10. Revolutionary advances in medical waste management. The Sanitec system.

    PubMed

    Edlich, Richard F; Borel, Lise; Jensen, H Gordon; Winters, Kathryne L; Long, William B; Gubler, K Dean; Buschbacher, Ralph M; Becker, Daniel G; Chang, Dillon E; Korngold, Jonathan; Chitwood, W Randolph; Lin, Kant Y; Nichter, Larry S; Berenson, Susan; Britt, L D; Tafel, John A

    2006-01-01

    It is the purpose of this collective review to provide a detailed outline of a revolutionary medical waste disposal system that should be used in all medical centers in the world to prevent pollution of our planet from medical waste. The Sanitec medical waste disposal system consists of the following seven components: (1) an all-weather steel enclosure of the waste management system, allowing it to be used inside or outside of the hospital center; (2) an automatic mechanical lift-and-load system that protects the workers from devastating back injuries; (3) a sophisticated shredding system designed for medical waste; (4) a series of air filters including the High Efficiency Particulate Air (HEPA) filter; (5) microwave disinfection of the medical waste material; (6) a waste compactor or dumpster; and (7) an onboard microprocessor. It must be emphasized that this waste management system can be used either inside or outside the hospital. From start to finish, the Sanitec Microwave Disinfection system is designed to provide process and engineering controls that assure complete disinfection and destruction, while minimizing the operator's exposure to risk. There are numerous technologic benefits to the Sanitec systems, including environmental, operational, physical, and disinfection efficiency as well as waste residue disinfection. Wastes treated through the Sanitec system are thoroughly disinfected, unrecognizable, and reduced in volume by approximately 80% (saving valuable landfill space and reducing hauling requirements and costs). They are acceptable in any municipal solid waste program. Sanitec's Zero Pollution Advantage is augmented by a complete range of services, including installation, startup, testing, training, maintenance, and repair, over the life of this system. The Sanitec waste management system has essentially been designed to provide the best overall solution to the customer, when that customer actually looks at the total cost of dealing with the

  11. MIRMAID: A Content Management System for Medical Image Analysis Research.

    PubMed

    Korfiatis, Panagiotis D; Kline, Timothy L; Blezek, Daniel J; Langer, Steve G; Ryan, William J; Erickson, Bradley J

    2015-01-01

    Today, a typical clinical study can involve thousands of participants, with imaging data acquired over several time points across multiple institutions. The additional associated information (metadata) accompanying these data can cause data management to be a study-hindering bottleneck. Consistent data management is crucial for large-scale modern clinical imaging research studies. If the study is to be used for regulatory submissions, such systems must be able to meet regulatory compliance requirements for systems that manage clinical image trials, including protecting patient privacy. Our aim was to develop a system to address these needs by leveraging the capabilities of an open-source content management system (CMS) that has a highly configurable workflow; has a single interface that can store, manage, and retrieve imaging-based studies; and can handle the requirement for data auditing and project management. We developed a Web-accessible CMS for medical images called Medical Imaging Research Management and Associated Information Database (MIRMAID). From its inception, MIRMAID was developed to be highly flexible and to meet the needs of diverse studies. It fulfills the need for a complete system for medical imaging research management. PMID:26284301

  12. MEDEMAS -Medical Device Management and Maintenance System Architecture

    NASA Astrophysics Data System (ADS)

    Dogan, Ülkü Balcı; Dogan, Mehmet Ugur; Ülgen, Yekta; Özkan, Mehmed

    In the proposed study, a medical device maintenance management system (MEDEMAS) is designed and implemented which provides a data pool of medical devices, the maintenance protocols and other required information for these devices. The system also contains complete repair and maintenance history of a specific device. MEDEMAS creates optimal maintenance schedule for devices and enables the service technician to carry out and report maintenance/repair processes via remote access. Thus predicted future failures are possible to prevent or minimize. Maintenance and repair is essential for patient safety and proper functioning of the medical devices, as it prevents performance decrease of the devices, deterioration of the equipment, and detrimental effects on the health of a patient, the user or other interacting people. The study aims to make the maintenance process more accurate, more efficient, faster and easier to manage and organize; and much less confusing. The accumulated history of medical devices and maintenance personnel helps efficient facility planning.

  13. Risk management in the design of medical device software systems.

    PubMed

    Jones, Paul L; Jorgens, Joseph; Taylor, Alford R; Weber, Markus

    2002-01-01

    The safety of any medical device system is dependent on the application of a disciplined, well-defined, risk management process throughout the product life cycle. Hardware, software, human, and environmental interactions must be assessed in terms of intended use, risk, and cost/benefit criteria. This article addresses these issues in the context of medical devices that incorporate software. The article explains the principles of risk management, using terminology and examples from the domain of software engineering. It may serve as a guide to those new to the concepts of risk management and as an aide-memoire for medical device system/software engineers who are more familiar with the topic. PMID:12162111

  14. Medical Information Management System (MIMS): An automated hospital information system

    NASA Technical Reports Server (NTRS)

    Alterescu, S.; Simmons, P. B.; Schwartz, R. A.

    1971-01-01

    An automated hospital information system that handles all data related to patient-care activities is described. The description is designed to serve as a manual for potential users, nontechnical medical personnel who may use the system. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

  15. Medical Information Management System (MIMS): A generalized interactive information system

    NASA Technical Reports Server (NTRS)

    Alterescu, S.; Friedman, C. A.; Hipkins, K. R.

    1975-01-01

    An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

  16. Management information system of medical equipment using mobile devices

    NASA Astrophysics Data System (ADS)

    Núñez, C.; Castro, D.

    2011-09-01

    The large numbers of technologies currently incorporated into mobile devices transform them into excellent tools for capture and to manage the information, because of the increasing computing power and storage that allow to add many miscellaneous applications. In order to obtain benefits of these technologies, in the biomedical engineering field, it was developed a mobile information system for medical equipment management. The central platform for the system it's a mobile phone, which by a connection with a web server, it's capable to send and receive information relative to any medical equipment. Decoding a type of barcodes, known as QR-Codes, the management process is simplified and improved. These barcodes identified the medical equipments in a database, when these codes are photographed and decoded with the mobile device, you can access to relevant information about the medical equipment in question. This Project in it's actual state is a basic support tool for the maintenance of medical equipment. It is also a modern alternative, competitive and economic in the actual market.

  17. Medical Information Management System (MIMS): A Generalized Interactive Information System.

    ERIC Educational Resources Information Center

    Alterescu,Sidney; And Others

    This report describes an interactive information system. It is a general purpose, free format system which can offer immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. The report is designed to serve as a manual for potential users--nontechnical personnel who will use the…

  18. [A Medical Devices Management Information System Supporting Full Life-Cycle Process Management].

    PubMed

    Tang, Guoping; Hu, Liang

    2015-07-01

    Medical equipments are essential supplies to carry out medical work. How to ensure the safety and reliability of the medical equipments in diagnosis, and reduce procurement and maintenance costs is a topic of concern to everyone. In this paper, product lifecycle management (PLM) and enterprise resource planning (ERP) are cited to establish a lifecycle management information system. Through integrative and analysis of the various stages of the relevant data in life-cycle, it can ensure safety and reliability of medical equipments in the operation and provide the convincing data for meticulous management. PMID:26665958

  19. UbiMMS: an ubiquitous medication monitoring system based on remote device management methods.

    PubMed

    Pak, JuGeon; Park, KeeHyun

    2012-01-01

    Medication adherence is one of the most important factors in treating chronic diseases. However, current medication dispensers, which are devices that deliver medication to chronic disease patients according to predetermined schedules, are not equipped with internal remote management functions. Here, we propose a ubiquitous medication monitoring system (UbiMMS) that provides remote functions for medication status transmission, configuration management, software management, and real-time error management. We provide an overview and performance evaluation of the UbiMMS, and show that the proposed system is adequate for remotely monitoring and managing a medication dispenser in real time. PMID:22754967

  20. Towards a paperless medical physics residency management system.

    PubMed

    Schubert, Leah K; Miften, Moyed

    2014-01-01

    Documentation is a required component of a residency program, but can be difficult to collect and disseminate, resulting in minimal utilization by residents and faculty. The purpose of this work is to adapt a commercially-available Web-based medical residency management system to improve the learning experience by efficiently distributing program information, documenting resident activities, and providing frequent monitoring and timely feedback of resident progress. To distribute pro- gram information, program requirements and rotation readings were uploaded. An educational conference calendar was created with associated files and attendance records added. To document resident progress, requirements for over 37 different clinical procedures were added, for which the resident logged the total number of procedures performed. Progress reports were created and automatically distributed. To provide feedback to the resident, an extensive electronic evaluation system was created. Results are shown for the initial 21 months of program existence, consisting of a single resident for the first 12 months and two residents for the subsequent 9 months. The system recorded that 130 documents were uploaded and 100% of required documents were downloaded by the resident. In total, 385 educational conferences and meetings were offered, of which the residents attended 95%. The second-year and first-year residents logged 1030 and 522 clinical proce- dures, respectively. The residents submitted a total of 116 status reports detailing weekly activities, 100% of which were reviewed by faculty within an average of 11.3 days. A total of 65 evaluations of the residents were submitted. The residents reviewed 100% of respective evaluations within an average of 1.5 days. We have successfully incorporated a paperless, Web-based management system in a medical physics residency program. A robust electronic documentation system has been implemented, which has played a central role in enhancing the

  1. 75 FR 391 - Medical Device Quality System Regulation Educational Forum on Risk Management Through the Product...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-05

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Medical Device Quality System Regulation Educational Forum... ``Medical Device Quality System Regulation Educational Forum on Risk Management through the Product...

  2. Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

    PubMed

    Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

    2016-06-01

    Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care

  3. An integrated system to represent and manage medical knowledge.

    PubMed

    Fiore, M; Sicurello, F; Indorato, G

    1995-01-01

    This paper describes an integrated system in Prolog that permits the creation of a personal Knowledge Base to express and formalize specialist knowledge in medicine. Formalisms used are production rules and frames. The integrated system is able to manage data and knowledge stored in a database built in M Technology (MUMPS). PMID:8591590

  4. 21 CFR 880.6315 - Remote Medication Management System.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... delivery unit, to permit a health care professional to remotely schedule the patient's prescribed... to record a history of the event for the health care professional. The system is intended for use as an aid to health care professionals in managing therapeutic regimens for patients in the home...

  5. 21 CFR 880.6315 - Remote Medication Management System.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... delivery unit, to permit a health care professional to remotely schedule the patient's prescribed... to record a history of the event for the health care professional. The system is intended for use as an aid to health care professionals in managing therapeutic regimens for patients in the home...

  6. 21 CFR 880.6315 - Remote Medication Management System.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... delivery unit, to permit a health care professional to remotely schedule the patient's prescribed... to record a history of the event for the health care professional. The system is intended for use as an aid to health care professionals in managing therapeutic regimens for patients in the home...

  7. [Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

    PubMed

    Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

    2010-04-01

    To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform. PMID:20481307

  8. Creating a state medical response system for medical disaster management: the North Carolina experience.

    PubMed

    Kearns, Randy D; Skarote, Mary Beth; Peterson, Jeff; Hubble, Michael W; Winslow, James E

    2014-09-01

    The purpose of this work was to examine the creation and evolution of the North Carolina state medical response system (SMRS). During the past 30 years, states and local communities have developed a somewhat incongruent patchwork of medical disaster response systems. Several local or regional programs participated in the National Disaster Medical System; however, aside from the Disaster Medical Assistance Teams, most of these local resources lacked national standards and national direction. The September 11, 2001 terrorist attacks in Washington, DC and New York, and the anthrax-laced letters mailed to prominent individuals in the US media and others (bioterrorism) in the months that followed were tragic, but they served as both a tipping point and a unifying factor to drive preparedness activities on a national level. Each state responded to the September 11, 2001 attacks by escalating planning and preparedness efforts for a medical disaster response. The North Carolina SMRS was created based on the overall national direction and was tailored to meet local needs such as hurricane response. This article reviews the accomplishments to date and examines future aims. From regional medical response teams to specialty programs such as ambulance strike teams, burn surge planning, electronic inventory and tracking systems, and mobile pharmacy resources, the North Carolina SMRS has emerged as a national leader. Each regional coalition, working with state leadership, has developed resources and has used those resources while responding to disasters in North Carolina. The program is an example of how national leadership can work with state and local agencies to develop a comprehensive and effective medical disaster response system. PMID:25188616

  9. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    PubMed Central

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

  10. Medication Management in Schools: A Systems Approach to Reducing Risk and Strengthening Quality in School Medication Management

    ERIC Educational Resources Information Center

    Center for Health and Health Care in Schools, 2004

    2004-01-01

    This paper and the invitational meeting for which it has been prepared make certain assumptions about the challenge of strengthening the quality of medication management in school. The participants believe that recent research on improving the safety and quality of patient care has relevance for health services in school, particularly the safety…

  11. Polymyositis: Medical Management

    MedlinePlus

    ... print email share facebook twitter google plus linkedin Medical Management Polymyositis (PM) is a highly treatable disease. ... Polymyositis (PM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research Find MDA in your Community Grants ...

  12. Dermatomysitis: Medical Management

    MedlinePlus

    ... print email share facebook twitter google plus linkedin Medical Management Dermatomysitis (DM) is a highly treatable disease. ... Dermatomyositis (DM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research Living With Dermatomyositis (DM) News Not ...

  13. PASTE: patient-centered SMS text tagging in a medication management system

    PubMed Central

    Johnson, Kevin B; Denny, Joshua C

    2011-01-01

    Objective To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Design Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. Measurements A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Results Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Conclusion Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages. PMID:21984605

  14. Medical information systems and their importance in managed care.

    PubMed

    Hawkins, R S

    1997-12-01

    The increasing emphasis on managed care has added a new class of information-management responsibilities to providers' clinical obligations. Fiscal constraints have placed a premium on operational efficiency, and managing payer and patient expectations requires ready access to increasing amounts of information. Provider groups may benefit from an understanding of the tools that are becoming available to address their emerging information management tasks. Modern information applications of potential use to providers are outlined. The data acquisition and decision-support features of provider workstations are described. A simplified schema is presented to assist caregivers in identifying their information-management needs and in crafting a strategy for addressing them. Recent technological trends (including the growing impact of Internet-based tools) are highlighted. PMID:9439958

  15. Treating asthma by the guidelines: developing a medication management information system for use in primary care.

    PubMed

    Twiggs, Joan E; Fifield, J; Jackson, E; Cushman, R; Apter, A

    2004-01-01

    The aim of this study was to develop, implement, and assess an automated asthma medication management information system (MMIS) that provides patient-specific evaluative guidance based on 1997 NAEPP clinical consensus guidelines. MMIS was developed and implemented in primary care settings within a pediatric asthma disease management program. MMIS infrastructure featured a centralized database with Internet access. MMIS collects detailed patient asthma medication data, evaluates pharmacotherapy relative to practitioner-reported disease severity, symptom control and model of guideline-recommended severity-appropriate medications and produces a patient-specific "curbside consult" feedback report. A system algorithm translates actual detailed medication data into actual severity-specific medication-class combinations. A table-driven computer program compares actual medication-class combinations to a guideline-based medication-class combinations model. Methodology determines whether the patient was prescribed a "severity-appropriate" amount or an amount "more" or "less" medication than indicated for patient's reported severity. Feedback messages comment on comparison. Missing data, unrecognized amounts of controller medication or unrecognized medication combinations create error cases. Post hoc review analyzed error cases to determine prevalence of non-guideline medicating practices among these practitioners. Proportion of valid and error cases across two clinical visits before and after post hoc clinical review were measured, as well as proportion of severity-appropriate, out-of-severity and non-guideline medications. MMIS produced a valid feedback report for 83% of patient visits. Missing data accounted for 60% of error cases. Practitioners used severity-appropriate medications for 60% of cases. When non-severity-appropriate medications were used they tended to be "too much" rather than "too little" (22%, 5%), suggesting appropriate use of guideline-recommended "step

  16. [Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

    PubMed

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital. PMID:26485982

  17. Remote access to medical specialists: home care interactive patient management system

    NASA Astrophysics Data System (ADS)

    Martin, Peter J.; Draghic, Nicole; Wiesmann, William P.

    1999-07-01

    Diabetes management involves constant care and rigorous compliance. Glucose control is often difficult to maintain and onset of complications further compound health care needs. Status can be further hampered by geographic isolation from immediate medical infrastructures. The Home Care Interactive Patient Management System is an experimental telemedicine program that could improve chronic illness management through Internet-based applications. The goal of the system is to provide a customized, integrated approach to diabetes management to supplement and coordinate physician protocol while supporting routine patient activity, by supplying a set of customized automated services including health data collection, transmission, analysis and decision support.

  18. A next-generation enterprise medical object management system (MOMS) architecture

    NASA Astrophysics Data System (ADS)

    Kol, Tomer; Shachor, Gal; Shani, Uri

    2004-04-01

    The sheer amount of digital data generated by the proliferation of filmless medical imaging, poses great scalability and manageability challenges to PACS systems. Manageability challenges are aggravated when weighing legislative requirements. An architecture for an enterprise level PACS should support the management of assorted medical objects (e.g., images and reports). Additionally, the architecture should allow services, including performance and reliability, to be tailored to classes of objects according to complex and possibly varying rules. The design should be flexible, allowing for on-demand cost-effective scaling, using a mix-and-match selection of hardware, operating systems, and storage devices. In light of the increased reliance on stored data, it should ensure 24x7 availability, even during system upgrade, and allow pluggable support for future formats. The Medical Object Management System (MOMS) presented in this paper, is an enterprise medical imaging solution architectured to meet the above demands. Flexible, configurable and scalable content and source based management of objects enables administrators to define and modify policies that govern various aspects of the objects' life-cycles, using either configuration files or a Web-based GUI. The modular architecture of MOMS includes (possibly multiple) instances of interface (DICOM, HL7 and Tivoli Storage Manager), storage management and administration agents. Agent instances are hot-pluggable, allowing for zero-downtime upgrades, and can be deployed on a heterogeneous and distributed infrastructure. Leveraging the expertise gained in the development and deployment of the IDMR research PACS project, combined with recent technological advances and modern middleware, MOMS delivers a solution for the present and future requirements of medical objects management.

  19. Medical Information Management System (MIMS) CareWindows.

    PubMed Central

    Stiphout, R. M.; Schiffman, R. M.; Christner, M. F.; Ward, R.; Purves, T. M.

    1991-01-01

    The demonstration of MIMS/CareWindows will include: (1) a review of the application environment and development history, (2) a demonstration of a very large, comprehensive clinical information system with a cost effective graphic user server and communications interface. PMID:1807755

  20. Medical Information Systems.

    ERIC Educational Resources Information Center

    Smith, Kent A.

    1986-01-01

    Description of information services from the National Library of Medicine (NLM) highlights a new system for retrieving information from NLM's databases (GRATEFUL MED); a formal Regional Medical Library Network; DOCLINE; the Unified Medical Language System; and Integrated Academic Information Management Systems. Research and development and the…

  1. [The social psychological support of the system of quality management in medical organization].

    PubMed

    Beliakin, S A; Kazakova, T V; Breskina, T N; Azbarov, A A; Koval'chuk, M M

    2011-01-01

    The effective activities of any medical organization targeted to enhance the consumer's satisfaction require the implementation of the actual techniques and organizational technologies of quality management. The social psychological techniques based on the system approach and up-to-date innovations play the key role. The study intends a required involvement of medical personnel and direction of their efforts to the continual enhancement of their activities. The core purpose of the study was to develop the system of social psychological support of its basic element--the ethical standard of medical personnel. The involvement of all personnel in the medical organization makes it possible to develop in employees the commitment to the postulates of ethical standard and to decrease the risks of opposition to innovations. The comprehensive approach of developing of the subsystem of social psychological support within the structure of the quality management system to facilitate the practical implementation and improvement of all components is considered. This design ensures the amelioration of effectiveness of activities, sustainable development and competitiveness of modern medical organization. PMID:22168060

  2. Q-Pro: a quality control management system for medical equipment.

    PubMed

    Kolitsi, Z; Bliznakov, J; Gueorguieva-Bliznakova, K; Theodorakos, Y; Pallikarakis, N

    2000-01-01

    Q-Pro is an application for quality control (QC) and inspection of medical equipment. The system has been designed on the basis of a broad requirements analysis, contributed by clinical engineers from several European countries and with a focus on current and forthcoming regulatory requirements concerning the quality control and risk management for medical equipment. Q-Pro comprises a generalized application, providing the necessary flexibility to accommodate the different degrees of difficulty and specialization in creating or customizing QC protocols, carrying out inspections and managing collected data. The system incorporates a tool library for QC protocol design, widely used multimedia as well as a local database for protocol and inventory data archiving. The paper presents a detailed account of the system context of use, design and functionality. PMID:11036578

  3. Computer-Based Medical System

    NASA Technical Reports Server (NTRS)

    1998-01-01

    SYMED, Inc., developed a unique electronic medical records and information management system. The S2000 Medical Interactive Care System (MICS) incorporates both a comprehensive and interactive medical care support capability and an extensive array of digital medical reference materials in either text or high resolution graphic form. The system was designed, in cooperation with NASA, to improve the effectiveness and efficiency of physician practices. The S2000 is a MS (Microsoft) Windows based software product which combines electronic forms, medical documents, records management, and features a comprehensive medical information system for medical diagnostic support and treatment. SYMED, Inc. offers access to its medical systems to all companies seeking competitive advantages.

  4. Medical waste management plan.

    SciTech Connect

    Lane, Todd W.; VanderNoot, Victoria A.

    2004-12-01

    This plan describes the process for managing research generated medical waste at Sandia National Laboratories/California. It applies to operations at the Chemical and Radiation Detection Laboratory (CRDL), Building 968, and other biosafety level 1 or 2 activities at the site. It addresses the accumulation, storage, treatment and disposal of medical waste and sharps waste. It also describes the procedures to comply with regulatory requirements and SNL policies applicable to medical waste.

  5. Medical pedagogical resources management.

    PubMed

    Pouliquen, Bruno; Le Duff, Franck; Delamarre, Denis; Cuggia, Marc; Mougin, Fleur; Le Beux, Pierre

    2003-01-01

    The main objective of this work is to help the management of training resources for students using a pedagogical network available at the Medical School of Rennes. With the increase of the number of connections and the number of medical documents available on this network, the management of new contents requires a lot of efforts for the webmaster. In order to improve the management of the resources, we implemented an automatic web engine for teachers, able to manage the links for the most interesting resources for their practice. PMID:14664034

  6. How does the healthcare system affect medication self-management among older adults with multimorbidity?

    PubMed

    Meranius, Martina Summer; Hammar, Lena Marmstål

    2016-03-01

    Individuals with multimorbidity commonly have several concurrent prescriptions and experience healthcare obstacles related to managing different diagnoses and medications. This study aimed to provide a deeper understanding of how older adults with multimorbidity experience medication self-management and how this is affected by the healthcare system. The National Board of Research Ethics approved the study, and 20 older adults with multimorbidity participated in in-depth interviews that were analysed using a hermeneutic approach. Three levels of interpretation emerged. At the first level, lack of participation in healthcare communication hinders adherence and safety, and feeling abandoned to self-care leads to health risk-taking. At the second level, the healthcare organisation is seen as an obstacle to medication self-management. The overall interpretation was a system of repairing 'parts' but not enabling the experience of health. This study shows that the healthcare system is able to treat and relieve an individual's symptoms, but seems unable to help them achieve and promote good health, or to provide the support they need to function in everyday life. PMID:25919419

  7. Next Generation RFID-Based Medical Service Management System Architecture in Wireless Sensor Network

    NASA Astrophysics Data System (ADS)

    Tolentino, Randy S.; Lee, Kijeong; Kim, Yong-Tae; Park, Gil-Cheol

    Radio Frequency Identification (RFID) and Wireless Sensor Network (WSN) are two important wireless technologies that have wide variety of applications and provide unlimited future potentials most especially in healthcare systems. RFID is used to detect presence and location of objects while WSN is used to sense and monitor the environment. Integrating RFID with WSN not only provides identity and location of an object but also provides information regarding the condition of the object carrying the sensors enabled RFID tag. However, there isn't any flexible and robust communication infrastructure to integrate these devices into an emergency care setting. An efficient wireless communication substrate for medical devices that addresses ad hoc or fixed network formation, naming and discovery, transmission efficiency of data, data security and authentication, as well as filtration and aggregation of vital sign data need to be study and analyze. This paper proposed an efficient next generation architecture for RFID-based medical service management system in WSN that possesses the essential elements of each future medical application that are integrated with existing medical practices and technologies in real-time, remote monitoring, in giving medication, and patient status tracking assisted by embedded wearable wireless sensors which are integrated in wireless sensor network.

  8. Space Management for Medical Education.

    ERIC Educational Resources Information Center

    Agro, Dino

    1978-01-01

    A reference on current methods and procedures for managing space in academic medical centers is provided. Focus is on elements of space management systems that can enhance the effectiveness of space allocation decisions. These include: space inventory, space standards, evaluation of space utilization, and space allocation. A bibliography is…

  9. The Houston Academy of Medicine--Texas Medical Center Library management information system.

    PubMed Central

    Camille, D; Chadha, S; Lyders, R A

    1993-01-01

    A management information system (MIS) provides a means for collecting, reporting, and analyzing data from all segments of an organization. Such systems are common in business but rare in libraries. The Houston Academy of Medicine-Texas Medical Center Library developed an MIS that operates on a system of networked IBM PCs and Paradox, a commercial database software package. The data collected in the system include monthly reports, client profile information, and data collected at the time of service requests. The MIS assists with enforcement of library policies, ensures that correct information is recorded, and provides reports for library managers. It also can be used to help answer a variety of ad hoc questions. Future plans call for the development of an MIS that could be adapted to other libraries' needs, and a decision-support interface that would facilitate access to the data contained in the MIS databases. PMID:8251972

  10. The Role of Evaluation Pharmacy Information System in Management of Medication Related Complications

    PubMed Central

    Isfahani, Sakineh Saghaeiannejad; Raeisi, Ahmad Reza; Ehteshami, Asghar; Janesari, Hassan; Feizi, Avat; Mirzaeian, Razieh

    2013-01-01

    Introduction As a natural phenomenon in the patient’s medication therapy, medication clinical complications potentially or concretely interrupt medical care consequential productivity for the patients. Medication related clinical complications include drug errors, drug side effects, drug interactions and drug usage-related challenges. The present research intends to explore the role that the Pharmacy Information System (PIS) may play in the management of medication complications with reference to the pharmaceutical societies of America and Australia in selected teaching, private and social services hospitals of the city of Isfahan. Methodology As an applied, descriptive-analytical study, this study has been conducted in teaching, private and social services hospitals situated in the city of Isfahan in 2011. The research population consisted of the PISs used in the hospitals under study. Research sample was the same as the population. The data collection instrument used was a self-designed checklist developed based on the guidelines of the American Society of Health System Pharmacists and Pharmaceutical Society of Australia validity of which was assessed by expert professors’ views. The data, collected by observation and interview methods, were put into SPSS 18 software to be analyzed. Findings The findings of the study revealed that among the 19 hospitals in question, the highest and lowest ranks in observing the societies of the pharmacists’ established standards related to medication therapy, i.e. registration of drug use status and drug interactions belonged to social services hospitals (mean score of %10.1) and private hospitals (mean score of %6.24), respectively. Conclusion Based on the findings, it can be claimed that the hospitals in question did not pay due attention to standards established by the societies of pharmacists regarding the medication therapy including register of drug usage status, drug interactions and drug side effects in their PISs

  11. Towards Building High Performance Medical Image Management System for Clinical Trials.

    PubMed

    Wang, Fusheng; Lee, Rubao; Zhang, Xiaodong; Saltz, Joel

    2011-01-01

    Medical image based biomarkers are being established for therapeutic cancer clinical trials, where image assessment is among the essential tasks. Large scale image assessment is often performed by a large group of experts by retrieving images from a centralized image repository to workstations to markup and annotate images. In such environment, it is critical to provide a high performance image management system that supports efficient concurrent image retrievals in a distributed environment. There are several major challenges: high throughput of large scale image data over the Internet from the server for multiple concurrent client users, efficient communication protocols for transporting data, and effective management of versioning of data for audit trails. We study the major bottlenecks for such a system, propose and evaluate a solution by using a hybrid image storage with solid state drives and hard disk drives, RESTful Web Services based protocols for exchanging image data, and a database based versioning scheme for efficient archive of image revision history. Our experiments show promising results of our methods, and our work provides a guideline for building enterprise level high performance medical image management systems. PMID:21603096

  12. Towards building high performance medical image management system for clinical trials

    NASA Astrophysics Data System (ADS)

    Wang, Fusheng; Lee, Rubao; Zhang, Xiaodong; Saltz, Joel

    2011-03-01

    Medical image based biomarkers are being established for therapeutic cancer clinical trials, where image assessment is among the essential tasks. Large scale image assessment is often performed by a large group of experts by retrieving images from a centralized image repository to workstations to markup and annotate images. In such environment, it is critical to provide a high performance image management system that supports efficient concurrent image retrievals in a distributed environment. There are several major challenges: high throughput of large scale image data over the Internet from the server for multiple concurrent client users, efficient communication protocols for transporting data, and effective management of versioning of data for audit trails. We study the major bottlenecks for such a system, propose and evaluate a solution by using a hybrid image storage with solid state drives and hard disk drives, RESTfulWeb Services based protocols for exchanging image data, and a database based versioning scheme for efficient archive of image revision history. Our experiments show promising results of our methods, and our work provides a guideline for building enterprise level high performance medical image management systems.

  13. Interconnection of electronic medical record with clinical data management system by CDISC ODM.

    PubMed

    Matsumura, Yasushi; Hattori, Atsushi; Manabe, Shiro; Takeda, Toshihiro; Takahashi, Daiyo; Yamamoto, Yuichiro; Murata, Taizo; Mihara, Naoki

    2014-01-01

    EDC system has been used in the field of clinical research. The current EDC system does not connect with electronic medical record system (EMR), thus a medical staff has to transcribe the data in EMR to EDC system manually. This redundant process causes not only inefficiency but also human error. We developed an EDC system cooperating with EMR, in which the data required for a clinical research form (CRF) is transcribed automatically from EMR to electronic CRF (eCRF) and is sent via network. We call this system as "eCRF reporter". The interface module of eCRF reporter can retrieves the data in EMR database including patient biography data, laboratory test data, prescription data and data entered by template in progress notes. The eCRF reporter also enables users to enter data directly to eCRF. The eCRF reporter generates CDISC ODM file and PDF which is a translated form of Clinical data in ODM. After storing eCRF in EMR, it is transferred via VPN to a clinical data management system (CDMS) which can receive the eCRF files and parse ODM. We started some clinical research by using this system. This system is expected to promote clinical research efficiency and strictness. PMID:25160311

  14. [Quality management in medical laboratories].

    PubMed

    Fritzer-Szekeres, M

    2010-05-01

    During the 20th century understanding for quality has changed and international and national requirements for quality have been published. Therefore also medical branches started to establish quality management systems. Quality assurance has always been important for medical laboratories. Certification according to the standard ISO 9001 and accreditation according to the standard ISO 17025 have been the proof of fulfilling quality requirements. The relatively new standard ISO 15189 is the first standard for medical laboratories. This standard includes technical and management requirements for the medical laboratory. The main focus is the proof of competence within the personnel. As this standard is accepted throughout the European Union an increase in accreditations of medical laboratories is predictable. PMID:20454753

  15. An intelligent healthcare management system: a new approach in work-order prioritization for medical equipment maintenance requests.

    PubMed

    Hamdi, Naser; Oweis, Rami; Abu Zraiq, Hamzeh; Abu Sammour, Denis

    2012-04-01

    The effective maintenance management of medical technology influences the quality of care delivered and the profitability of healthcare facilities. Medical equipment maintenance in Jordan lacks an objective prioritization system; consequently, the system is not sensitive to the impact of equipment downtime on patient morbidity and mortality. The current work presents a novel software system (EQUIMEDCOMP) that is designed to achieve valuable improvements in the maintenance management of medical technology. This work-order prioritization model sorts medical maintenance requests by calculating a priority index for each request. Model performance was assessed by utilizing maintenance requests from several Jordanian hospitals. The system proved highly efficient in minimizing equipment downtime based on healthcare delivery capacity, and, consequently, patient outcome. Additionally, a preventive maintenance optimization module and an equipment quality control system are incorporated. The system is, therefore, expected to improve the reliability of medical equipment and significantly improve safety and cost-efficiency. PMID:20703695

  16. MITIS: a WWW-based medical system for managing and processing gynecological-obstetrical-radiological data.

    PubMed

    Matsopoulos, George K; Kouloulias, Vassilis; Asvestas, Pantelis; Mouravliansky, Nikolaos; Delibasis, Kostantinos; Demetriades, Damianos

    2004-10-01

    In this paper a World Wide Web (WWW)-based medical system, called MITIS, is designed and developed for the management and processing of obstetrical, gynecological and radiological medical data. The system records all the necessary medical information in terms of patient data, examinations, and operations and provides the user-expert with advanced image processing tools for the manipulation, processing and storage of ultrasound and mammographic images. The system can be installed in a hospital's Local Area Network (LAN) where it can access picture archival and communication systems (PACS) servers (if available), or any other server within the radiology department, for image archiving and retrieval, based on the digital imaging and communication in medicine (DICOM) 3.0 protocol, over TCP/IP and also it is accessible to external physicians via the hospital's Internet connection. MITIS is composed as a set of independent WWW modules (ISAPI server extension dlls) and a Win32 application (COM+ server) for mammography image processing and evaluation. PMID:15313542

  17. The pharmaceutical management system at Shade Tree Family Clinic: a medical student-run free clinic's experience.

    PubMed

    Rosenbaum, Benjamin P; Patel, Sanjay G; Guyer, Dana L; Dunn, Sarah R; Herceg, Megan E; Knox, Caroline K; Miller, Robert F

    2008-09-01

    The Shade Tree Family Clinic (STFC) is a student-run free walk-in health clinic opened by Vanderbilt University medical students in October 2005 to address the acute and chronic health needs of the underinsured community in East Nashville. STFC founders decided that the clinic would provide complete medical care, including dispensing commonly prescribed medications at no charge to patients. After several months of managing the inventory in a log book, a medical student author created a Web-based pharmaceutical tracking system to manage the medication formulary. In the process, the authors found little literature available addressing the logistics of setting up an electronic pharmacy system. The system created uses the freely available RxNorm and US Department of Veterans Affairs National Drug File Reference Terminology databases for medication and classification data. Incorporation of these databases allows medical students to dispense and restock medications with ease. The system ensures accurate data entry, improves efficiency, and facilitates continuity of care at a clinic staffed by hundreds of different students and physicians. The STFC pharmaceutical tracking system has facilitated the acquisition and efficient management of medications and consequently has had a great impact on the success of STFC. PMID:18850398

  18. Medical Imaging System

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The MD Image System, a true-color image processing system that serves as a diagnostic aid and tool for storage and distribution of images, was developed by Medical Image Management Systems, Huntsville, AL, as a "spinoff from a spinoff." The original spinoff, Geostar 8800, developed by Crystal Image Technologies, Huntsville, incorporates advanced UNIX versions of ELAS (developed by NASA's Earth Resources Laboratory for analysis of Landsat images) for general purpose image processing. The MD Image System is an application of this technology to a medical system that aids in the diagnosis of cancer, and can accept, store and analyze images from other sources such as Magnetic Resonance Imaging.

  19. Exploration Medical System Demonstration

    NASA Technical Reports Server (NTRS)

    Rubin, D. A.; Watkins, S. D.

    2014-01-01

    BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

  20. [Medical audit: a modern undervalued management tool].

    PubMed

    Osorio, Guido; Sayes, Nilda; Fernández, Lautaro; Araya, Ester; Poblete, Dennis

    2002-02-01

    Medical audit is defined as the critical and periodical assessment of the quality of medical care, through the revision on medical records and hospital statistics. This review defines the work of the medical auditor and shows the fields of action of medical audit, emphasizing its importance and usefulness as a management tool. The authors propose that every hospital should create an audit system, should provide the necessary tools to carry out medical audits and should form an audit committee. PMID:11974537

  1. [The Traceability Management for Qualification Documents of Medical Instruments].

    PubMed

    Tang, Guoping; Hu, Liang; Xu, Xia; Fang, Zhiqiang; Hu, Juan

    2016-01-01

    The management for qualification documents of medical instruments is very important work to management department of medical instruments. Because the number of qualification documents of medical instruments is very large and they have an expiry date, it is difficult to manage them. This article discussed how to manage qualification documents of medical instruments, and an information management system that has a function of traceability management has been developed. This information management system standardizes management for qualification documents of medical instruments, and ensures that qualification documents of medical instruments are available and can be traced. Besides, it can reduce the amount of work for medical instruments management. PMID:27197505

  2. Embedding a Learning Management System Into an Undergraduate Medical Informatics Course in Saudi Arabia: Lessons Learned

    PubMed Central

    2013-01-01

    Background Public universities in Saudi Arabia today are making substantial investments in e-learning as part of their educational system, especially in the implementation of learning management systems (LMS). To our knowledge, this is the first study conducted in Saudi Arabia exploring medical students’ experience with an LMS, particularly as part of a medical informatics course. Objective This study investigates students’ use of various features of the LMS embedded in a recently implemented medical informatics course. Methods A mixed methodology approach was employed. Survey questionnaires were distributed to all third year medical informatics students at the end of the course. In addition, two focus group sessions were conducted with twelve students. A thematic analysis of the focus group was performed. Results A total of 265 third year medical student surveys (167/265, 63% male and 98/265, 37% female) were completed and analyzed. Overall, 50.6% (134/265) of the students agreed that the course was well planned and up-to-date, had clearly stated objectives and clear evaluation methods, appropriate course assignment, and that the LMS offered easy navigation. Most of the students rated the course as good/fair overall. In general, females were 10.4% more likely to prefer the LMS, as revealed by higher odd ratios (odds ratio [OR] 1.104, 95% CI 0.86-1.42) compared to males. Survey results showed that students’ use of LMS tools increased after taking the course compared to before taking the course. The full model containing all items were statistically significant (χ2 25=69.52, P<.001, n=243), indicating that the model was able to distinguish between students who had positive attitudes towards LMS and those who did not. The focus group, however, revealed that the students used social networking for general use rather than learning purposes, but they were using other Internet resources and mobile devices for learning. Male students showed a higher preference for

  3. Assurance of Medical Device Quality with Quality Management System: An Analysis of Good Manufacturing Practice Implementation in Taiwan

    PubMed Central

    Tu, Pei-Weng; Wu, Shiow-Ing

    2015-01-01

    The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development. PMID:26075255

  4. Assurance of medical device quality with quality management system: an analysis of good manufacturing practice implementation in Taiwan.

    PubMed

    Li, Tzu-Wei; Tu, Pei-Weng; Liu, Li-Ling; Wu, Shiow-Ing

    2015-01-01

    The implementation of an effective quality management system has always been considered a principal method for a manufacturer to maintain and improve its product and service quality. Globally many regulatory authorities incorporate quality management system as one of the mandatory requirements for the regulatory control of high-risk medical devices. The present study aims to analyze the GMP enforcement experience in Taiwan between 1998 and 2013. It describes the regulatory implementation of medical device GMP requirement and initiatives taken to assist small and medium-sized enterprises in compliance with the regulatory requirement. Based on statistical data collected by the competent authority and industry research institutes, the present paper reports the growth of Taiwan local medical device industry after the enforcement of GMP regulation. Transition in the production, technologies, and number of employees of Taiwan medical device industry between 1998 and 2013 provides the competent authorities around the world with an empirical foundation for further policy development. PMID:26075255

  5. Cost-effectiveness analysis of a hospital electronic medication management system

    PubMed Central

    Gospodarevskaya, Elena; Li, Ling; Richardson, Katrina L; Roffe, David; Heywood, Maureen; Day, Richard O; Graves, Nicholas

    2015-01-01

    Objective To conduct a cost–effectiveness analysis of a hospital electronic medication management system (eMMS). Methods We compared costs and benefits of paper-based prescribing with a commercial eMMS (CSC MedChart) on one cardiology ward in a major 326-bed teaching hospital, assuming a 15-year time horizon and a health system perspective. The eMMS implementation and operating costs were obtained from the study site. We used data on eMMS effectiveness in reducing potential adverse drug events (ADEs), and potential ADEs intercepted, based on review of 1 202 patient charts before (n = 801) and after (n = 401) eMMS. These were combined with published estimates of actual ADEs and their costs. Results The rate of potential ADEs following eMMS fell from 0.17 per admission to 0.05; a reduction of 71%. The annualized eMMS implementation, maintenance, and operating costs for the cardiology ward were A$61 741 (US$55 296). The estimated reduction in ADEs post eMMS was approximately 80 actual ADEs per year. The reduced costs associated with these ADEs were more than sufficient to offset the costs of the eMMS. Estimated savings resulting from eMMS implementation were A$63–66 (US$56–59) per admission (A$97 740–$102 000 per annum for this ward). Sensitivity analyses demonstrated results were robust when both eMMS effectiveness and costs of actual ADEs were varied substantially. Conclusion The eMMS within this setting was more effective and less expensive than paper-based prescribing. Comparison with the few previous full economic evaluations available suggests a marked improvement in the cost–effectiveness of eMMS, largely driven by increased effectiveness of contemporary eMMs in reducing medication errors. PMID:25670756

  6. Exploration Medical System Demonstration Project

    NASA Technical Reports Server (NTRS)

    Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

    2011-01-01

    A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

  7. An Examination of Safety Management Systems and Aviation Technologies in the Helicopter Emergency Medical Services Industry

    NASA Astrophysics Data System (ADS)

    Buckner, Steven A.

    The Helicopter Emergency Medical Service (HEMS) industry has a significant role in the transportation of injured patients, but has experienced more accidents than all other segments of the aviation industry combined. With the objective of addressing this discrepancy, this study assesses the effect of safety management systems implementation and aviation technologies utilization on the reduction of HEMS accident rates. Participating were 147 pilots from Federal Aviation Regulations Part 135 HEMS operators, who completed a survey questionnaire based on the Safety Culture and Safety Management System Survey (SCSMSS). The study assessed the predictor value of SMS implementation and aviation technologies to the frequency of HEMS accident rates with correlation and multiple linear regression. The correlation analysis identified three significant positive relationships. HEMS years of experience had a high significant positive relationship with accident rate (r=.90; p<.05); SMS had a moderate significant positive relationship to Night Vision Goggles (NVG) (r=.38; p<.05); and SMS had a slight significant positive relationship with Terrain Avoidance Warning System (TAWS) (r=.234; p<.05). Multiple regression analysis suggested that when combined with NVG, TAWS, and SMS, HEMS years of experience explained 81.4% of the variance in accident rate scores (p<.05), and HEMS years of experience was found to be a significant predictor of accident rates (p<.05). Additional quantitative regression analysis was recommended to replicate the results of this study and to consider the influence of these variables for continued reduction of HEMS accidents, and to induce execution of SMS and aviation technologies from a systems engineering application. Recommendations for practice included the adoption of existing regulatory guidance for a SMS program. A qualitative analysis was also recommended for future study SMS implementation and HEMS accident rate from the pilot's perspective. A

  8. Emergency Medical Services Systems Research Projects, 1977. NCHSR Research Management Series.

    ERIC Educational Resources Information Center

    National Center for Health Services Research (DHEW/PHS), Hyattsville, MD.

    This document contains summaries of thirty-two research projects supported by the National Center for Health Services Research (NCHSR) under authority of the Emergency Medical Services (EMS) Systems Act. (Focus of these research projects is to describe, explain, and predict the performance of more than 200 EMS systems being established under Title…

  9. A strategy for coping with change: an affiliation between a medical school and a managed care health system.

    PubMed

    Stevens, D P; Leach, D C; Warden, G L; Cherniack, N S

    1996-02-01

    Case Western Reserve University School of Medicine (CWRU), a private research-focused medical school, and Henry Ford Health System (HFHS), an integrated health system with a preponderance of managed care, have established a formal, broad affiliation that includes substantial commitments that bind the two organizations. Among them are formal full-time faculty appointments at CWRU for qualified professional staff of HFHS, designation of an associate dean for CWRU at HFHS, election of HFHS faculty to key medical school committees such as admission, curriculum, and promotions and tenure, and the commitment of funds to the affiliation by both organizations: a grant from HFHS to CWRU for curriculum development, and investment from CWRU to HFHS. The alliance of two such organizations is made complex by a number of issues. They include differences of institutional cultures as well as traditional issues in academic health centers such as departmental authority over curriculum and faculty appointments, competition for academic preeminence, and competition among hospitals for patients. The affiliation was facilitated by shared commitments to education, agreement on the need to adapt student education to the emerging managed care environment, a shared commitment to health services research, investment in the concept that learners add value to a health care delivery setting, and the desire to develop graduates with knowledge of practice in managed care. The authors conclude that medical schools and integrated managed care health systems gain sufficiently from such an affiliation that the investment of time, effort, and resources is readily justified. PMID:8615924

  10. Medical management of venous ulcers.

    PubMed

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. PMID:26358306

  11. Mission Medical Information System

    NASA Technical Reports Server (NTRS)

    Johnson-Throop, Kathy A.; Joe, John C.; Follansbee, Nicole M.

    2008-01-01

    This viewgraph presentation gives an overview of the Mission Medical Information System (MMIS). The topics include: 1) What is MMIS?; 2) MMIS Goals; 3) Terrestrial Health Information Technology Vision; 4) NASA Health Information Technology Needs; 5) Mission Medical Information System Components; 6) Electronic Medical Record; 7) Longitudinal Study of Astronaut Health (LSAH); 8) Methods; and 9) Data Submission Agreement (example).

  12. Total quality management approach improves medication replacement.

    PubMed

    Anderson, L K

    1994-07-01

    Total quality management (TQM) is based on understanding customer needs, improving key processes that affect customer satisfaction, and creating cross-functional teams to resolve process problems. This article describes application of TQM principles and problem-solving processes to improve one OR's medication exchange system. The problem was excessive monthly pharmacy medication replacement costs. The goal was to reduce the monthly medication replacement costs by 50%. Within four months, monthly medication replacement charges decreased from $656 to $302, and by one year, monthly charges decreased to $160. The new process had fewer steps, fewer staff members involved, and fewer delays in medication replacement. PMID:8085806

  13. The politics of healthcare informatics: knowledge management using an electronic medical record system.

    PubMed

    Bar-Lev, Shirly

    2015-03-01

    The design and implementation of an electronic medical record system pose significant epistemological and practical complexities. Despite optimistic assessments of their potential contribution to the quality of care, their implementation has been problematic, and their actual employment in various clinical settings remains controversial. Little is known about how their use actually mediates knowing. Employing a variety of qualitative research methods, this article attempts an answer by illustrating how omitting, editing and excessive reporting were employed as part of nurses' and physicians' political efforts to shape knowledge production and knowledge sharing in a technologically mediated healthcare setting. PMID:25581280

  14. Autonomous, In-Flight Crew Health Risk Management for Exploration-Class Missions: Leveraging the Integrated Medical Model for the Exploration Medical System Demonstration Project

    NASA Technical Reports Server (NTRS)

    Butler, D. J.; Kerstman, E.; Saile, L.; Myers, J.; Walton, M.; Lopez, V.; McGrath, T.

    2011-01-01

    The Integrated Medical Model (IMM) captures organizational knowledge across the space medicine, training, operations, engineering, and research domains. IMM uses this knowledge in the context of a mission and crew profile to forecast risks to crew health and mission success. The IMM establishes a quantified, statistical relationship among medical conditions, risk factors, available medical resources, and crew health and mission outcomes. These relationships may provide an appropriate foundation for developing an in-flight medical decision support tool that helps optimize the use of medical resources and assists in overall crew health management by an autonomous crew with extremely limited interactions with ground support personnel and no chance of resupply.

  15. UMLS as Knowledge Base-A Rule-Based Expert System Approach to Controlled Medical Vocabulary Management

    PubMed Central

    Cimino, James J.; Hripcsak, George; Johnson, Stephen B.; Friedman, Carol; Fink, Daniel J.; Clayton, Paul D.

    1990-01-01

    The National Library of Medicine is developing a Unified Medical Language System (UMLS) which addresses the need for integration of several large, nationally accepted vocabularies. This is important to the clinical information system under development at the Columbia-Presbyterian Medical Center (CPMC). We are using UMLS components as the core of our effort to integrate existing local CPMC vocabularies which are not among the source vocabularies of the UMLS. We are also using the UMLS to build a knowledge base of vocabulary structure and content such that logical rules can be developed to assist in the management of our integrated vocabularies. At present, the UMLS Semantic Network is used to organize terms which describe laboratory procedures. We have developed a set of rules for identifying undesirable conditions in our vocabulary. We have applied these rules to 526 laboratory test terms and have found ten cases (2%) of definite redundancy and sixty-eight cases (13%) of potential redundancy. The rules have also been used to organize the terminology in new ways that facilitate its management. Using the UMLS model as a vocabulary knowledge base allows us to apply an expert system approach to vocabulary integration and management.

  16. A System for Information Management in BioMedical Studies—SIMBioMS

    PubMed Central

    Krestyaninova, Maria; Zarins, Andris; Viksna, Juris; Kurbatova, Natalja; Rucevskis, Peteris; Neogi, Sudeshna Guha; Gostev, Mike; Perheentupa, Teemu; Knuuttila, Juha; Barrett, Amy; Lappalainen, Ilkka; Rung, Johan; Podnieks, Karlis; Sarkans, Ugis; McCarthy, Mark I; Brazma, Alvis

    2009-01-01

    Summary: SIMBioMS is a web-based open source software system for managing data and information in biomedical studies. It provides a solution for the collection, storage, management and retrieval of information about research subjects and biomedical samples, as well as experimental data obtained using a range of high-throughput technologies, including gene expression, genotyping, proteomics and metabonomics. The system can easily be customized and has proven to be successful in several large-scale multi-site collaborative projects. It is compatible with emerging functional genomics data standards and provides data import and export in accepted standard formats. Protocols for transferring data to durable archives at the European Bioinformatics Institute have been implemented. Availability: The source code, documentation and initialization scripts are available at http://simbioms.org. Contact: support@simbioms.org; mariak@ebi.ac.uk PMID:19633095

  17. Medical Management of Constipation

    PubMed Central

    Portalatin, Meredith; Winstead, Nathaniel

    2012-01-01

    Constipation is a common clinical problem. Initial management of chronic constipation should include lifestyle maneuvers, and increased fiber and fluids. Polyethylene glycol, sodium picosulfate, bisacodyl, prucalopride, lubiprostone, and linaclotide were all more effective than placebo for treating chronic idiopathic constipation. Many commonly used agents lack quality evidence supporting their use. PMID:23449608

  18. Development and implementation of a secure, integrated management system for medical images and electronic clinical records for small hospitals.

    PubMed

    Pereira, Javier; Castro, Antonio F; Perez, Juan L; Novoa, Francisco J; Vázquez, Jose M; Teijeiro, Jorge; Pazos, Alejandro; Ezquerra, Norberto

    2007-06-01

    The field of Medical Informatics is currently experiencing increasing demands for new models of the Picture Archiving and Communication Systems (PACS) and Digital Imaging and Communications in Medicine (DICOM) protocols. Despite of the considerable advantages of current systems, implementation in hospitals is remarkably slow, due primarily to difficulties in integration and relatively high costs. Even though the success of DICOM standards has greatly contributed to the development of PACS, many hospitals remain unable to support it or to make full use of its potential because various imaging modalities in use at these sites generate images that cannot be stored in the PACS and cannot be managed in a centralized manner without DICOM standardization modules. Furthermore, the imaging modalities being used in such smaller centers are expensive and unlikely to be replaced, making DICOM compliance untenable. With this in mind, this paper describes the design, development, and implementation of a management system for medical diagnostic imaging, based on the DICOM standard and adapted to the needs of a small hospital. The system is currently being implemented in the San Rafael Hospital at A Coruna in Spain, and integrated with the existing hospital information system (HIS). We have studied the networking infrastructure of the hospital and its available image generation devices, and have subsequently carried out a series of measurements including transmission times, image file size, compression ratios, and many others that allow us to analyze the behavior of the system. Results obtained from these investigations demonstrate both the flexibility of using such a "small-hospital" DICOM-based framework as well as the relative cost-effectiveness of the system. In this regard, the approach, described herein, might serve as a model for other small, and possibly mid-sized, medical centers. PMID:17603833

  19. Argon laser peripheral iridoplasty versus systemic intraocular pressure-lowering medications as immediate management for acute phacomorphic angle closure

    PubMed Central

    Lee, Jacky WY; Lai, Jimmy SM; Yick, Doris WF; Yuen, Can YF

    2013-01-01

    Background The purpose of this study was to compare the efficacy and safety of argon laser peripheral iridoplasty (ALPI) and systemic intraocular pressure (IOP)-lowering medications in the immediate management of acute phacomorphic angle closure. Methods Consecutive cases of acute phacomorphic angle closure were randomized to receive ALPI and an intravenous or oral carbonic anhydrase inhibitor as initial treatment. Intravenous mannitol was administered for presenting IOP > 60 mmHg or IOP > 40 mmHg 2 hours posttreatment in both arms. Results Of 10 consecutive cases, six received medical therapy and four received ALPI. Fifty percent in the medical group and none in the ALPI group required intravenous mannitol. The ALPI group took less time to achieve IOP < 25 mmHg (18.8 ± 7.5 minutes versus 115.0 ± 97.0 minutes, P = 0.001, F test); had a greater IOP reduction within 30 minutes (69.8% ± 7.7% versus 40.9 ± 23.9%, P = 0.03, t-test); and had a consistently smaller post-attack cup to disc ratio (0.50 ± 0.02 versus 0.60 ± 0.20, P = 0.002, F test). Conclusion ALPI offers greater safety, consistency, and efficacy than systemic IOP-lowering medications as initial treatment for phacomorphic angle closure. PMID:23326185

  20. Evolution of a Patient Information Management System in a Local Area Network Environment at Loyola University of Chicago Medical Center

    PubMed Central

    Price, Ronald N; Chandrasekhar, Arcot J; Tamirisa, Balaji

    1990-01-01

    The Department of Medicine at Loyola University Medical Center (LUMC) of Chicago has implemented a local area network (LAN) based Patient Information Management System (PIMS) as part of its integrated departmental database management system. PIMS consists of related database applications encompassing demographic information, current medications, problem lists, clinical data, prior events, and on-line procedure results. Integration into the existing departmental database system permits PIMS to capture and manipulate data in other departmental applications. Standardization of clinical data is accomplished through three data tables that verify diagnosis codes, procedures codes and a standardized set of clinical data elements. The modularity of the system, coupled with standardized data formats, allowed the development of a Patient Information Protocol System (PIPS). PIPS, a userdefinable protocol processor, provides physicians with individualized data entry or review screens customized for their specific research protocols or practice habits. Physician feedback indicates that the PIMS/PIPS combination enhances their ability to collect and review specific patient information by filtering large amount of clinical data.

  1. Medical equipment management strategies.

    PubMed

    Wang, Binseng; Furst, Emanuel; Cohen, Ted; Keil, Ode R; Ridgway, Malcolm; Stiefel, Robert

    2006-01-01

    Clinical engineering professionals need to continually review and improve their management strategies in order to keep up with improvements in equipment technology, as well as with increasing expectations of health care organizations. In the last 20 years, management strategies have evolved from the initial obsession with electrical safety to flexible criteria that fit the individual institution's needs. Few hospitals, however, are taking full advantage of the paradigm shift offered by the evolution of joint Commission standards. The focus should be on risks caused by equipment failure, rather than on equipment with highest maintenance demands. Furthermore, it is not enough to consider risks posed by individual pieces of equipment to individual patients. It is critical to anticipate the impact of an equipment failure on larger groups of patients, especially when dealing with one of a kind, sophisticated pieces of equipment that are required to provide timely and accurate diagnoses for immediate therapeutic decisions or surgical interventions. A strategy for incorporating multiple criteria to formulate appropriate management strategies is provided in this article. PMID:16796335

  2. Knowledge Management within the Medical University.

    PubMed

    Rauzina, Svetlana Ye; Tikhonova, Tatiana A; Karpenko, Dmitriy S; Bogopolskiy, Gennady A; Zarubina, Tatiana V

    2015-01-01

    The aim of the work is studying the possibilities of ontological engineering in managing of medical knowledge. And also practical implementation of knowledge management system (KMS) in medical university. The educational process model is established that allows analyzing learning results within time scale. Glossary sub-system has been developed; ontologies of educational disciplines are constructed; environment for setup and solution of situational cases is established; ontological approach to assess competencies is developed. The possibilities of the system for solving situation tasks have been described. The approach to the evaluation of competence has been developed. PMID:26152966

  3. [Evaluation of an Experimental Production Wireless Dose Monitoring System for Radiation Exposure Management of Medical Staff].

    PubMed

    Fujibuchi, Toshioh; Murazaki, Hiroo; Kuramoto, Taku; Umedzu, Yoshiyuki; Ishigaki, Yung

    2015-08-01

    Because of the more advanced and more complex procedures in interventional radiology, longer treatment times have become necessary. Therefore, it is important to determine the exposure doses received by operators and patients. The aim of our study was to evaluate an experimental production wireless dose monitoring system for pulse radiation in diagnostic X-ray. The energy, dose rate, and pulse fluoroscopy dependence were evaluated as the basic characteristics of this system for diagnostic X-ray using a fully digital fluoroscopy system. The error of 1 cm dose equivalent rate was less than 15% from 35.1 keV to 43.2 keV with energy correction using metal filter. It was possible to accurately measure the dose rate dependence of this system, which was highly linear until 100 μSv/h. This system showed a constant response to the pulse fluoroscopy. This system will become useful wireless dosimeter for the individual exposure management by improving the high dose rate and the energy characteristics. PMID:26289982

  4. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE... management, quality assurance, and medication therapy management programs (MTMPs). (a) General rule. Each... and systems to reduce medication errors and adverse drug interactions and improve medication use...

  5. Intelligent distributed medical image management

    NASA Astrophysics Data System (ADS)

    Garcia, Hong-Mei C.; Yun, David Y.

    1995-05-01

    The rapid advancements in high performance global communication have accelerated cooperative image-based medical services to a new frontier. Traditional image-based medical services such as radiology and diagnostic consultation can now fully utilize multimedia technologies in order to provide novel services, including remote cooperative medical triage, distributed virtual simulation of operations, as well as cross-country collaborative medical research and training. Fast (efficient) and easy (flexible) retrieval of relevant images remains a critical requirement for the provision of remote medical services. This paper describes the database system requirements, identifies technological building blocks for meeting the requirements, and presents a system architecture for our target image database system, MISSION-DBS, which has been designed to fulfill the goals of Project MISSION (medical imaging support via satellite integrated optical network) -- an experimental high performance gigabit satellite communication network with access to remote supercomputing power, medical image databases, and 3D visualization capabilities in addition to medical expertise anywhere and anytime around the country. The MISSION-DBS design employs a synergistic fusion of techniques in distributed databases (DDB) and artificial intelligence (AI) for storing, migrating, accessing, and exploring images. The efficient storage and retrieval of voluminous image information is achieved by integrating DDB modeling and AI techniques for image processing while the flexible retrieval mechanisms are accomplished by combining attribute- based and content-based retrievals.

  6. Medical management after parathyroid intervention

    PubMed Central

    Tanaka, Motoko; Fukagawa, Masafumi

    2008-01-01

    Vitamin D or vitamin D analogues pulse therapy is seldom effective in patients with at least one parathyroid gland with nodular hyperplasia, and surgical parathyroidectomy or parathyroid intervention is indicated. In parathyroid interventions, especially in selective percutaneous ethanol injection therapy (PEIT), the enlarged parathyroid gland(s) with nodular hyperplasia is selectively destroyed by ethanol injection, while other glands with diffuse hyperplasia are managed by medical therapy. Thus, medical management, e.g., use of appropriate dose of vitamin D or vitamin D analogues after the PEIT procedure, is as important as the destruction of the hyperplastic tissue itself. Recent studies showed that the combination of PEIT and intravenous vitamin D pulse therapy lead to reduce serum PTH level and calcium-phosphorus products in haemodialysis patients. In this article, we focus on the importance of medical therapy after PEIT, and review the efficacy of the combination of PEIT and intravenous vitamin D pulse therapy for haemodialysis patients with secondary hyperparathyroidism. PMID:25983966

  7. Management of medical waste in Tanzanian hospitals.

    PubMed

    Manyele, S V; Anicetus, H

    2006-09-01

    A survey was conducted to study the existing medical waste management (MWM) systems in Tanzanian hospitals during a nationwide health-care waste management-training programme conducted from 2003 to 2005. The aim of the programme was to enable health workers to establish MWM systems in their health facilities aimed at improving infection prevention and control and occupational health aspects. During the training sessions, a questionnaire was prepared and circulated to collect information on the MWM practices existing in hospitals in eight regions of the Tanzania. The analysis showed that increased population and poor MWM systems as well as expanded use of disposables were the main reasons for increased medical wastes in hospitals. The main disposal methods comprised of open pit burning (50%) and burying (30%) of the waste. A large proportion (71%) of the hospitals used dust bins for transporting waste from generation points to incinerator without plastic bags. Most hospitals had low incineration capacity, with few of them having fire brick incinerators. Most of the respondents preferred on-site versus off-site waste incineration. Some hospitals were using untrained casual labourers in medical waste management and general cleanliness. The knowledge level in MWM issues was low among the health workers. It is concluded that hospital waste management in Tanzania is poor. There is need for proper training and management regarding awareness and practices of medical waste management to cover all carders of health workers in the country. PMID:18254511

  8. System hazards in managing laboratory test requests and results in primary care: medical protection database analysis and conceptual model

    PubMed Central

    Bowie, Paul; Price, Julie; Hepworth, Neil; Dinwoodie, Mark; McKay, John

    2015-01-01

    Objectives To analyse a medical protection organisation's database to identify hazards related to general practice systems for ordering laboratory tests, managing test results and communicating test result outcomes to patients. To integrate these data with other published evidence sources to inform design of a systems-based conceptual model of related hazards. Design A retrospective database analysis. Setting General practices in the UK and Ireland. Participants 778 UK and Ireland general practices participating in a medical protection organisation's clinical risk self-assessment (CRSA) programme from January 2008 to December 2014. Main outcome measures Proportion of practices with system risks; categorisation of identified hazards; most frequently occurring hazards; development of a conceptual model of hazards; and potential impacts on health, well-being and organisational performance. Results CRSA visits were undertaken to 778 UK and Ireland general practices of which a range of systems hazards were recorded across the laboratory test ordering and results management systems in 647 practices (83.2%). A total of 45 discrete hazard categories were identified with a mean of 3.6 per practice (SD=1.94). The most frequently occurring hazard was the inadequate process for matching test requests and results received (n=350, 54.1%). Of the 1604 instances where hazards were recorded, the most frequent was at the ‘postanalytical test stage’ (n=702, 43.8%), followed closely by ‘communication outcomes issues’ (n=628, 39.1%). Conclusions Based on arguably the largest data set currently available on the subject matter, our study findings shed new light on the scale and nature of hazards related to test results handling systems, which can inform future efforts to research and improve the design and reliability of these systems. PMID:26614621

  9. Medical imaging systems

    DOEpatents

    Frangioni, John V

    2013-06-25

    A medical imaging system provides simultaneous rendering of visible light and diagnostic or functional images. The system may be portable, and may include adapters for connecting various light sources and cameras in open surgical environments or laparascopic or endoscopic environments. A user interface provides control over the functionality of the integrated imaging system. In one embodiment, the system provides a tool for surgical pathology.

  10. [Neutral Medical Claim Management Committee].

    PubMed

    Komatsu, Mitsuru

    2013-03-01

    The Ibaraki Medical Association established the Committee for Alternative Dispute Resolution called the Neutral Medical Claim Management Committee in 2006. Among 64 claims presented to the committee, 29 were settled through mediation or consultation. Patients were generally satisfied that their claims were considered fairly by the committee and that they were able to talk directly with healthcare professionals. However, some did not consider the committee to be completely neutral. The healthcare professionals involved rated the committee highly because they felt that the processes were neutral and no emotional aspects were involved. PMID:23617190

  11. Medical Waste Management Implications for Small Medical Facilities.

    ERIC Educational Resources Information Center

    Byrns, George; Burke, Thomas

    1992-01-01

    Discusses the implications of the Medical Waste Management Act of 1988 for small medical facilities, public health, and the environment. Reviews health and environmental risks associated with medical waste, current regulatory approaches, and classifications. Concludes that the health risk of medical wastes has been overestimated; makes…

  12. Management studies in medical education.

    PubMed

    Noor Ghani, S; Saimy, I

    2005-08-01

    In 1977, the World Health Assembly (WHA) set the social target--the "Health For All" goal and in 1995, urged member states to "re-orientate medical education and medical practice for "Health For All" (resolution WHA 48.8). This led to World Health Organisation to enunciate the "5-star doctor" needing skills in healthcare management, quality assurance and health economics. The Faculty of Medicine, University of Malaya introduced the New Integrated Curriculum (NIC) in 1995. The objective was aimed at producing a competent doctor with a holistic approach to the practice of medicine. This was to be achieved by having 3 strands of studies i.e. The Scientific Basis of Medicine (SBM), the Doctor, Patient, Health and Society (DPHS), and Personal and Professional Development (PPD) over the 5-year programme, split into 3 phases. Elements of the "5-star doctor" were introduced in strand 2--DPHS and strand 3--PPD. Management studies were introduced in the Personal and Professional Development (PPD) strand. This led to an instructional module--"Principles of Management in Health Care Services (PMGT)" comprising of the Management of Self, Resources and People and incorporating a three week field programme. Evaluation is undertaken at the end of the phase IIIA of the studies. This NIC approach will be able to produce a "5-star doctor", a team player, leader, communicator and an effective manager. PMID:16315627

  13. Electronic Medical Business Operations System

    Energy Science and Technology Software Center (ESTSC)

    2012-04-16

    Electronic Management of medical records has taken a back seat both in private industry and in the government. Record volumes continue to rise every day and management of these paper records is inefficient and very expensive. In 2005, the White House announced support for the development of electronic medical records across the federal government. In 2006, the DOE issued 10 CFR 851 requiring all medical records be electronically available by 2015. The Y-12 National Securitymore » Complex is currently investing funds to develop a comprehensive EMR to incorporate the requirements of an occupational health facility which are common across the Nuclear Weapons Complex (NWC). Scheduling, workflow, and data capture from medical surveillance, certification, and qualification examinations are core pieces of the system. The Electronic Medical Business Operations System (EMBOS) will provide a comprehensive health tool solution to 10 CFR 851 for Y-12 and can be leveraged to the Nuclear Weapon Complex (NWC); all site in the NWC must meet the requirements of 10 CFR 851 which states that all medical records must be electronically available by 2015. There is also potential to leverage EMBOS to the private4 sector. EMBOS is being developed and deployed in phases. When fully deployed the EMBOS will be a state-of-the-art web-enabled integrated electronic solution providing a complete electronic medical record (EMR). EMBOS has been deployed and provides a dynamic electronic medical history and surveillance program (e.g., Asbestos, Hearing Conservation, and Respirator Wearer) questionnaire. Table 1 below lists EMBOS capabilities and data to be tracked. Data to be tracked: Patient Demographics – Current/Historical; Physical Examination Data; Employee Medical Health History; Medical Surveillance Programs; Patient and Provider Schedules; Medical Qualification/Certifications; Laboratory Data; Standardized Abnormal Lab Notifications; Prescription Medication Tracking and Dispensing

  14. Electronic Medical Business Operations System

    SciTech Connect

    Cannon, D. T.; Metcalf, J. R.; North, M. P.; Richardson, T. L.; Underwood, S. A.; Shelton, P. M.; Ray, W. B.; Morrell, M. L.; Caldwell, III, D. C.

    2012-04-16

    Electronic Management of medical records has taken a back seat both in private industry and in the government. Record volumes continue to rise every day and management of these paper records is inefficient and very expensive. In 2005, the White House announced support for the development of electronic medical records across the federal government. In 2006, the DOE issued 10 CFR 851 requiring all medical records be electronically available by 2015. The Y-12 National Security Complex is currently investing funds to develop a comprehensive EMR to incorporate the requirements of an occupational health facility which are common across the Nuclear Weapons Complex (NWC). Scheduling, workflow, and data capture from medical surveillance, certification, and qualification examinations are core pieces of the system. The Electronic Medical Business Operations System (EMBOS) will provide a comprehensive health tool solution to 10 CFR 851 for Y-12 and can be leveraged to the Nuclear Weapon Complex (NWC); all site in the NWC must meet the requirements of 10 CFR 851 which states that all medical records must be electronically available by 2015. There is also potential to leverage EMBOS to the private4 sector. EMBOS is being developed and deployed in phases. When fully deployed the EMBOS will be a state-of-the-art web-enabled integrated electronic solution providing a complete electronic medical record (EMR). EMBOS has been deployed and provides a dynamic electronic medical history and surveillance program (e.g., Asbestos, Hearing Conservation, and Respirator Wearer) questionnaire. Table 1 below lists EMBOS capabilities and data to be tracked. Data to be tracked: Patient Demographics – Current/Historical; Physical Examination Data; Employee Medical Health History; Medical Surveillance Programs; Patient and Provider Schedules; Medical Qualification/Certifications; Laboratory Data; Standardized Abnormal Lab Notifications; Prescription Medication Tracking and Dispensing; Allergies

  15. Instrumentation in medical systems

    SciTech Connect

    Chu, W.T.

    1995-05-01

    The demand for clinical use of accelerated heavy charged-particle (proton and light-ion) beams for cancer treatment is now burgeoning worldwide. Clinical trials are underway at more than a dozen accelerators. Several hospital-based accelerator facilities dedicated to radiation treatment of human cancer have been constructed, and their number is growing. Many instruments in medical systems have been developed for modifying extracted particle beams for clinical application, monitoring the delivery of the treatment beams, and controlling the treatment processes to ensure patient safety. These in turn demand new developments of instruments in controlling beam extraction, beam tuning, and beam transportation at the medical systems.

  16. Medical management of abnormal pregnancy.

    PubMed

    Ratnam, S S; Prasad, R N

    1990-06-01

    Medical termination of abnormal pregnancy requires specific techniques since some conditions make therapy more effective, e.g., missed abortion intrauterine death and molar pregnancy, and others less so, e.g. anencephalic pregnancy. In all cases it is best to terminate the pregnancy as soon as possible to reduce anguish and risks of complications such as consumptive coagulopathy. Oxytocin is not consistently effective, but intraamniotic rivanol has oxytocic properties, and prostaglandins (PGs) are effective by several routes. Surgical methods are more popular in Japan and the US. A diagnostic flow chart is included and described. For missed abortion and fetal death vacuum aspiration or dilatation and evacuation are appropriate for early pregnancy, or PGs are used for later pregnancy, unless there are medical contraindications. Anencephalic pregnancy, usually diagnoses in 2nd or 3rd trimester, is resistant to medical therapy and must often be terminated by cesarean section. Molar pregnancy can be managed with vacuum aspiration at any length of gestation, but must be completed by curettage. Intraamniotic PGs are not advised for mole or fetal death. PG analogs can be administered intramuscularly, or vaginally in gel form. Other types of abnormal pregnancy that can be managed with PGs are spina bifida, hydrocephalus, hydrops fetalis, Dandy-Walker syndrome and Down's syndrome. Tubal pregnancy can be evacuated with intratubally administered PGs under laparoscopic control, thereby preserving tubal integrity. PMID:2225605

  17. Integrated Medical Information Services: A Resource Management View of Automated Hospital Information Systems

    PubMed Central

    Melrose, J. Peter; Ericson, R. Peter

    1981-01-01

    Rapid changes in information processing technology have made the problems of administrative and technical planning and integration difficult. Vendor-inspired terms such as “office of the future” have created confusion rather than clarification. However, the term “information resource management” (IRM) that has evolved in the private sector has potential merit. From the idea of IRM, the authors have developed the planning concept of Integrated Medical Information Services (IMIS) as a common administrative-technical basis for planning and implementing new information technology in the hospital environment.

  18. Designing an architectural style for dynamic medical Cross-Organizational Workflow management system: an approach based on agents and web services.

    PubMed

    Bouzguenda, Lotfi; Turki, Manel

    2014-04-01

    This paper shows how the combined use of agent and web services technologies can help to design an architectural style for dynamic medical Cross-Organizational Workflow (COW) management system. Medical COW aims at supporting the collaboration between several autonomous and possibly heterogeneous medical processes, distributed over different organizations (Hospitals, Clinic or laboratories). Dynamic medical COW refers to occasional cooperation between these health organizations, free of structural constraints, where the medical partners involved and their number are not pre-defined. More precisely, this paper proposes a new architecture style based on agents and web services technologies to deal with two key coordination issues of dynamic COW: medical partners finding and negotiation between them. It also proposes how the proposed architecture for dynamic medical COW management system can connect to a multi-agent system coupling the Clinical Decision Support System (CDSS) with Computerized Prescriber Order Entry (CPOE). The idea is to assist the health professionals such as doctors, nurses and pharmacists with decision making tasks, as determining diagnosis or patient data analysis without stopping their clinical processes in order to act in a coherent way and to give care to the patient. PMID:24682670

  19. The development of medical-manager roles in European hospital systems: a framework for comparison.

    PubMed

    Kirkpatrick, I; Bullinger, B; Dent, M; Lega, F

    2012-02-01

    A central motif of health reforms around the world has been the drive to persuade doctors and other clinical professionals to become more actively engaged in the management of services. Examples include moves to extend the commissioning role of primary care doctors (such as general practitioners in the UK) and the introduction of ‘clinical directorates’ in secondary care. This strategy has been seen as a means of controlling professionals, turning ‘poachers into game keepers’, especially with regard to resource allocation. However, there is also a mounting body of evidence pointing to how clinical leadership may play a role in stimulating quality improvement and new innovations inservice design, with positive consequences for patient safety and satisfaction (1). Focusing on the top 100 hospitals in the US Goodall (2) finds a strong positive association between the ranked quality of hospitals and whether the chief executive officer was a clinician. A survey of 1200 hospitals across seven countries (UK, US, Germany, France, Italy,Canada and Sweden) conducted by McKinsey and LSE also finds that clinically qualified managers improve both the effectiveness of management decisions and clinical performance of hospitals overall (3). PMID:22257036

  20. Portable Medical System

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Portable Medical Status and Treatment System (PMSTS) is designed for use in remote areas where considerable time may elapse before a patient can be transported to a hospital. First units were delivered to the Department of Transportation last year and tested in two types of medical emergency environments: one in a rural Pennsylvania community and another aboard a U.S. Coast Guard rescue helicopter operating along Florida's Gulf Coast. The system has the capability to transmit vital signs to a distantly located physician, who can perform diagnosis and relay treatment instructions to the attendant at the scene. The battery powered PMSTS includes a vital signs monitor and a defibrillator. Narco has also developed a companion system, called Porta-Fib III designed for use in a hospital environment with modifications accordingly. Both systems are offshoots of an earlier NASA project known as the Physician's Black Bag developed by Telecare, Inc., a company now acquired by NARCO.

  1. Medical technology management: from planning to application.

    PubMed

    David, Y; Jahnke, E

    2005-01-01

    Appropriate deployment of technological innovation contributes to improvement in the quality of healthcare delivered, the containment of cost, and access to the healthcare system. Hospitals have been allocating a significant portion of their resources to procuring and managing capital assets; they are continuously faced with demands for new medical equipment and are asked to manage existing inventory for which they are not well prepared. To objectively manage their investment, hospitals are developing medical technology management programs that need pertinent information and planning methodology for integrating new equipment into existing operations as well as for optimizing costs of ownership of all equipment. Clinical engineers can identify technological solutions based on the matching of new medical equipment with hospital's objectives. They can review their institution's overall technological position, determine strengths and weaknesses, develop equipment-selection criteria, supervise installations, train users and monitor post procurement performance to assure meeting of goals. This program, together with cost accounting analysis, will objectively guide the capital assets decision-making process. Cost accounting analysis is a multivariate function that includes determining the amount, based upon a strategic plan and financial resources, of funding to be allocated annually for medical equipment acquisition and replacement. Often this function works closely with clinical engineering to establish equipment useful life and prioritization of acquisition, upgrade, and replacement of inventory within budget confines and without conducting time consuming, individual financial capital project evaluations. PMID:17282142

  2. Multimedia medical archiving system

    NASA Astrophysics Data System (ADS)

    Sood, Arun K.; Atallah, George C.; Rao, Amar; Perez-Lopez, Kathleen G.; Freedman, Matthew T.

    1995-11-01

    The demand for digital radiological imaging and archiving applications has been increasingly rapidly. These digital applications offer significant advantages to the physician over the traditional film-based technique. They result in faster and better quality services, support remote access and conferencing capabilities, provide on demand service availability, eliminate film processing costs, and most significantly, they are suitable services for the evolving global information super highway. Several existing medical multimedia systems incorporate and utilize those advanced technical features. However, radiologists are seeking an order of magnitude improvement in the overall current system design and performance indices (such as transactions response times, system utilization and throughput). One of the main technical concern radiologists are raising is the miss-filing occurrence. This even will decrease the radiologist productivity; introduce unnecessarily workload; and will result in total customer dissatisfaction. This paper presents Multimedia Medical Archiving System, which can be used in hospitals and medical centers for storing and retrieving radiological images. Furthermore, this paper emphasizes a viable solution for the miss-filing problem. The results obtained demonstrate and quantify the improvement in the overall radiological operations. Specifically this paper demonstrates an order of 80% improvement in the response time for retrieving images. This enhancement in system performance directly translates to a tremendous improvement in the radiologist's productivity.

  3. [The application of ISO 9000 quality control system in the medical equipment management].

    PubMed

    Ma, Qiao-yun

    2006-05-01

    This paper expounds the importance of the application of ISO 9000 quality control system in hospitals, introduces the program files and the relavant software established for its application, and gives its effective results. PMID:16929782

  4. [The practice of development and implementation of quality management systems in medical laboratories. The GOST R ISO 15189-2009 "medical laboratories. The detailed requirements to quality and competence". Particular difficulties of global nature].

    PubMed

    Emanuel', A V; Ivanov, G A; Fleganova, I N; Emanuel', V L

    2012-12-01

    The article discusses the methodological issues related to the implementation of international principles of standardization in the format of GOST R ISO 9001-2008 "Quality management systems. Requirements", GOST R ISO 15189-2009 "Medical laboratories. The detailed requirements to quality and competence" and GOST R ISO 18113.1-5 "Medical items for diagnostics in vitro. Information provided by manufacturer (marking)". This approach legibly assigns the responsibility concerning the support of metrological correctness of laboratory measurements. The lacking of both full-value public and sectorial normative documentation and coordinated positions of Rosstandard and Minzdrav of Russia on functioning of medical laboratories is noted. PMID:23479974

  5. Integrating an Open-Source Course Management System (Moodle) into the Teaching of a First-Year Medical Physiology Course: A Case Study

    ERIC Educational Resources Information Center

    Seluakumaran, Kumar; Jusof, Felicita Fedelis; Ismail, Rosnah; Husain, Ruby

    2011-01-01

    Educators in medical schools around the world are presently experimenting with innovative ways of using web-based learning to supplement the existing teaching and learning process. We have recently used a popular open-source course management system (CMS) called the modular object-oriented dynamic learning environment (Moodle) to construct an…

  6. Medical ultrasound systems

    PubMed Central

    Powers, Jeff; Kremkau, Frederick

    2011-01-01

    Medical ultrasound imaging has advanced dramatically since its introduction only a few decades ago. This paper provides a short historical background, and then briefly describes many of the system features and concepts required in a modern commercial ultrasound system. The topics addressed include array beam formation, steering and focusing; array and matrix transducers; echo image formation; tissue harmonic imaging; speckle reduction through frequency and spatial compounding, and image processing; tissue aberration; Doppler flow detection; and system architectures. It then describes some of the more practical aspects of ultrasound system design necessary to be taken into account for today's marketplace. It finally discusses the recent explosion of portable and handheld devices and their potential to expand the clinical footprint of ultrasound into regions of the world where medical care is practically non-existent. Throughout the article reference is made to ways in which ultrasound imaging has benefited from advances in the commercial electronics industry. It is meant to be an overview of the field as an introduction to other more detailed papers in this special issue. PMID:22866226

  7. DEFENSE MEDICAL SURVEILLANCE SYSTEM (DMSS)

    EPA Science Inventory

    AMSA operates the Defense Medical Surveillance System (DMSS), an executive information system whose database contains up-to-date and historical data on diseases and medical events (e.g., hospitalizations, ambulatory visits, reportable diseases, HIV tests, acute respiratory diseas...

  8. In-Flight Personalized Medication Management

    NASA Technical Reports Server (NTRS)

    Peletskaya, E.; Griko, Y. V.

    2016-01-01

    , technologies capable of predicting and managing medication side effects, interactions, and toxicity of drugs during spaceflight are needed. We propose to develop and customize for NASAs applications available on the market Personalized Prescribing System (PPS) that would provide a comprehensive, non-invasive solution for safer, targeted medication management for every crew member resulting in safer and more effective treatment and, consequently, better performance. PPS will function as both decision support and record-keeping tool for flight surgeons and astronauts in applying the recommended medications for situations arising in flight. The information on individual drug sensitivity will translate into personalized risk assessment for adverse drug reactions and treatment failures for each drug from the medication kit as well as predefined outcome of any combination of them. Dosage recommendations will also be made individually. The mobile app will facilitate ease of use by crew and medical professionals during training and flight missions.

  9. Implantable medical sensor system

    DOEpatents

    Darrow, Christopher B.; Satcher, Jr., Joe H.; Lane, Stephen M.; Lee, Abraham P.; Wang, Amy W.

    2001-01-01

    An implantable chemical sensor system for medical applications is described which permits selective recognition of an analyte using an expandable biocompatible sensor, such as a polymer, that undergoes a dimensional change in the presence of the analyte. The expandable polymer is incorporated into an electronic circuit component that changes its properties (e.g., frequency) when the polymer changes dimension. As the circuit changes its characteristics, an external interrogator transmits a signal transdermally to the transducer, and the concentration of the analyte is determined from the measured changes in the circuit. This invention may be used for minimally invasive monitoring of blood glucose levels in diabetic patients.

  10. Medical imaging systems

    SciTech Connect

    Frangioni, John V.

    2012-07-24

    A medical imaging system provides simultaneous rendering of visible light and fluorescent images. The system may employ dyes in a small-molecule form that remains in a subject's blood stream for several minutes, allowing real-time imaging of the subject's circulatory system superimposed upon a conventional, visible light image of the subject. The system may also employ dyes or other fluorescent substances associated with antibodies, antibody fragments, or ligands that accumulate within a region of diagnostic significance. In one embodiment, the system provides an excitation light source to excite the fluorescent substance and a visible light source for general illumination within the same optical guide that is used to capture images. In another embodiment, the system is configured for use in open surgical procedures by providing an operating area that is closed to ambient light. More broadly, the systems described herein may be used in imaging applications where a visible light image may be usefully supplemented by an image formed from fluorescent emissions from a fluorescent substance that marks areas of functional interest.

  11. TMR: An Automated System for Managing Revenue.

    ERIC Educational Resources Information Center

    Hansen, John P.; And Others

    1980-01-01

    The Total Medical Record (TMR) system is an integrated computer record that associates medical and administrative data in a single system. TMR provides a framework for effective medical care and efficient business management. (JN)

  12. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    PubMed Central

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  13. Pharmacists' Role in Improving Diabetes Medication Management

    PubMed Central

    Smith, Marie

    2009-01-01

    Today there are significant gaps between reaching the goal of “optimal medication therapy” and the current state of medication use in the United States. Pharmacists are highly accessible and well-trained—yet often underutilized—key health care professionals who can move us closer toward achieving better medication therapy outcomes for patients. Diabetes medication management programs led by pharmacists are described. This is consistent with the “medical home” concept of care that promotes primary care providers working collaboratively to coordinate patient-centered care. Pharmacists utilize their clinical expertise in monitoring and managing diabetes medication plans to positively impact health outcomes and empower patients to actively manage their health. In addition, pharmacists can serve as a resource to other health care providers and payers to assure safe, appropriate, cost-effective diabetes medication use. PMID:20046662

  14. Exploration Medical System Demonstration (EMSD) Project

    NASA Technical Reports Server (NTRS)

    Chin, Duane

    2012-01-01

    The Exploration Medical System Demonstration (EMSD) is a project under the Exploration Medical Capability (ExMC) element managed by the Human Research Program (HRP). The vision for the EMSD is to utilize ISS as a test bed to show that several medical technologies needed for an exploration mission and medical informatics tools for managing evidence and decision making can be integrated into a single system and used by the on-orbit crew in an efficient and meaningful manner. Objectives: a) Reduce and even possibly eliminate the time required for on-orbit crew and ground personnel (which include Surgeon, Biomedical Engineer (BME) Flight Controller, and Medical Operations Data Specialist) to access and move medical data from one application to another. b) Demonstrate that the on-orbit crew has the ability to access medical data/information using an intuitive and crew-friendly software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management framework and architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities.

  15. Medical Research System

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Based on Johnson Space Flight Center's development of a rotating bioreactor cell culture apparatus for Space Shuttle medical research, Johnson Space Flight Center engineers who worked on the original project formed a company called Synthecon, with the intention of commercializing the bioreactor technology. Synthecon grows three dimensional tissues in the bioreactor. These are superior to previous two-dimensional tissue samples in the study of human cell growth. A refined version of the Johnson Space Center technology, Synthecon's Rotary Cell Culture System includes a cell culture chamber that rotates around a horizontal axis. The cells establish an orbit that approximates free fall through the liquid medium in the chamber. The technology has significant applications for cancer research and treatment as well as AIDS research.

  16. The National Disaster Medical System

    NASA Technical Reports Server (NTRS)

    Reutershan, Thomas P.

    1991-01-01

    The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

  17. Robotic automation of medication-use management.

    PubMed

    Enright, S M

    1993-11-01

    In the October 1993 issue of Physician Assistant, we published "Robots for Health Care," the first of two articles on the medical applications of robotics. That article discussed ways in which robots could help patients with manipulative disabilities to perform activities of daily living and hold paid employment; transfer patients from bed to chair and back again; add precision to the most exacting surgical procedures; and someday carry out diagnostic and therapeutic techniques from within the human body. This month, we are pleased to offer an article by Sharon Enright, an authority on pharmacy operations, who considers how an automated medication-management system that makes use of bar-code technology is capable of streamlining drug dispensing, controlling safety, increasing cost-effectiveness, and ensuring accurate and complete record-keeping. PMID:10130909

  18. [Medical record management and risk management processes. State of the art and new normative guidelines about the organization and the management of the sanitary documentation in the National Health System or Hospital Trusts].

    PubMed

    Spolaore, P; Murolo, G; Sommavilla, M

    2003-01-01

    Recent health care reforms, the start of accreditation processes of health institutions, and the introduction also in the health system of risk management concepts and instruments, borrowed from the enterprise culture and the emphasis put on the protection of privacy, render evident the need and the urgency to define and to implement improvement processes of the organization and management of the medical documentation in the hospital with the aim of facilitation in fulfilment of regional and local health authorities policies about protection of the safety and improvement of quality of care. Currently the normative context that disciplines the management of medical records inside the hospital appears somewhat fragmentary, incomplete and however not able to clearly orientate health operators with the aim of a correct application of the enforced norms in the respect of the interests of the user and of local health authority. In this job we individuate the critical steps in the various phases of management process of the clinical folder and propose a new model of regulations, with the purpose to improve and to simplify the management processes and the modalities of compilation, conservation and release to entitled people of all clinical documentation. PMID:15049537

  19. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention. PMID:9391932

  20. Managed care and medical education: hard cases and hard choices.

    PubMed

    Friedman, E

    1997-05-01

    As managed care becomes more and more dominant in U.S. health care, it is coming into conflict with medical education. There are historical reasons for this: medical education traditionally excluded physicians who chose to work in health plans, and for profit managed care has tended to avoid subsidizing medical education. In order to improve the climate, three changes are necessary: medical education must understand the tense history of discord between the two; distinctions must be made between responsible and irresponsible managed care plans; and medical educators should not assume they own the moral high ground. Arrogance, a gross oversupply of physicians and especially specialists, scandals and fraud, an often callous attitude toward the poor, and other sins can be laid at medical education's door. The worse threat for both sides is that the public and payers could simply abandon both, leading to underfunding for health professions education, a society that does not trust its health care system, and the loss of superb teaching organizations. To prevent this, managed care and medical education should work together to solve several difficult problems: how to shrink the medical education infrastructure; how to report honestly the uses to which medical education funds are put; and how to identify and end irresponsible behavior on the part of health plans and medical education entities alike. If the two sides can exercise leadership in these areas, they will be able to protect and enhance the singular place of honor that medical education holds in this society. PMID:9159575

  1. [Evidence-based management of medical disposable materials].

    PubMed

    Yang, Hai

    2009-03-01

    Evidence-based management of medical disposable materials pays attention to collect evidence comprehensively and systematically, accumulate and create evidence through its own work and also evaluate evidence strictly. This can be used as a function to guide out job. Medical disposable materials evidence system contains product register qualification, product quality certification, supplier's behavior, internal and external communication evidence. Managers can find different ways in creating and using evidence referring to specific inside and outside condition. Evidence-based management can help accelerating the development of management of medical disposable materials from traditional experience pattern to a systematic and scientific pattern. It also has the very important meaning to improve medical quality, control the unreasonable growth of medical expense and make purchase and supply chain be more efficient. PMID:19565800

  2. Medical management of vascular anomalies.

    PubMed

    Trenor, Cameron C

    2016-03-01

    We have entered an exciting era in the care of patients with vascular anomalies. These disorders require multidisciplinary care and coordination and dedicated centers have emerged to address this need. Vascular tumors have been treated with medical therapies for many years, while malformations have been historically treated with endovascular and operative procedures. The recent serendipitous discoveries of propranolol and sirolimus for vascular anomalies have revolutionized this field. In particular, sirolimus responses are challenging the dogma that vascular malformations are not biologically active. While initially explored for lymphatic anomalies, sirolimus is now being used broadly throughout the spectrum of vascular anomalies. Whether medical therapies are reserved for refractory patients or used first line is currently dependent on the experience and availability of alternative therapies at each institution. On the horizon, we anticipate new drugs targeting genes and pathways involved in vascular anomalies to be developed. Also, combinations of medications and protocols combining medical and procedural approaches are in development for refractory patients. PMID:27607327

  3. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    PubMed

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  4. Medical and Surgical Management of Male Infertility

    PubMed Central

    Sadri-Ardekani, Hooman

    2014-01-01

    This article is the review of the book “Medical & Surgical Management of Male Infertility” edited by Botros RMB Rizk, Nabil Aziz, Ashok Agarwal and Edmund Sabanegh Jr. This book (hardcover) was published by Jaypee Brothers Medical Publishing, New Delhi.London.Philadelphia.Panama on September 2013 (1st edition). The contents of the book and its relevance to medical education are discussed in this invited review.

  5. Medication management during electroconvulsant therapy.

    PubMed

    Zolezzi, Monica

    2016-01-01

    Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords. PMID:27143894

  6. Medication management during electroconvulsant therapy

    PubMed Central

    Zolezzi, Monica

    2016-01-01

    Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords. PMID:27143894

  7. A Terminology Server for medical language and medical information systems.

    PubMed

    Rector, A L; Solomon, W D; Nowlan, W A; Rush, T W; Zanstra, P E; Claassen, W M

    1995-03-01

    GALEN is developing a Terminology Server to support the development and integration of clinical systems through a range of key terminological services, built around a language-independent, re-usable, shared system of concepts--the CORE model. The focus is on supporting applications for medical records, clinical user interfaces and clinical information systems, but also includes systems for natural language understanding, clinical decision support, management of coding and classification schemes, and bibliographic retrieval. The Terminology Server integrates three modules: the Concept Module which implements the GRAIL formalism and manages the internal representation of concept entities, the Multilingual Module which manages the mapping of concept entities to natural language, and the Code Conversion Module which manages the mapping of concept entities to and from existing coding and classification schemes. The Terminology Server also provides external referencing to concept entities, coercion between data types, and makes its services available through a uniform applications programming interface. Taken together these services represent a new approach to the development of clinical systems and the sharing of medical knowledge. PMID:9082124

  8. Medical management of thyroid eye disease

    PubMed Central

    Yang, Dawn D.; Gonzalez, Mithra O.; Durairaj, Vikram D.

    2010-01-01

    Thyroid eye disease (TED) is the most common cause of orbital disease in adults. The immunologic pathogenesis of TED has been an area of active research and considerable progress has resulted in an expansion of therapeutic options. Although surgical intervention may be required, a majority of TED patients can be managed with medical therapies. Of medical therapies, glucocorticoids remain the agent of choice in the control of TED activity. The objective of this review is to discuss the paradigm and options in medical management of TED. PMID:23960897

  9. Flexible medical image management using service-oriented architecture.

    PubMed

    Shaham, Oded; Melament, Alex; Barak-Corren, Yuval; Kostirev, Igor; Shmueli, Noam; Peres, Yardena

    2012-01-01

    Management of medical images increasingly involves the need for integration with a variety of information systems. To address this need, we developed Content Management Offering (CMO), a platform for medical image management supporting interoperability through compliance with standards. CMO is based on the principles of service-oriented architecture, implemented with emphasis on three areas: clarity of business process definition, consolidation of service configuration management, and system scalability. Owing to the flexibility of this platform, a small team is able to accommodate requirements of customers varying in scale and in business needs. We describe two deployments of CMO, highlighting the platform's value to customers. CMO represents a flexible approach to medical image management, which can be applied to a variety of information technology challenges in healthcare and life sciences organizations. PMID:22874344

  10. Stress Management Training in Medical School.

    ERIC Educational Resources Information Center

    Kelly, Jeffrey A.; And Others

    1982-01-01

    An effort to teach medical students practical stress management skills is discussed. A group of students volunteered to participate in a six-session program that taught them personal stress management techniques including self-relaxation training, schedule-planning, priority-setting, leisure time-planning, and cognitive modification techniques.…

  11. Communicating Medical Needs to Non-Medical Managers

    NASA Technical Reports Server (NTRS)

    Bacal, Kira; Miller, Robert; Doerr, Harold

    2004-01-01

    Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these

  12. Medical management of adult headache.

    PubMed

    Freitag, Frederick G; Schloemer, Fallon

    2014-04-01

    We review the therapies for primary headache disorders: migraine, chronic migraine, tension-type headache, and cluster headache. Recommendations follow the evidence-based treatments so far as is possible with expert opinion to give clinical guidance. Headache has 2 levels of care: acute treatments designed to stop a headache from progressing and alleviate all symptoms associated with the headache and preventive therapies for patients whose headache frequency is such that by itself produces significant disability and impact on quality of life, or where the frequency of use of acute medications, regardless of efficacy, poses risks in terms of overuse or adverse events. PMID:24680490

  13. Medical management considerations for upper airway disease.

    PubMed

    Spaulding, G L

    1992-06-01

    The conducting airways, also commonly referred to as the upper airways, provide for the passage of air to and from the atmosphere and lungs. Anatomical components include the nasal passages, pharynx, larynx, trachea, and mainstem bronchi. Clinical problems involving the conducting airways can be manifested by relatively mild clinical signs of stertorous breathing, by life-threatening dyspnea, or by chronic bouts of inspiratory stridor and cough. Concurrent disease of the lower respiratory system (ie, chronic bronchitis) as well as other organ systems (ie, cardiovascular, nervous, endocrine) may significantly contribute to the etiology and pathophysiology of upper airway disease. Diagnosis of the diseases of the conducting airways is primarily based on history and physical examination. The dynamic nature of some conditions, related to the phases of respiration, can make diagnosis more difficult. In addition to direct visualization, radiographic and endoscopic evaluation are often useful. Many upper airway problems, especially congenital conditions, lend themselves to surgical palliation that should be performed as early in life as possible. Medical management is often directed at treating underlying diseases and the relief of clinical signs. Historically, the use of variety of drugs have been advocated and frequently include decongestants, cough suppressants, bronchodilators, glucocorticoids, and antibiotics. However, their use may be detrimental and contraindicated. In addition, therapy for some conditions (ie, laryngeal paralysis and intrathoracic tracheal collapse) may be better directed at increasing airway muscle tone in order to stabilized airway patency. Therapeutic agents that may be useful include aspirin and digitalis. The overall objective to medical management must be to balance potential therapeutic benefit against untoward effects in order to minimize clinical signs and to improve the animal's quality of life. PMID:1643322

  14. [Managing digital medical imaging projects in healthcare services: lessons learned].

    PubMed

    Rojas de la Escalera, D

    2013-01-01

    Medical imaging is one of the most important diagnostic instruments in clinical practice. The technological development of digital medical imaging has enabled healthcare services to undertake large scale projects that require the participation and collaboration of many professionals of varied backgrounds and interests as well as substantial investments in infrastructures. Rather than focusing on systems for dealing with digital medical images, this article deals with the management of projects for implementing these systems, reviewing various organizational, technological, and human factors that are critical to ensure the success of these projects and to guarantee the compatibility and integration of digital medical imaging systems with other health information systems. To this end, the author relates several lessons learned from a review of the literature and the author's own experience in the technical coordination of digital medical imaging projects. PMID:22944485

  15. Medical management of Peyronie's disease.

    PubMed

    Hellstrom, Wayne J G

    2009-01-01

    Peyronie's disease (PD) is a wound-healing disorder in which a fibrotic plaque forms in the tunica albuginea layer of the penis. It clinically presents as any combination of penile pain, angulation, and erectile dysfunction. Recent studies indicate that PD has a prevalence of 3%-9% in adult men. Although the exact etiology has not been established, PD likely results from a predisposing genetic susceptibility combined with an inciting event such as microtrauma during intercourse. During the initial acute phase (6-18 months), the condition may progress, stabilize, or regress. For this reason authorities recommend a more conservative treatment approach, with a trial of oral and/or intralesional pharmacotherapy, before surgical reconstruction is considered. Oral therapies most commonly employed include tocopherol (vitamin E) and paraaminobenzoate (Potaba), with colchicine, tamoxifen, propoleum, and acetyl-L-carnitine being used less often. There are a limited number of long-term placebo-controlled studies with these oral agents, and for the most part, studies have failed to show a consistent beneficial effect. Intralesional injection therapy for PD is more commonly used as a first-line therapy. The current standard of care includes injection with interferon-alpha-2b, verapamil, or collagenase. Interferon-alpha-2b, in particular, has been documented in a large, multicenter, placebo-controlled study to show significant benefit over placebo in decreasing penile curvature, plaque size, penile pain, and plaque density. However, intralesional interferon is associated with posttreatment flu-like symptoms unless patients are premedicated with a nonsteroid anti-inflammatory agent. Other available therapies that have not consistently shown efficacy in placebo-controlled studies include corticosteroids, orgotein, radiation, and extracorporeal shockwave therapy. Surgery is considered when men with PD do not respond to conservative or medical therapy for approximately 1 year and

  16. Development of the Inventory Management and Tracking System (IMATS) to Track the Availability of Public Health Department Medical Countermeasures During Public Health Emergencies

    PubMed Central

    Sahar, Liora; Faler, Guy; Hristov, Emil; Hughes, Susan; Lee, Leslie; Westnedge, Caroline; Erickson, Benjamin; Nichols, Barbara

    2015-01-01

    Objective To bridge gaps identified during the 2009 H1N1 influenza pandemic by developing a system that provides public health departments improved capability to manage and track medical countermeasures at the state and local levels and to report their inventory levels to the Centers for Disease Control and Prevention (CDC). Materials and Methods The CDC Countermeasure Tracking Systems (CTS) program designed and implemented the Inventory Management and Tracking System (IMATS) to manage, track, and report medical countermeasure inventories at the state and local levels. IMATS was designed by CDC in collaboration with state and local public health departments to ensure a “user-centered design approach.” A survey was completed to assess functionality and user satisfaction. Results IMATS was deployed in September 2011 and is provided at no cost to public health departments. Many state and local public health departments nationwide have adopted IMATS and use it to track countermeasure inventories during public health emergencies and daily operations. Discussion A successful response to public health emergencies requires efficient, accurate reporting of countermeasure inventory levels. IMATS is designed to support both emergency operations and everyday activities. Future improvements to the system include integrating barcoding technology and streamlining user access. To maintain system readiness, we continue to collect user feedback, improve technology, and enhance its functionality. Conclusion IMATS satisfies the need for a system for monitoring and reporting health departments’ countermeasure quantities so that decision makers are better informed. The “user-centered design approach” was successful, as evident by the many public health departments that adopted IMATS. PMID:26392843

  17. Self-management of medical abortion: a qualitative evidence synthesis.

    PubMed

    Wainwright, Megan; Colvin, Christopher J; Swartz, Alison; Leon, Natalie

    2016-05-01

    Medical abortion is a method of pregnancy termination that by its nature enables more active involvement of women in the process of managing, and sometimes even administering the medications for, their abortions. This qualitative evidence synthesis reviewed the global evidence on experiences with, preferences for, and concerns about greater self-management of medical abortion with lesser health professional involvement. We focused on qualitative research from multiple perspectives on women's experiences of self-management of first trimester medical abortion (<12weeks gestation). We included research from both legal and legally-restricted contexts whether medical abortion was accessed through formal or informal systems. A review team of four identified 36 studies meeting inclusion criteria, extracted data from these studies, and synthesized review findings. Review findings were organized under the following themes: general perceptions of self-management, preparation for self-management, logistical considerations, issues of choice and control, and meaning and experience. The synthesis highlights that the qualitative evidence base is still small, but that the available evidence points to the overall acceptability of self-administration of medical abortion. We highlight particular considerations when offering self-management options, and identify key areas for future research. Further qualitative research is needed to strengthen this important evidence base. PMID:27578349

  18. The Medical System in Ghana

    PubMed Central

    Drislane, Frank W.; Akpalu, Albert; Wegdam, Harry H.J.

    2014-01-01

    Ghana is a developing country in West Africa with a population of about 25 million. Medical illnesses in Ghana overlap with those in developed countries, but infection, trauma, and women’s health problems are much more prominent. Medical practice in rural Africa faces extremely limited resources, a multiplicity of languages (hundreds in Ghana), and presentation of severe illnesses at later stages than seen elsewhere. Despite these limitations, Ghana has established a relatively successful national medical insurance system, and the quality of medical practice is high, at least where it is available. Ghana also has a well-established and sophisticated administrative structure for the supervision of medical education and accreditation, but it has proven very difficult to extend medical training to rural areas, where health care facilities are particularly short of personnel. Physicians are sorely needed in rural areas, but there are few because of the working conditions and financial limitations. Hospital wards and clinics are crowded; time per patient is limited. This article details some of the differences between medical practice in Ghana and that in wealthier countries and how it functions with very limited resources. It also introduces the medical education and training system in Ghana. The following article describes an attempt to establish and maintain a residency training program in General Medicine in a rural area of Ghana. PMID:25191147

  19. Medical management of paraquat ingestion

    PubMed Central

    Gawarammana, Indika B; Buckley, Nicholas A

    2011-01-01

    Poisoning by paraquat herbicide is a major medical problem in parts of Asia while sporadic cases occur elsewhere. The very high case fatality of paraquat is due to inherent toxicity and lack of effective treatments. We conducted a systematic search for human studies that report toxicokinetics, mechanisms, clinical features, prognosis and treatment. Paraquat is rapidly but incompletely absorbed and then largely eliminated unchanged in urine within 12–24 h. Clinical features are largely due to intracellular effects. Paraquat generates reactive oxygen species which cause cellular damage via lipid peroxidation, activation of NF-κB, mitochondrial damage and apoptosis in many organs. Kinetics of distribution into these target tissues can be described by a two-compartment model. Paraquat is actively taken up against a concentration gradient into lung tissue leading to pneumonitis and lung fibrosis. Paraquat also causes renal and liver injury. Plasma paraquat concentrations, urine and plasma dithionite tests and clinical features provide a good guide to prognosis. Activated charcoal and Fuller's earth are routinely given to minimize further absorption. Gastric lavage should not be performed. Elimination methods such as haemodialysis and haemoperfusion are unlikely to change the clinical course. Immunosuppression with dexamethasone, cyclophosphamide and methylprednisolone is widely practised, but evidence for efficacy is very weak. Antioxidants such as acetylcysteine and salicylate might be beneficial through free radical scavenging, anti-inflammatory and NF-κB inhibitory actions. However, there are no published human trials. The case fatality is very high in all centres despite large variations in treatment. PMID:21615775

  20. Medical management of paraquat ingestion.

    PubMed

    Gawarammana, Indika B; Buckley, Nicholas A

    2011-11-01

    Poisoning by paraquat herbicide is a major medical problem in parts of Asia while sporadic cases occur elsewhere. The very high case fatality of paraquat is due to inherent toxicity and lack of effective treatments. We conducted a systematic search for human studies that report toxicokinetics, mechanisms, clinical features, prognosis and treatment. Paraquat is rapidly but incompletely absorbed and then largely eliminated unchanged in urine within 12-24 h. Clinical features are largely due to intracellular effects. Paraquat generates reactive oxygen species which cause cellular damage via lipid peroxidation, activation of NF-κB, mitochondrial damage and apoptosis in many organs. Kinetics of distribution into these target tissues can be described by a two-compartment model. Paraquat is actively taken up against a concentration gradient into lung tissue leading to pneumonitis and lung fibrosis. Paraquat also causes renal and liver injury. Plasma paraquat concentrations, urine and plasma dithionite tests and clinical features provide a good guide to prognosis. Activated charcoal and Fuller's earth are routinely given to minimize further absorption. Gastric lavage should not be performed. Elimination methods such as haemodialysis and haemoperfusion are unlikely to change the clinical course. Immunosuppression with dexamethasone, cyclophosphamide and methylprednisolone is widely practised, but evidence for efficacy is very weak. Antioxidants such as acetylcysteine and salicylate might be beneficial through free radical scavenging, anti-inflammatory and NF-κB inhibitory actions. However, there are no published human trials. The case fatality is very high in all centres despite large variations in treatment. PMID:21615775

  1. Co-Design of a Computer-Assisted Medical Decision Support System to Manage Antibiotic Prescription in an ICU Ward.

    PubMed

    Gil, Miguel; Pinto, Pedro; Simões, Alexandra S; Póvoa, Pedro; Da Silva, Miguel Mira; Lapão, Luís Velez

    2016-01-01

    About 37 thousand people die per year in Europe due to infections by resistant bacteria. Fighting antimicrobial resistances (AR) is a top priority to save lives and reduce costs. AR is triggered mostly by uncritical antibiotic prescription. This paper presents HAITool, a decision-making information system to support antibiotic prescription. The system was co-developed together with health professionals using Design Science Research Methodology, empowered with innovative data visualization techniques to improve AR management. HAITool includes integrated visualizations of patient, microbiology, and pharmacy data, facilitating clinical decision support, antibiotic prescriptions quality and antibiotic-resistant bacteria monitoring. It also includes an alert module that monitors conformance of antibiotic prescriptions with norms and guidelines. HAITool is evaluated using both the Österle principles and interviews with physicians and infection control team from three participant hospitals. PMID:27577433

  2. Quality management for the processing of medical devices

    PubMed Central

    Klosz, Kerstin

    2008-01-01

    Rules on the reprocessing of medical devices were put into place in Germany in 2001. The present article explains the background situation and the provisions that are currently in force. The implementation of these statutory requirements is described using the example of the quality management system of Germany’s market leader, Vanguard AG. This quality management system was successfully certified pursuant to DIN EN ISO 13485:2003 for the scope "reprocessing of medical devices", including class “critical C”, in accordance with the recommendation of the Commission for Hospital Hygiene and the Prevention of Infection at the Robert-Koch-Institute (RKI) and the German Federal Institute for Drugs and Medical Devices (BfArM) on the “Hygiene requirements for reprocessing of medical devices”. PMID:20204094

  3. Quality assurance in military medical research and medical radiation accident management.

    PubMed

    Hotz, Mark E; Meineke, Viktor

    2012-08-01

    The provision of quality radiation-related medical diagnostic and therapeutic treatments cannot occur without the presence of robust quality assurance and standardization programs. Medical laboratory services are essential in patient treatment and must be able to meet the needs of all patients and the clinical personnel responsible for the medical care of these patients. Clinical personnel involved in patient care must embody the quality assurance process in daily work to ensure program sustainability. In conformance with the German Federal Government's concept for modern departmental research, the international standard ISO 9001, one of the relevant standards of the International Organization for Standardization (ISO), is applied in quality assurance in military medical research. By its holistic approach, this internationally accepted standard provides an excellent basis for establishing a modern quality management system in line with international standards. Furthermore, this standard can serve as a sound basis for the further development of an already established quality management system when additional standards shall apply, as for instance in reference laboratories or medical laboratories. Besides quality assurance, a military medical facility must manage additional risk events in the context of early recognition/detection of health risks of military personnel on deployment in order to be able to take appropriate preventive and protective measures; for instance, with medical radiation accident management. The international standard ISO 31000:2009 can serve as a guideline for establishing risk management. Clear organizational structures and defined work processes are required when individual laboratory units seek accreditation according to specific laboratory standards. Furthermore, international efforts to develop health laboratory standards must be reinforced that support sustainable quality assurance, as in the exchange and comparison of test results within

  4. District nurses' role in managing medication dysphagia.

    PubMed

    Griffith, Richard

    2016-08-01

    A survey commissioned by the Patients Association (2015) has shown that the risky practice of altering solid-form medication to assist patients with swallowing difficulties is a daily occurrence in care homes. District nurses and community matrons who provide care to patients and assist staff in care homes are well-placed to raise awareness of the impact that tampering with tablets has on patient safety. It is essential that district nurses and community matrons discharge their duty of care to patients in care homes by supporting effective medication management that meets the individual needs of those patients. This article considers the legal and professional standards that must inform a district nurse's support of medication management for a patient with swallowing difficulties residing in a care home. PMID:27479856

  5. Personnel Administration: Management of Large Medical Libraries *

    PubMed Central

    Kronick, David A.

    1965-01-01

    Machines themselves are not dehumanizing. Employed with proper management in total systems they enable us better to achieve human goals. Large libraries are complex systems involving man-machine relationships which must be studied with the new management techniques of systems analysis and operations research. Management science deals with a wide variety of problems encountered in the economy of the modern library. Librarians must know about these techniques if they are to fulfill their roles as managers of information services and systems. Good management also involves taking cognizance of the human factors in the old meaning of the term. Some parallels may be found between child rearing and personnel management, but the primary one is that managers must pay the same kind of thoughtful attention to their problems. Good management techniques may be learned empirically by trial and error, but they are better acquired systematically through consultation and study. PMID:5897259

  6. Medical management of renal stones.

    PubMed

    Morgan, Monica S C; Pearle, Margaret S

    2016-01-01

    The prevalence of kidney stones is increasing in industrialized nations, resulting in a corresponding rise in economic burden. Nephrolithiasis is now recognized as both a chronic and systemic condition, which further underscores the impact of the disease. Diet and environment play an important role in stone disease, presumably by modulating urine composition. Dietary modification as a preventive treatment to decrease lithogenic risk factors and prevent stone recurrence has gained interest because of its potential to be safer and more economical than drug treatment. However, not all abnormalities are likely to be amenable to dietary therapy, and in some cases drugs are necessary to reduce the risk of stone formation. Unfortunately, no new drugs have been developed for stone prevention since the 1980s when potassium citrate was introduced, perhaps because the long observation period needed to demonstrate efficacy discourages investigators from embarking on clinical trials. Nonetheless, effective established treatment regimens are currently available for stone prevention. PMID:26977089

  7. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Initial medical evaluation and management... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... Bureau institution considered medically appropriate, or to a community hospital....

  8. The medical management of unintentional radionuclide intakes.

    PubMed

    Breitenstein, B D

    2003-01-01

    As a general medical problem, radionuclide intakes that may cause significant health effects are uncommon events. In preparing to manage a radionuclide accident, planning is the key. The medical aspects of such an accident are only one part of the management, and a professional team approach is required. Specific priorities and sequencing are necessary in medically managing a radionuclide intake. As soon as is reasonably practical, promptly remove the victim(s) from further radionuclide, radiation field, or chemical exposure. Life and limb-saving medical aid takes precedence over ionising radiation concerns in nearly all cases. Next are the prevention and/or minimisation of internal intake of radionuclides and evaluation and control of external radionuclide contamination, followed by institution of treatment to minimise the retained radionuclide. Communication with the accident victim, and his or her family, and public affairs/media issues are important. Finally, follow-up treatment for internal intakes that may cause delayed health effects is given. PMID:14527016

  9. Strategic Planning: An Integrated Academic Information Management System (IAIMS) at Georgetown University Medical Center. Volume 1, Implementation Plan. Volume 2, Planning Accomplishments. Volume 3, Environmental Forecast. Volume 4, Institutional Self Study.

    ERIC Educational Resources Information Center

    Broering, Naomi C.; And Others

    Strategic planning for an Integrated Academic Information Management System (IAIMS) for Georgetown University Medical Center is considered. The goal is to organize and transmit accessible and timely biomedical information where it is needed. Activities are proposed for education, research, patient care, management, sharing information on…

  10. Medical management of chronic stable angina

    PubMed Central

    Wee, Yong; Burns, Kylie; Bett, Nicholas

    2015-01-01

    Summary Stable angina pectoris is characterised by typical exertional chest pain that is relieved by rest or nitrates. Risk stratification of patients is important to define prognosis, to guide medical management and to select patients suitable for revascularisation. Medical treatment aims to relieve angina and prevent cardiovascular events. Beta blockers and calcium channel antagonists are first-line options for treatment. Short-acting nitrates can be used for symptom relief. Low-dose aspirin and statins are prescribed to prevent cardiovascular events. PMID:26648642

  11. Medical librarianship: a systems perspective.

    PubMed Central

    Cruzat, G S

    1980-01-01

    Medical or health sciences librarianship is viewed as a system whose components are the professional school, the professional group, and the professional association. As an open system it imports energy from these components, or subsystems, and transforms this energy into professionally identifiable products. The subsystems, in influencing the character of the medical and health sciences library profession, are interdependent and interrelated. However, linkages between the subsystems are becoming defective due primarily to lack of communication, information, and feedback. Stronger and more vigorous interaction among the subsystems is needed. PMID:7362921

  12. Integrated medication management in mHealth applications.

    PubMed

    Ebner, Hubert; Modre-Osprian, Robert; Kastner, Peter; Schreier, Günter

    2014-01-01

    Continuous medication monitoring is essential for successful management of heart failure patients. Experiences with the recently established heart failure network HerzMobil Tirol show that medication monitoring limited to heart failure specific drugs could be insufficient, in particular for general practitioners. Additionally, some patients are confused about monitoring only part of their prescribed drugs. Sometimes medication will be changed without informing the responsible physician. As part of the upcoming Austrian electronic health record system ELGA, the eMedication system will collect prescription and dispensing data of drugs and these data will be accessible to authorized healthcare professionals on an inter-institutional level. Therefore, we propose two concepts on integrated medication management in mHealth applications that integrate ELGA eMedication and closed-loop mHealth-based telemonitoring. As a next step, we will implement these concepts and analyze--in a feasibility study--usability and practicability as well as legal aspects with respect to automatic data transfer from the ELGA eMedication service. PMID:24825709

  13. Impact of an electronic medication management system on hospital doctors’ and nurses’ work: a controlled pre–post, time and motion study

    PubMed Central

    Westbrook, Johanna I; Li, Ling; Georgiou, Andrew; Paoloni, Richard; Cullen, John

    2013-01-01

    Objective To quantify and compare the time doctors and nurses spent on direct patient care, medication-related tasks, and interactions before and after electronic medication management system (eMMS) introduction. Methods Controlled pre–post, time and motion study of 129 doctors and nurses for 633.2 h on four wards in a 400-bed hospital in Sydney, Australia. We measured changes in proportions of time on tasks and interactions by period, intervention/control group, and profession. Results eMMS was associated with no significant change in proportions of time spent on direct care or medication-related tasks relative to control wards. In the post-period control ward, doctors spent 19.7% (2 h/10 h shift) of their time on direct care and 7.4% (44.4 min/10 h shift) on medication tasks, compared to intervention ward doctors (25.7% (2.6 h/shift; p=0.08) and 8.5% (51 min/shift; p=0.40), respectively). Control ward nurses in the post-period spent 22.1% (1.9 h/8.5 h shift) of their time on direct care and 23.7% on medication tasks compared to intervention ward nurses (26.1% (2.2 h/shift; p=0.23) and 22.6% (1.9 h/shift; p=0.28), respectively). We found intervention ward doctors spent less time alone (p=0.0003) and more time with other doctors (p=0.003) and patients (p=0.009). Nurses on the intervention wards spent less time with doctors following eMMS introduction (p=0.0001). Conclusions eMMS introduction did not result in redistribution of time away from direct care or towards medication tasks. Work patterns observed on these intervention wards were associated with previously reported significant reductions in prescribing error rates relative to the control wards. PMID:23715803

  14. Role of Medical Management for Uterine Leiomyomas.

    PubMed

    Kashani, Banafsheh N; Centini, Gabriele; Morelli, Sara S; Weiss, Gerson; Petraglia, Felice

    2016-07-01

    Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient's symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. This manuscript will detail the available and emerging hormonal and non-hormonal treatments for symptomatic uterine leiomyomas. PMID:26796059

  15. Implementing electronic medication management at an Australian teaching hospital.

    PubMed

    Day, Richard O; Roffe, David J; Richardson, Katrina L; Baysari, Melissa T; Brennan, Nicholas J; Beveridge, Sandy; Melocco, Teresa; Ainge, John; Westbrook, Johanna I

    2011-11-01

    We describe the implementation of an electronic medication management system (eMMS) in an Australian teaching hospital, to inform future similar exercises. The success of eMMS implementation depends on: a positive workplace culture (leadership, teamwork and clinician ownership); acceptance of the major impact on work practices by all staff; timely system response to user feedback; training and support for clinicians; a usable system; adequate decision support. PMID:22060071

  16. Development of an integrated medical supply information system

    NASA Astrophysics Data System (ADS)

    Xu, Eric; Wermus, Marek; Blythe Bauman, Deborah

    2011-08-01

    The integrated medical supply inventory control system introduced in this study is a hybrid system that is shaped by the nature of medical supply, usage and storage capacity limitations of health care facilities. The system links demand, service provided at the clinic, health care service provider's information, inventory storage data and decision support tools into an integrated information system. ABC analysis method, economic order quantity model, two-bin method and safety stock concept are applied as decision support models to tackle inventory management issues at health care facilities. In the decision support module, each medical item and storage location has been scrutinised to determine the best-fit inventory control policy. The pilot case study demonstrates that the integrated medical supply information system holds several advantages for inventory managers, since it entails benefits of deploying enterprise information systems to manage medical supply and better patient services.

  17. Web-based medical image archive system

    NASA Astrophysics Data System (ADS)

    Suh, Edward B.; Warach, Steven; Cheung, Huey; Wang, Shaohua A.; Tangiral, Phanidral; Luby, Marie; Martino, Robert L.

    2002-05-01

    This paper presents a Web-based medical image archive system in three-tier, client-server architecture for the storage and retrieval of medical image data, as well as patient information and clinical data. The Web-based medical image archive system was designed to meet the need of the National Institute of Neurological Disorders and Stroke for a central image repository to address questions of stroke pathophysiology and imaging biomarkers in stroke clinical trials by analyzing images obtained from a large number of clinical trials conducted by government, academic and pharmaceutical industry researchers. In the database management-tier, we designed the image storage hierarchy to accommodate large binary image data files that the database software can access in parallel. In the middle-tier, a commercial Enterprise Java Bean server and secure Web server manages user access to the image database system. User-friendly Web-interfaces and applet tools are provided in the client-tier for easy access to the image archive system over the Internet. Benchmark test results show that our three-tier image archive system yields fast system response time for uploading, downloading, and querying the image database.

  18. Columbia-Presbyterian Medical Center Integrated Academic Information Management System (IAIMS) Outpatient Clinical Information System Implemented in a Faculty General Medicine Practice

    PubMed Central

    Shea, Steven; Clark, Anthony S.; Clayton, Paul D.

    1990-01-01

    We describe a clinical information system for hospital-based ambulatory care implemented in the context of the institution's IAIMS Phase III effort. Key features of this application are physician data entry to maintain summary clinical profiles that include medication lists, problem lists, and preventive care, and integration with other components of the Clinical Information System at the levels of the database, the user interface, and data sharing. A goal of this application is to provide coded data as a substrate for computer-based decision support.

  19. Medical Practice Support System. A medical practitioner's multimedia workstation.

    PubMed

    Stetson, D M; Eberhart, R C; Dobbins, R W; Pugh, W

    1991-01-01

    The United States Navy has developed a computer based Medical Practice Support System (MEPSS) intended for use by medical practitioners working in isolated situations. The system, now being tested in operational settings, emphasizes inexpensive, easily obtained off-the-shelf hardware and specially developed, readily implemented software to provide users with: 1) medical record keeping, 2) an electronic medical library, 3) interactive video instruction programs suitable for continuing medical education, 4) computer based medical diagnosis and treatment assistance, and 5) electronic communications with other facilities. This demonstration emphasizes a user based developmental approach, integration of diverse systems under a single user interface, and portable hardware. The resulting system makes medical information needed by practitioners instantly available at the time of a patient encounter, whenever and wherever that encounter may occur. Making clinically valuable information immediately available, MEPSS demonstrates how practitioners can use computers to help their own efforts to improve patient care quality and efficiency. PMID:1807756

  20. Medication therapy management services: definitions and outcomes.

    PubMed

    Pellegrino, Annette N; Martin, Michelle T; Tilton, Jessica J; Touchette, Daniel R

    2009-01-01

    In the US, the Medicare Modernization Act of 2003 required that Medicare Part D insurers provide medication therapy management (MTM) services (MTMS) to selected beneficiaries, with the goals of providing education, improving adherence, or detecting adverse drug events and medication misuse. These broad goals and variety in MTM programmes available make assessment of these programmes difficult. The objectives of this article are to review the definitions of MTMS proposed by various stakeholders, and to summarize and evaluate the outcomes of MTMS consistent with those that may be offered in Medicare Part D or reimbursed by State Medicaid programmes. MTM programmes are approved by the Centers for Medicare and Medicaid Services (CMS). Pharmacy, medical and insurance organizations have provided guidelines and definitions for MTM programmes, distinguishing them from other types of community pharmacy activities. MTM has been distinguished from disease state management because of the focus on medications and multiple conditions. It differs from patient counselling because it is delivered independent of dispensing and involves collaboration with patients and providers. There is no consensus on the recommended mode of delivery (i.e. face-to-face or by telephone) for MTM. A MEDLINE search was conducted to identify articles published after 2000 using the search terms 'medication therapy management' and 'medication management'. Studies with outcomes evaluating community-based programmes consistent with MTMS, regardless of MTMS reimbursement source, were included in the review. Seven publications describing four MTMS were identified. For each of the identified articles, we describe the study design, service setting, inclusion criteria and outcomes. An additional three surveys describing multiple MTMS were identified and are summarized. Finally, ongoing efforts by CMS to evaluate the success of MTMS in the US are described. To date, there are limited outcomes available for MTMS

  1. Development of medical equipment alarm monitoring system.

    PubMed

    Yamashita, Yoshinori; Ogaito, Tatoku; Kasamatsu, Shingo

    2013-01-01

    In a hospital, we use a large number of medical equipment. In these use, I support the safe use by the alarm such as errors from medical equipment. There is the instrument notifying of alarm in communication, but there is the instrument by a sound and the light. For the medical safety management, confirmation of the alarm is important. We thought that stability was improved by integrating alarm from the instrument of the different type. Therefore, we thought that we integrated alarm from medical equipment. We decided to transmit an alarm signal from medical equipment by adding radio module program unit. The type of the radio used IEEE 802.15.4 (ZigBee) at a point of view of low power, International Standard, simple radio equipment. This system deals with only alarm information from medical equipment and does not handle the data. However, we understood that we were helpful very much even if it was only alarm information. We were able to in this way reduce the number of incidents. PMID:23920969

  2. Medical device data systems and FDA regulation. Should medical device data systems require FDA clearance?

    PubMed

    Kelley, Peter

    2010-01-01

    It is widely understood why medical devices need to be regulated by the FDA and other governing bodies. However medical software does not typically require the same level of regulation. Currently the FDA is investigating whether one type of medical software, Medical Device Data Systems (MDDS), should require FDA clearance because of the potential risk they impose when interconnected with medical devices. Hospitals are looking to implement MDDS because the technology allows nursing staff to spend more time on direct patient care and reduces charting errors. This article will explore the FDA's proposal and will review the possible risks and provide a rationale for why MDDS should be regulated by the FDA and why MDDS vendors should have the right level of quality and risk management procedures in place to ensure that they are developing and bringing to market the safest products possible. PMID:20677470

  3. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Initial medical evaluation and management... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3)...

  4. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Initial medical evaluation and management... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3)...

  5. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Initial medical evaluation and management... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3)...

  6. 28 CFR 549.63 - Initial medical evaluation and management.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Initial medical evaluation and management... MANAGEMENT MEDICAL SERVICES Hunger Strikes, Inmate § 549.63 Initial medical evaluation and management. (a... hunger strike: (1) Measure and record height and weight; (2) Take and record vital signs; (3)...

  7. Medical Device Risk Management For Performance Assurance Optimization and Prioritization.

    PubMed

    Gaamangwe, Tidimogo; Babbar, Vishvek; Krivoy, Agustina; Moore, Michael; Kresta, Petr

    2015-01-01

    Performance assurance (PA) is an integral component of clinical engineering medical device risk management. For that reason, the clinical engineering (CE) community has made concerted efforts to define appropriate risk factors and develop quantitative risk models for efficient data processing and improved PA program operational decision making. However, a common framework that relates the various processes of a quantitative risk system does not exist. This article provides a perspective that focuses on medical device quality and risk-based elements of the PA program, which include device inclusion/exclusion, schedule optimization, and inspection prioritization. A PA risk management framework is provided, and previous quantitative models that have contributed to the advancement of PA risk management are examined. A general model for quantitative risk systems is proposed, and further perspective on possible future directions in the area of PA technology is also provided. PMID:26618842

  8. Legal obstacles to medical communities' full participation in managed care.

    PubMed

    Hilgers, D W

    1995-01-01

    Strong physician-driven delivery systems are vital to the creation of a quality medical system for the United States. To compete with employers, insurers, hospitals, and the government, physicians must consolidate. Physicians do not generally have the necessary capital, management skills, or desire to manage large organizations, however. In addition, antitrust restrictions, antireferral statutes, insurance regulation, and malpractice liability risks are major legal obstacles that restrain physicians from consolidating. The government needs to recognize the problems that federal and state laws have created for the development of physician-driven delivery systems. The benefit to the medical system by relaxing these laws will outweigh any potential risk of loss to the public. PMID:7600242

  9. A proposed approach for safety management in medical software design.

    PubMed

    Rafeh, Reza

    2013-02-01

    Safe behavior of modern medical systems is the most important issue in this industry. Software has to follow safety instructions to keep the system away from any error situation. This paper proposes a new approach for safety management which can be used in different phases of software development before implementation and disposal phase. In the proposed approach safety begins from requirements as the infrastructure of design and continues through other phases of software production. PMID:23321965

  10. Facilitating Virtual Health Management Using Medical Device Integration.

    PubMed

    Zaleski, John R

    2015-01-01

    Data from connected medical devices (CMDS) provides an objective and rich source of information to augment patient care management and clinical decision making. A principal reason is measurements of patient properties made through bedside CMDs are not typically subject to errors associated with misinterpretation, incorrect recording, and incorrect time stamping. Furthermore, data from CMDs can be collected regularly, ensuring a dense and robust data record on a given patient. The ability to remotely manage and monitor patients is greatly facilitated by access to data, as measurements represent an objective source of information that facilitate clinical decision making. In my recent book, Connected Medical Devices: Integrating Patient Care Data in Healthcare System, I discuss the topic of medical device integration (MDI) in relation to implementing CMDs in healthcare settings as a guide to assist hospitals in this undertaking. The following discussion about MDI are the opening paragraphs from this text, followed by a discussion of MDI architectures. PMID:26571635

  11. Stereoscopic medical imaging collaboration system

    NASA Astrophysics Data System (ADS)

    Okuyama, Fumio; Hirano, Takenori; Nakabayasi, Yuusuke; Minoura, Hirohito; Tsuruoka, Shinji

    2007-02-01

    The computerization of the clinical record and the realization of the multimedia have brought improvement of the medical service in medical facilities. It is very important for the patients to obtain comprehensible informed consent. Therefore, the doctor should plainly explain the purpose and the content of the diagnoses and treatments for the patient. We propose and design a Telemedicine Imaging Collaboration System which presents a three dimensional medical image as X-ray CT, MRI with stereoscopic image by using virtual common information space and operating the image from a remote location. This system is composed of two personal computers, two 15 inches stereoscopic parallax barrier type LCD display (LL-151D, Sharp), one 1Gbps router and 1000base LAN cables. The software is composed of a DICOM format data transfer program, an operation program of the images, the communication program between two personal computers and a real time rendering program. Two identical images of 512×768 pixcels are displayed on two stereoscopic LCD display, and both images show an expansion, reduction by mouse operation. This system can offer a comprehensible three-dimensional image of the diseased part. Therefore, the doctor and the patient can easily understand it, depending on their needs.

  12. Etiology and medical management of NEC.

    PubMed

    Gupta, Amit; Paria, Anshuman

    2016-06-01

    Necrotising enterocolitis (NEC) is a serious infection of the bowel that predominantly affects preterm infants and is a leading cause for mortality and morbidity in preterm infants. It involves a spectrum of pathology including widespread inflammation of the intestinal mucosa, invasion of the immature gut by enteric gas forming bacteria, dissection of the gut wall and portal veins by this gas, often culminating in ischemic necrosis of the intestine. This article provides an overview of the incidence, etio-pathological risk factors, preventive strategies and medical management of NEC. PMID:27080373

  13. Medical Management of Drug-Resistant Tuberculosis

    PubMed Central

    2015-01-01

    Drug-resistant tuberculosis (TB) is still a major threat worldwide. However, recent scientific advances in diagnostic and therapeutic tools have improved the management of drug-resistant TB. The development of rapid molecular testing methods allows for the early detection of drug resistance and prompt initiation of an appropriate treatment. In addition, there has been growing supportive evidence for shorter treatment regimens in multidrug-resistant TB; and for the first time in over 50 years, new anti-TB drugs have been developed. The World Health Organization has recently revised their guidelines, primarily based on evidence from a meta-analysis of individual patient data (n=9,153) derived from 32 observational studies, and outlined the recommended combination and correct use of available anti-TB drugs. This review summarizes the updated guidelines with a focus on the medical management of drug-resistant TB. PMID:26175768

  14. Fingerprint verification on medical image reporting system.

    PubMed

    Chen, Yen-Cheng; Chen, Liang-Kuang; Tsai, Ming-Dar; Chiu, Hou-Chang; Chiu, Jainn-Shiun; Chong, Chee-Fah

    2008-03-01

    The healthcare industry is recently going through extensive changes, through adoption of robust, interoperable healthcare information technology by means of electronic medical records (EMR). However, a major concern of EMR is adequate confidentiality of the individual records being managed electronically. Multiple access points over an open network like the Internet increases possible patient data interception. The obligation is on healthcare providers to procure information security solutions that do not hamper patient care while still providing the confidentiality of patient information. Medical images are also part of the EMR which need to be protected from unauthorized users. This study integrates the techniques of fingerprint verification, DICOM object, digital signature and digital envelope in order to ensure that access to the hospital Picture Archiving and Communication System (PACS) or radiology information system (RIS) is only by certified parties. PMID:18178287

  15. Psychotropic Medication Management in a Residential Group Care Program

    ERIC Educational Resources Information Center

    Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

    2010-01-01

    This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

  16. Medication Management of Jaw Lesions for Dental Patients.

    PubMed

    Ogle, Orrett E; Santosh, Arvind Babu Rajendra

    2016-04-01

    Most pathologic lesions of the jaws or of oral mucosa are treated successfully by surgical interventions. For treatment of the central giant cell lesion, aneurysmal bone cysts, histiocytosis of the mandible, hemangioma, odontogenic keratocyst, Paget disease, oral submucous fibrosis, and oral lichen planus, medical management consisting of intralesional injections, sclerosing agents, and systemic bisphosphonates is as successful as surgical procedures with fewer complications. Pharmacology of agents used and protocols are presented. PMID:27040297

  17. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE... Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). (a... to reduce medication errors and adverse drug interactions and improve medication use that include...

  18. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... medication therapy management programs (MTMPs). 423.153 Section 423.153 Public Health CENTERS FOR MEDICARE... Drug utilization management, quality assurance, and medication therapy management programs (MTMPs). (a... to reduce medication errors and adverse drug interactions and improve medication use that include...

  19. The Changing Medical Care System: Some Implications for Medical Education.

    ERIC Educational Resources Information Center

    Foreman, Spencer

    1986-01-01

    The medical care system is undergoing widespread and significant changes. Individual hospitals may be disappearing as mergers, acquisitions, and a variety of multi-institutional arrangements become the dominant form and as a host of free-standing medical enterprises spread out into the community. (MLW)

  20. [The system of quality management in medical laboratory: the problematic issues of implementation of GOST RKS 9001-2008, GOST R ISO 15189-2009 and GOST R ISO 53079-2008].

    PubMed

    Dolgikh, T I

    2013-04-01

    The article presents the approaches to development and implementation of system of quality management in laboratory as an integral part of the given system in whole medical institution. The costs of works execution concerning quality support are to be weighted with economic profitability and timeliness of medical care provision to ill people considering pre-analytic stage (out-laboratory and in-laboratory) laboratory analysis. Factually it is a matter of development of system of balanced indicators concerning quality management of institution and laboratory functioning. The problematic issues are presented concerning maintenance of particular requirements of GOSTR ISO 15189 about quality of production. The emphasis is made on the necessity of training of administrations of laboratories in the field of quality management and economics of laboratory business. PMID:23984558

  1. Medical waste management in Ibadan, Nigeria: Obstacles and prospects

    SciTech Connect

    Coker, Akinwale Sangodoyin, Abimbola; Sridhar, Mynepalli; Booth, Colin; Olomolaiye, Paul; Hammond, Felix

    2009-02-15

    Quantification and characterization of medical waste generated in healthcare facilities (HCFs) in a developing African nation has been conducted to provide insights into existing waste collection and disposal approaches, so as to provide sustainable avenues for institutional policy improvement. The study, in Ibadan city, Nigeria, entailed a representative classification of nearly 400 healthcare facilities, from 11 local government areas (LGA) of Ibadan, into tertiary, secondary, primary, and diagnostic HCFs, of which, 52 HCFs were strategically selected. Primary data sources included field measurements, waste sampling and analysis and a questionnaire, while secondary information sources included public and private records from hospitals and government ministries. Results indicate secondary HCFs generate the greatest amounts of medical waste (mean of 10,238 kg/day per facility) followed by tertiary, primary and diagnostic HCFs, respectively. Characterised waste revealed that only {approx}3% was deemed infectious and highlights opportunities for composting, reuse and recycling. Furthermore, the management practices in most facilities expose patients, staff, waste handlers and the populace to unnecessary health risks. This study proffers recommendations to include (i) a need for sustained cooperation among all key actors (government, hospitals and waste managers) in implementing a safe and reliable medical waste management strategy, not only in legislation and policy formation but also particularly in its monitoring and enforcement and (ii) an obligation for each HCF to ensure a safe and hygienic system of medical waste handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment.

  2. Integrating an open-source course management system (Moodle) into the teaching of a first-year medical physiology course: a case study.

    PubMed

    Seluakumaran, Kumar; Jusof, Felicita Fedelis; Ismail, Rosnah; Husain, Ruby

    2011-12-01

    Educators in medical schools around the world are presently experimenting with innovative ways of using web-based learning to supplement the existing teaching and learning process. We have recently used a popular open-source course management system (CMS) called the modular object-oriented dynamic learning environment (Moodle) to construct an online site (DPhysiol) to facilitate our face-to-face teaching of physiology to a group of first-year students in the Bachelor of Medicine and Bachelor of Surgery program. The integration of the Moodle site into our teaching was assessed using online log activity, student examination marks, and feedback from students. The freely available Moodle platform was simple to use, helped to effectively deliver course materials, and has features that allowed cooperative learning. Students who used the CMS throughout their academic year and commented favorably regarding its use as a complement to the face-to-face classroom sessions. The group of students used the CMS obtained significantly higher scores in the final examination compared with the previous class that did not use the CMS. In addition, there was a significant correlation between student participation and performance in online quizzes and their final examination marks. However, students' overall online usage of the CMS did not correlate with their examination marks. We recommend Moodle as a useful tool for physiology educators who are interested in integrating web-based learning into their existing teaching curriculum. PMID:22139773

  3. Recent trends: Medical management of infectious keratitis

    PubMed Central

    Solanki, Sneha; Rathi, Manisha; Khanduja, Sumeet; Dhull, C.S.; Sachdeva, Sumit; Phogat, Jitender

    2015-01-01

    This review article highlights the newer diagnostic modalities and approaches in the medical management of infectious keratitis. A Medline literature search conducted to March 2014 has been included. Recent studies or publications were selected from international indexed journals using suitable key words. Development of specular microscopy and polymerase chain reaction (PCR) has a promising role as diagnostic modalities in infectious keratitis, especially in refractory cases. Previously fortified antibiotics have been the mainstay of treatment for bacterial keratitis. Recently, the advent of fourth-generation fluoroquinolones monotherapy has shown promising results in the management of bacterial keratitis. Corneal collagen cross-linking is being considered in the refractory cases. Topical natamycin and amphotericin B should be considered as the first choice anti-fungal agents in suspected filamentous or yeast infection respectively. Voriconazole and newer routes of administration such as intrastromal and intracameral injection of conventional anti-fungal agents have demonstrated a positive clinical response. Ganciclovir is a newer anti-viral agent with promising results in herpes simplex keratitis. Thus, introduction of newer diagnostic modalities and collagen cross-linking along with fourth-generation fluoroquinolones and newer azoles have a promising role in the management of infectious keratitis. PMID:26622133

  4. Image integrity verification in medical information systems.

    PubMed

    Lenti, Jozsef; Lovanyi, Istvan

    2003-01-01

    In nowadays it is a major objective to protect healthcare information against unauthorized access. Comparing conventional and electronic management of medical images the later one demands much more complex security measures. We propose a new scenario for watermark data buildup and embedding which is independent from the applied watermarking technology. In our proposed method the embedded watermark data is dependant on image and patient information too. The proposed watermark buildup method provides watermark information where it is small in size and represents a unique digest of the image and image related data. The embedded data can be considered unique with high probability even if the same algorithm was used in different medical information systems. Described procedures ensure new, more secure links between image and related data, offering further perspectives in smartcard implementations. PMID:14664001

  5. Collaborative drug therapy management and comprehensive medication management-2015.

    PubMed

    McBane, Sarah E; Dopp, Anna L; Abe, Andrew; Benavides, Sandra; Chester, Elizabeth A; Dixon, Dave L; Dunn, Michaelia; Johnson, Melissa D; Nigro, Sarah J; Rothrock-Christian, Tracie; Schwartz, Amy H; Thrasher, Kim; Walker, Scot

    2015-04-01

    The American College of Clinical Pharmacy (ACCP) previously published position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Since 2003, significant federal and state legislation addressing CDTM has evolved and expanded throughout the United States. CDTM is well suited to facilitate the delivery of comprehensive medication management (CMM) by clinical pharmacists. CMM, defined by ACCP as a core component of the standards of practice for clinical pharmacists, is designed to optimize medication-related outcomes in collaborative practice environments. New models of care delivery emphasize patient-centered, team-based care and increasingly link payment to the achievement of positive economic, clinical, and humanistic outcomes. Hence clinical pharmacists practicing under CDTM agreements or through other privileging processes are well positioned to provide CMM. The economic value of clinical pharmacists in team-based settings is well documented. However, patient access to CMM remains limited due to lack of payer recognition of the value of clinical pharmacists in collaborative care settings and current health care payment policy. Therefore, the clinical pharmacy discipline must continue to establish and expand its use of CDTM agreements and other collaborative privileging mechanisms to provide CMM. Continued growth in the provision of CMM by appropriately qualified clinical pharmacists in collaborative practice settings will enhance recognition of their positive impact on medication-related outcomes. PMID:25884536

  6. 78 FR 57159 - Scientific Information Request on Medication Therapy Management

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Medication... scientific information submissions. SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from the public on medication therapy management Scientific information...

  7. Medical management of a cutaneous contamination.

    PubMed

    Berard, Philippe; Michel, Xavier; Menetrier, Florence; Laroche, Pierre

    2010-10-01

    The authors propose a process to improve the medical management of a cutaneous contamination in two ways: firstly by analysis of practices and products of decontamination used; secondly, by developing computer tools for the occupational physicians. This software will allow them to have a rapid dosimetric assessment in the event of a skin contamination by radioactive particles and will help them in their diagnostic and therapeutic decisions. A standardized data sheet was created allowing the exhaustive collection of adequate information in order to evaluate the skin dose. The selection of appropriate monitoring equipment with a 1 cm2 detector, depending on the place and on the surface of the contaminated area, will allow the evaluation and the quantification of the surface activities. A tool has been made as a software package, named Cutadose®, allowing the assessment of the skin dose in situ as well as the efficacy of the prescribed therapy. PMID:20838101

  8. Monitors Enable Medication Management in Patients' Homes

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Glenn Research Center awarded SBIR funding to ZIN Technologies to develop a platform that could incorporate sensors quantifying an astronaut’s health status and then communicate with the ground. ZIN created a device, developed the system further, and then formed Cleveland-based FlexLife Health to commercialize the technology. Today it is part of an anti-coagulation management system for people with cardiovascular disease.

  9. Biometric identity management for standard mobile medical networks.

    PubMed

    Egner, Alexandru; Soceanu, Alexandru; Moldoveanu, Florica

    2012-01-01

    The explosion of healthcare costs over the last decade has prompted the ICT industry to respond with solutions for reducing costs while improving healthcare quality. The ISO/IEEE 11073 family of standards recently released is the first step towards interoperability of mobile medical devices used in patient environments. The standards do not, however, tackle security problems, such as identity management, or the secure exchange of medical data. This paper proposes an enhancement of the ISO/IEEE 11073-20601 protocol with an identity management system based on biometry. The paper describes a novel biometric-based authentication process, together with the biometric key generation algorithm. The proposed extension of the ISO/IEEE 11073-20601 is also presented. PMID:23366356

  10. Managing adverse effects of glaucoma medications

    PubMed Central

    Inoue, Kenji

    2014-01-01

    Glaucoma is a chronic, progressive disease in which retinal ganglion cells disappear and subsequent, gradual reductions in the visual field ensues. Glaucoma eye drops have hypotensive effects and like all other medications are associated with adverse effects. Adverse reactions may either result from the main agent or from preservatives used in the drug vehicle. The preservative benzalkonium chloride, is one such compound that causes frequent adverse reactions such as superficial punctate keratitis, corneal erosion, conjunctival allergy, and conjunctival injection. Adverse reactions related to main hypotensive agents have been divided into those affecting the eye and those affecting the entire body. In particular, β-blockers frequently cause systematic adverse reactions, including bradycardia, decrease in blood pressure, irregular pulse and asthma attacks. Prostaglandin analogs have distinctive local adverse reactions, including eyelash bristling/lengthening, eyelid pigmentation, iris pigmentation, and upper eyelid deepening. No systemic adverse reactions have been linked to prostaglandin analog eye drop usage. These adverse reactions may be minimized when they are detected early and prevented by reducing the number of different eye drops used (via fixed combination eye drops), reducing the number of times eye drops are administered, using benzalkonium chloride-free eye drops, using lower concentration eye drops, and providing proper drop instillation training. Additionally, a one-time topical medication can be given to patients to allow observation of any adverse reactions, thereafter the preparation of a topical medication with the fewest known adverse reactions can be prescribed. This does require precise patient monitoring and inquiries about patient symptoms following medication use. PMID:24872675

  11. Understanding patient management: the need for medication adherence and persistence.

    PubMed

    Chia, Yc

    2008-01-01

    Poor patient adherence to medication is one of the major factors contributing to poor disease control, in particular in asymptomatic chronic diseases like hypertension and dyslipidaemia. The physical and economic burden on patients and the health care system as a result of non-adherence is great. It is estimated that poor adherence to hypertension medication accounts for as many as 7.1 million preventable deaths annually. Hence recognising and identifying non-adherence is the first step to addressing this problem. Medication adherence can be measured in various ways including self-report to electronic monitoring. In order to be more successful in managing non-adherence, attention must be paid to barriers to adherence, namely the interplay of patient factors, the health care providers themselves and the health care system itself. Taking these into account will probably have the greatest impact on improving medication adherence. Consequently strategies to help overcome these barriers are of paramount importance. Some of these strategies will include education of patients, improving communication between patients and health care providers, improving dose scheduling, providing drugs with less adverse effects, and improving accessibility to health care. Poor mediation adherence continues to be a huge challenge. While the patient is ultimately responsible for the taking of medication, good communication, involving the patient in decision making about their care and simplifying drug regimens go a long way in improving it. PMID:25606104

  12. Demystifying the Medical Management of Nephrolithiasis

    PubMed Central

    Lipkin, Michael E; Preminger, Glenn M

    2011-01-01

    Nephrolithiasis is a common problem associated with significant costs to the health care system. Its prevalence continues to increase, particularly in women, which is attributed to changes in diet and lifestyle. The costs associated with the evaluation and management of nephrolithiasis in the United States has been estimated to be $1.83 billion, and, without any intervention, the risk of recurrence is high. This article reviews the management options for nephrolithiasis including a new formulation of potassium citrate, Urocit®-K 15 mEq, that allows for dosing flexibility which can lead to improved compliance and tolerability. PMID:21826126

  13. An integrated multimedia medical information network system.

    PubMed

    Yamamoto, K; Makino, J; Sasagawa, N; Nagira, M

    1998-01-01

    An integrated multimedia medical information network system at Shimane Medical university has been developed to organize medical information generated from each section and provide information services useful for education, research and clinical practice. The report describes the outline of our system. It is designed to serve as a distributed database for electronic medical records and images. We are developing the MML engine that is to be linked to the world wide web (WWW) network system. To the users, this system will present an integrated multimedia representation of the patient records, providing access to both the image and text-based data required for an effective clinical decision making and medical education. PMID:10384445

  14. Medication Safety Systems and the Important Role of Pharmacists.

    PubMed

    Mansur, Jeannell M

    2016-03-01

    Preventable medication-related adverse events continue to occur in the healthcare setting. While the Institute of Medicine's To Err is Human, published in 2000, highlighted the prevalence of medical and medication-related errors in patient morbidity and mortality, there has not been significant documented progress in addressing system contributors to medication errors. The lack of progress may be related to the myriad of pharmaceutical options now available and the nuances of optimizing drug therapy to achieve desired outcomes and prevent undesirable outcomes. However, on a broader scale, there may be opportunities to focus on the design and performance of the many processes that are part of the medication system. Errors may occur in the storage, prescribing, transcription, preparation and dispensing, or administration and monitoring of medications. Each of these nodes of the medication system, with its many components, is prone to failure, resulting in harm to patients. The pharmacist is uniquely trained to be able to impact medication safety at the individual patient level through medication management skills that are part of the clinical pharmacist's role, but also to analyze the performance of medication processes and to lead redesign efforts to mitigate drug-related outcomes that may cause harm. One population that can benefit from a focus on medication safety through clinical pharmacy services and medication safety programs is the elderly, who are at risk for adverse drug events due to their many co-morbidities and the number of medications often used. This article describes the medication safety systems and provides a blueprint for creating a foundation for medication safety programs within healthcare organizations. The specific role of pharmacists and clinical pharmacy services in medication safety is also discussed here and in other articles in this Theme Issue. PMID:26932714

  15. Managing Medicare reimbursement on medical-psychiatry units.

    PubMed

    Goldberg, R J; Simundson, S

    1991-09-01

    Many general hospitals are confronting issues of financial strain precipitated to a large extent by Medicare payment reductions. The viability of psychiatry programs within general hospitals more than ever depends upon some demonstration of their financial as well as clinical contribution. The aim of this study is to review some of the basic parameters governing Part A (hospital) Medicare reimbursement of DRG-exempt general hospital psychiatry units and to provide options for improving their financial viability. There are a number of specific mechanisms involved in managing Medicare cost and reimbursement. Establishing a system for gatekeeping is important because significant control of payor mix and length of stay resides with the unit gatekeeper. Establishing liaison for short-stay patients with nursing home papers is important because Medicare pays on a target cost per discharge. The identification of short-stay patients is financially very favorable, and often critical to balance the unavoidable longer-stay patients. This paper also discusses how medical-psychiatric units can interface most effectively with medical-surgical units. Finally, there is some discussion of the need to develop pre- and postadmission outpatient medical-psychiatric programs. The financial aspects of medical-psychiatry care, if not the increasing scrutiny of managed care, will force further development of such outpatient programs. PMID:1743500

  16. Diffusion of Medical Technologies: Comparison With ADP Systems in Medical Environment

    PubMed Central

    Hanmer, Jean C.

    1980-01-01

    This health care industry would seem to be a logical user of management information systems. Indeed, a number of Medical Management Information Systems (MMIS) are available commercially. Yet, few hospitals use the technology. The author compares the diffusion of Automated Data Processing (ADP) technology in business with the diffusion of medical technologies among physicians. Both diffusion patterns form S-shaped curves. Close examination, however, of the characteristics of technologies successfully diffused to physicians reveal that MMIS as currently implemented, possess few attributes associated with successful adaption. The author suggests strategies of interest for further research to promote MMIS implementation.

  17. Patients’ Perspective on the Value of Medication Management Appointments

    PubMed Central

    Cruz, Mario; Cruz, Robyn Flaum; Pincus, Harold Alan

    2015-01-01

    Objectives: There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients’ views and opinions about the value of psychiatric medication management appointments. Methods: Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients’ views and opinions about the value of attending medication management appointments. Analysis: An iterative thematic analysis was performed. Findings: Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Conclusions: Patients’ perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

  18. A personalized framework for medication treatment management in chronic care.

    PubMed

    Koutkias, Vassilis G; Chouvarda, Ioanna; Triantafyllidis, Andreas; Malousi, Andigoni; Giaglis, Georgios D; Maglaveras, Nicos

    2010-03-01

    The ongoing efforts toward continuity of care and the recent advances in information and communication technologies have led to a number of successful personal health systems for the management of chronic care. These systems are mostly focused on monitoring efficiently the patient's medical status at home. This paper aims at extending home care services delivery by introducing a novel framework for monitoring the patient's condition and safety with respect to the medication treatment administered. For this purpose, considering a body area network (BAN) with advanced sensors and a mobile base unit as the central communication hub from the one side, and the clinical environment from the other side, an architecture was developed, offering monitoring patterns definition for the detection of possible adverse drug events and the assessment of medication response, supported by mechanisms enabling bidirectional communication between the BAN and the clinical site. Particular emphasis was given on communication and information flow aspects that have been addressed by defining/adopting appropriate formal information structures as well as the service-oriented architecture paradigm. The proposed framework is illustrated via an application scenario concerning hypertension management. PMID:20007042

  19. Medical foods: products for the management of chronic diseases.

    PubMed

    Morgan, Sarah L; Baggott, Joseph E

    2006-11-01

    Medical foods are a specific category of therapeutic agents created under the Orphan Drug Act of 1988, which separated medical foods from drugs for regulatory purposes. Products in this category share the requirements that they are intended for the nutritional management of a specific disease, are used under the guidance of a physician, and contain ingredients that are generally recognized as safe (GRAS). An example of medical foods are formulations intended to manage patients with inborn errors in amino acid metabolism. Newer medical foods are designed to manage hyperhomocysteinemia, pancreatic exocrine insufficiency, inflammatory conditions, cancer cachexia, and other diseases. PMID:17131945

  20. [Management of rheumatoid arthritis medications and pregnancy].

    PubMed

    Funakubo Asanuma, Yu

    2015-01-01

    Rheumatoid arthritis (RA) affects mainly women during their childbearing years. As aging of childbirth advances in Japan, women who plan pregnancy would increase after they developed RA. Recent findings showed that high disease activity of RA might impair fertility. Planning pregnancy is preferable after female patients achive and maintain low disease activity or remission of RA. Women on methotrexate, which is the anchor drug for RA, need to discontinue the medication with a high risk of causing birth defects during conception and pregnancy. Data of RA patients exposed TNF inhibitors during pregnancy has been accumulating in recent years. These data suggest that increased risk of spontaneous abortion and congenital abnomalies has not been observed. Although there is insufficient data about safety of breastfeeding while using TNF inhibitors, the secretion of the drugs in breast milk is very little and fetal toxicity has not been observed. Since long term safety of children exposed TNF inhibitors in uterus has not been established, we should discontinue the drugs as soon as pregnancy is recognized. TNF inhibitors may be an useful tools for management of active RA resistant to conventional DMARDs in women who desire to bear children. PMID:25765688

  1. Medical Management of Metastatic Medullary Thyroid Cancer

    PubMed Central

    Maxwell, Jessica E.; Sherman, Scott K.; O’Dorisio, Thomas M.; Howe, James R.

    2014-01-01

    Medullary thyroid cancer (MTC) is an aggressive form of thyroid cancer, which occurs in both heritable and sporadic forms. Discovery that mutations in the RET protooncogene predispose to familial cases of this disease has allowed for presymptomatic identification of gene carriers and prophylactic surgery to improve the prognosis of these patients. A significant number of patients with the sporadic type of MTC and even with familial disease, still present with nodal or distant metastases, making surgical cure difficult. Over the past several decades, many different types of therapy for metastatic disease have been attempted, with limited success. Improved understanding of the molecular defects and pathways involved in both familial and sporadic MTC has resulted in new hope for these patients with the development of drugs targeting the specific alterations responsible. This new era of targeted therapy with kinase inhibitors represents a significant step forward from previous trials of chemotherapy, radiotherapy, and hormonal therapy. Although much progress has been made, additional agents and strategies are needed to achieve durable, long-term responses in patients with metastatic MTC. This article reviews the history and results of medical management for metastatic MTC from the early 1970s up until the present day. PMID:24942936

  2. [Medical management of cholangiocarcinomas in 2015].

    PubMed

    Marret, Grégoire; Neuzillet, Cindy; Rousseau, Benoît; Tournigand, Christophe

    2016-04-01

    Cholangiocarcinoma is a rare malignancy carrying a poor prognosis. Most patients are diagnosed with advanced-stage disease and are then ineligible for surgical resection, which is the only potentially curative therapeutic modality. The aim of this article is to provide an up-to-date review of medical management of patients with cholangiocarcinoma. The benefit of adjuvant therapy in patients undergoing curative-intent surgery is under evaluation. Combination chemotherapy with gemcitabine and platinum is the standard first-line treatment for patients with advanced cholangiocarcinoma. Targeted agents are not currently recommended due to limited data on use in this setting. The role of second-line chemotherapy is not established in advanced cholangiocarcinoma. Identification of predictive and prognostic markers to select patients who could benefit from second-line therapy is a major issue. A better understanding of the biological and molecular mechanisms underlying the carcinogenesis and the phenotypic heterogeneity of cholangiocarcinoma may path the way of new therapeutic strategies. PMID:26922666

  3. Multiple sclerosis medical image analysis and information management.

    PubMed

    Liu, Lifeng; Meier, Dominik; Polgar-Turcsanyi, Mariann; Karkocha, Pawel; Bakshi, Rohit; Guttmann, Charles R G

    2005-01-01

    Magnetic resonance imaging (MRI) has become a central tool for patient management, as well as research, in multiple sclerosis (MS). Measurements of disease burden and activity derived from MRI through quantitative image analysis techniques are increasingly being used. There are many complexities and challenges in building computerized processing pipelines to ensure efficiency, reproducibility, and quality control for MRI scans from MS patients. Such paradigms require advanced image processing and analysis technologies, as well as integrated database management systems to ensure the most utility for clinical and research purposes. This article reviews pipelines available for quantitative clinical MRI research in MS, including image segmentation, registration, time-series analysis, performance validation, visualization techniques, and advanced medical imaging software packages. To address the complex demands of the sequential processes, the authors developed a workflow management system that uses a centralized database and distributed computing system for image processing and analysis. The implementation of their system includes a web-form-based Oracle database application for information management and event dispatching, and multiple modules for image processing and analysis. The seamless integration of processing pipelines with the database makes it more efficient for users to navigate complex, multistep analysis protocols, reduces the user's learning curve, reduces the time needed for combining and activating different computing modules, and allows for close monitoring for quality-control purposes. The authors' system can be extended to general applications in clinical trials and to routine processing for image-based clinical research. PMID:16385023

  4. Perspectives on management education: an exploratory study of UK and Portuguese medical students.

    PubMed

    Martins, Henrique M G; Detmer, Don E; Rubery, Eileen

    2005-09-01

    Healthcare management is becoming extremely important and large health organizations face increasing demands for leadership and system change. The role of doctors is pivotal but their relationship with management issues and practice has been a matter of long-lasting debate. The aim of this research was to establish opinions of medical students and other medical educational stakeholders on the value and structure of a management and leadership course in medical school. A survey of undergraduate medical students from two medical schools (n = 268) was carried out, and quantitative and qualitative data were analysed and compared with opinions collected from interviews with hospital managers and clinical professors. Portuguese medical students attributed higher relevance to leadership/management education than their UK counterparts. For both groups, such a course would be best: (1) situated in the clinical years, (2) optional and (3) one term/semester long. Main topics desired were 'Managing people/team management'; 'National Health Service'; 'Doctors and Leadership', 'Costs/prices and resource management'. In conclusion, leadership/management education is perceived as relevant but its inclusion in the medical curriculum as well as its content needs careful consideration. Education in informatics and knowledge management would also provide a positive contribution to professional development but is scarcely appreciated at present. PMID:16261667

  5. Implementation of medical monitor system based on networks

    NASA Astrophysics Data System (ADS)

    Yu, Hui; Cao, Yuzhen; Zhang, Lixin; Ding, Mingshi

    2006-11-01

    In this paper, the development trend of medical monitor system is analyzed and portable trend and network function become more and more popular among all kinds of medical monitor devices. The architecture of medical network monitor system solution is provided and design and implementation details of medical monitor terminal, monitor center software, distributed medical database and two kind of medical information terminal are especially discussed. Rabbit3000 system is used in medical monitor terminal to implement security administration of data transfer on network, human-machine interface, power management and DSP interface while DSP chip TMS5402 is used in signal analysis and data compression. Distributed medical database is designed for hospital center according to DICOM information model and HL7 standard. Pocket medical information terminal based on ARM9 embedded platform is also developed to interactive with center database on networks. Two kernels based on WINCE are customized and corresponding terminal software are developed for nurse's routine care and doctor's auxiliary diagnosis. Now invention patent of the monitor terminal is approved and manufacture and clinic test plans are scheduled. Applications for invention patent are also arranged for two medical information terminals.

  6. Things to come: postmodern digital knowledge management and medical informatics.

    PubMed Central

    Matheson, N W

    1995-01-01

    The overarching informatics grand challenge facing society is the creation of knowledge management systems that can acquire, conserve, organize, retrieve, display, and distribute what is known today in a manner that informs and educates, facilitates the discovery and creation of new knowledge, and contributes to the health and welfare of the planet. At one time the private, national, and university libraries of the world collectively constituted the memory of society's intellectual history. In the future, these new digital knowledge management systems will constitute human memory in its entirety. The current model of multiple local collections of duplicated resources will give way to specialized sole-source servers. In this new environment all scholarly scientific knowledge should be public domain knowledge: managed by scientists, organized for the advancement of knowledge, and readily available to all. Over the next decade, the challenge for the field of medical informatics and for the libraries that serve as the continuous memory for the biomedical sciences will be to come together to form a new organization that will lead to the development of postmodern digital knowledge management systems for medicine. These systems will form a portion of the evolving world brain of the 21st century. PMID:7743318

  7. Fluid Management System (FMS) fluid systems overview

    NASA Technical Reports Server (NTRS)

    Baird, R. S.

    1990-01-01

    Viewgraphs on fluid management system (FMS) fluid systems overview are presented. Topics addressed include: fluid management system description including system requirements (integrated nitrogen system, integrated water system, and integrated waste gas system) and physical description; and fluid management system evolution.

  8. Management of expatriate medical assistance in Mozambique

    PubMed Central

    Vio, Ferruccio

    2006-01-01

    This paper discusses how Mozambique coped with the health system needs in terms of specialized doctors since independence, in a troubled context of war, lack of financial resources and modifying settings of foreign aid. The Ministry of Health (MOH) managed to make up for its severe scarcity of specialist MDs especially through contracting expatriate technical assistance. Different scenarios, partnerships and contract schemes that have evolved since independence are briefly described, as well as self-reliance option possibility and implications. Lessons learned about donor initiatives aimed at contracting specialists from other developing countries are singled out. The issue of obtaining expertise and knowledge in the global market as cheap as possible is stressed, and realistic figures of cost planning are highlighted, as determined by the overall health system necessities and budget limitations. PMID:17140454

  9. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies

    PubMed Central

    Haddad, Peter M; Brain, Cecilia; Scott, Jan

    2014-01-01

    Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness’s association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive

  10. Nonadherence with antipsychotic medication in schizophrenia: challenges and management strategies.

    PubMed

    Haddad, Peter M; Brain, Cecilia; Scott, Jan

    2014-01-01

    Nonadherence with medication occurs in all chronic medical disorders. It is a particular challenge in schizophrenia due to the illness's association with social isolation, stigma, and comorbid substance misuse, plus the effect of symptom domains on adherence, including positive and negative symptoms, lack of insight, depression, and cognitive impairment. Nonadherence lies on a spectrum, is often covert, and is underestimated by clinicians, but affects more than one third of patients with schizophrenia per annum. It increases the risk of relapse, rehospitalization, and self-harm, increases inpatient costs, and lowers quality of life. It results from multiple patient, clinician, illness, medication, and service factors, but a useful distinction is between intentional and unintentional nonadherence. There is no gold standard approach to the measurement of adherence as all methods have pros and cons. Interventions to improve adherence include psychoeducation and other psychosocial interventions, antipsychotic long-acting injections, electronic reminders, service-based interventions, and financial incentives. These overlap, all have some evidence of effectiveness, and the intervention adopted should be tailored to the individual. Psychosocial interventions that utilize combined approaches seem more effective than unidimensional approaches. There is increasing interest in electronic reminders and monitoring systems to enhance adherence, eg, Short Message Service text messaging and real-time medication monitoring linked to smart pill containers or an electronic ingestible event marker. Financial incentives to enhance antipsychotic adherence raise ethical issues, and their place in practice remains unclear. Simple pragmatic strategies to improve medication adherence include shared decision-making, regular assessment of adherence, simplification of the medication regimen, ensuring that treatment is effective and that side effects are managed, and promoting a positive

  11. Defining Medically Necessary Services To Protect Children. Protecting Consumer Rights in Public Systems: Managed Mental Health Care Policy. A Series of Issue Papers on Contracting for Managed Behavioral Health Care, #5.

    ERIC Educational Resources Information Center

    Bazelon Center for Mental Health Law, Washington, DC.

    This issue paper is designed to help families, advocates and policymakers ensure that "medically necessary" standards in public-sector contracts for managed mental health care protect children's rights, particularly the rights of children who have serious emotional disturbance. Fundamental principles for developing sound contracts for public…

  12. Contingency Management Learning Systems.

    ERIC Educational Resources Information Center

    Darst, Paul W.

    Contingency management is a system focused on managing the motivation of students, and can be developed and utilized in any type of physical education environment from elementary to college levels. An analysis of two existing contingency management learning systems (one for a fifth-grade gymnastics unit and the other for a seventh- and eigth-grade…

  13. Medical Management of Oral Lichen Planus: A Systematic Review

    PubMed Central

    Chokshi, Krunal; Desai, Sachin; Malu, Rahul; Chokshi, Achala

    2016-01-01

    Introduction Oral Lichen Planus (OLP) is a chronic inflammatory, T-cell-mediated autoimmune oral mucosal disease with unclear aetiology. The clinical management of OLP poses considerable difficulties to the oral physician. Aim The aim was to assess the efficacy of any form of intervention used to medically manage OLP. Materials and Methods We searched and analysed the following databases (from January 1990 to December 2014):- Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. All Randomised Controlled Trials (RCTs) for the medical management of OLP which compared active treatment with placebo or between active treatments were considered in this systematic review. Participants of any age, gender or race having symptomatic OLP (including mixed forms), unconnected to any identifiable cause (e.g. lichenoid drug reactions) and confirmed by histopathology have been included. Interventions of all types, including topical treatments or systemic drugs of variable dosage, duration & frequency of delivery have been considered. All the trials identified were appraised by five review authors and the data for all the trials were synthesised using specifically designed data extraction form. Binary data has been presented as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CIs. Results A total of 35 RCTs were included in this systematic review on medical management of OLP. No strong evidence suggesting superiority of any specific intervention in reducing pain and clinical signs of OLP were shown by the RCTs included here. Conclusion Future RCTs on a larger scale, adopting standardized outcome assessing parameters should be considered. PMID:27042598

  14. National Disaster Medical System; medical manpower component establishment--Health Resources and Services Administration, HHS. Notice.

    PubMed

    1988-04-20

    This notice announces the creation of the medical manpower component within the Health Resources and Services Administration (HRSA), Department of Health and Human Services/Public Health Service (HHS/PHS) as a part of the National Disaster Medical System (NDMS). The NDMS is an organized resource that may be activated to serve national needs in the event of disasters or other major emergencies requiring extraordinary medical services. The manpower component will contain volunteer medical response personnel and technical staff that will be made available in situations requiring substantial medical services from outside the area affected by the disaster or emergency. The manpower component of NDMS is being established by HRSA/HHS/PHS in cooperation with the Department of Defense (DoD), Federal Emergency Management Agency (FEMA), and the Veterans Administration (VA). PMID:10287019

  15. The Charter Medical Corporation clinical information system: a preliminary report.

    PubMed

    White, S L; Wingfield, C C

    1992-01-01

    Charter Medical Corporation's computerized Clinical Information System is described. The computerized system helps clinicians formulate and document individualized patient treatment plans along the continuum of care and to improve internal medical record keeping. The system can also help improve the efficient collecting, storing, retrieving, and reporting of clinical information, both for internal use and for external utilization review and case management. In the future, the system will be linked to Charter's continuous quality improvement efforts and to its new Clinical Outcome Monitoring System. PMID:10116649

  16. Conceptual Drivers for an Exploration Medical System

    NASA Technical Reports Server (NTRS)

    Antonsen, E.; Canga, M.

    2016-01-01

    Interplanetary spaceflight provides unique challenges that have not been encountered in prior spaceflight experience. Extended distance and timeframes introduce new challenges such as an inability to resupply medications and consumables, inability to evacuate injured or ill crew, and communication delays that introduce a requirement for some level of autonomous medical capability. Because of these challenges the approaches used in prior programs have limited application to a proposed three year Mars mission. This paper proposes a paradigm shift in the approach to medical risk mitigation for crew health and mission objectives threatened by inadequate medical capabilities in the setting of severely limited resources. A conceptual approach is outlined to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this new paradigm. Using NASA Design Reference Missions this process assesses each mission phase to deconstruct medical needs at any point during a mission. Two operational categories are proposed, nominal operations (pre-planned activities) and contingency operations (medical conditions requiring evaluation) that meld clinical needs and research needs into a single system. These definitions are used to derive a task level analysis to support quantifiable studies into a medical capabilities trade. This trade allows system design to proceed from both a mission centric and ethics-based approach to medical limitations in an exploration class mission.

  17. Regional medical data mining system.

    PubMed

    Robu, Raul; Stoicu-Tivadar, Vasile

    2011-01-01

    This paper suggests a solution to acquire medical data from hospitals located in a region (addressing especially the DKMT Euroregion), and then perform data mining. The medical data from the hospital databases are exported in XML format, according to HL7 CDA standard. Afterwards, they are automatically centralized on a server in a database using web services calls. The data will be analyzed with the data mining tool WEKA. Data of interest are converted into ARFF format and loaded into WEKA. The next stage consists in preprocessing and analyzing the data based on the algorithms provided by WEKA, having as a goal several relevant medical conclusions. WEKA application interface has been improved to facilitate the process of performing predictions. PMID:21685596

  18. Modern Medical Engineering and Health Information Systems

    ERIC Educational Resources Information Center

    Davis, John F.

    1975-01-01

    Describes the impact of medical engineering and system design on hospital design and construction, health care in the home and hospital, equipment design, information systems, and health resources utilization. (GS)

  19. Strategic management of Public Hospitals' medical services.

    PubMed

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction. PMID:27273960

  20. Managing hybrid marketing systems.

    PubMed

    Moriarty, R T; Moran, U

    1990-01-01

    As competition increases and costs become critical, companies that once went to market only one way are adding new channels and using new methods - creating hybrid marketing systems. These hybrid marketing systems hold the promise of greater coverage and reduced costs. But they are also hard to manage; they inevitably raise questions of conflict and control: conflict because marketing units compete for customers; control because new indirect channels are less subject to management authority. Hard as they are to manage, however, hybrid marketing systems promise to become the dominant design, replacing the "purebred" channel strategy in all kinds of businesses. The trick to managing the hybrid is to analyze tasks and channels within and across a marketing system. A map - the hybrid grid - can help managers make sense of their hybrid system. What the chart reveals is that channels are not the basic building blocks of a marketing system; marketing tasks are. The hybrid grid forces managers to consider various combinations of channels and tasks that will optimize both cost and coverage. Managing conflict is also an important element of a successful hybrid system. Managers should first acknowledge the inevitability of conflict. Then they should move to bound it by creating guidelines that spell out which customers to serve through which methods. Finally, a marketing and sales productivity (MSP) system, consisting of a central marketing database, can act as the central nervous system of a hybrid marketing system, helping managers create customized channels and service for specific customer segments. PMID:10107959

  1. Sickle cell disease pain management and the medical home.

    PubMed

    Raphael, Jean L; Oyeku, Suzette O

    2013-01-01

    Pain is the most common cause for hospitalization and acute morbidity in sickle cell disease (SCD). The consequences of SCD-related pain are substantial, affecting both the individual and the health care system. The emergence of the patient-centered medical home (PCMH) provides new opportunities to align efforts to improve SCD management with innovative and potentially cost-effective models of patient-centered care. The Department of Health and Human Services has designated SCD as a priority area with emphasis on creating PCMHs for affected patients. The question for patients, clinicians, scientists, and policy-makers is how the PCMH can be designed to address pain, the hallmark feature of SCD. This article provides a framework of pain management within the PCMH model. We present an overview of pain and pain management in SCD, gaps in pain management, and current care models used by patients and discuss core PCMH concepts and multidisciplinary team-based PCMH care strategies for SCD pain management. PMID:24319216

  2. Medical laser system WOLF-1

    NASA Astrophysics Data System (ADS)

    Wolf, Leszek; Peszynski-Drews, Cezary; Szydlak, Jerzy; Nowakowski, Wlodzimierz

    2000-11-01

    In CDTL PL a set of lasers was installed with irradiation connected to treatment and operation rooms by energetic optical fibers. The introduction of irradiation of particular lasers into fiberguides is controlled by the computer. Fiber couplers were installed on the entrance of transmission fiberguides, and they were connected to optical fibers with different end-pieces according to medical needs.

  3. NASA's Risk Management System

    NASA Technical Reports Server (NTRS)

    Perera, Jeevan S.

    2011-01-01

    Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  4. Dietary and medical management of recurrent nephrolithiasis.

    PubMed

    Shah, Silvi; Calle, Juan Camilo

    2016-06-01

    Dietary approaches and medical treatment can prevent recurrence of urinary stones. Some interventions are appropriate for all types of stones, but there are particular risk factors that may need directed therapy. PMID:27281259

  5. Linking medical records to an expert system

    NASA Technical Reports Server (NTRS)

    Naeymi-Rad, Frank; Trace, David; Desouzaalmeida, Fabio

    1991-01-01

    This presentation will be done using the IMR-Entry (Intelligent Medical Record Entry) system. IMR-Entry is a software program developed as a front-end to our diagnostic consultant software MEDAS (Medical Emergency Decision Assistance System). MEDAS (the Medical Emergency Diagnostic Assistance System) is a diagnostic consultant system using a multimembership Bayesian design for its inference engine and relational database technology for its knowledge base maintenance. Research on MEDAS began at the University of Southern California and the Institute of Critical Care in the mid 1970's with support from NASA and NSF. The MEDAS project moved to Chicago in 1982; its current progress is due to collaboration between Illinois Institute of Technology, The Chicago Medical School, Lake Forest College and NASA at KSC. Since the purpose of an expert system is to derive a hypothesis, its communication vocabulary is limited to features used by its knowledge base. The development of a comprehensive problem based medical record entry system which could handshake with an expert system while creating an electronic medical record at the same time was studied. IMR-E is a computer based patient record that serves as a front end to the expert system MEDAS. IMR-E is a graphically oriented comprehensive medical record. The programs major components are demonstrated.

  6. [Establishment and management of documentation within QMS of medical device enterprises].

    PubMed

    Tian, Shaolei

    2013-09-01

    The objectives of QMS for quality assurance of products are achieved by formulation, implement, and management of document system. Document (includes record) system is important constituent part of QMS. In this paper, the important issues and relative requirements of GMP on the establishment and management of documentation within quality management system (QMS) of medical device enterprises are discussed with the aim of providing reference for relative enterprises to build and improve their QMS and to implement GMP. PMID:24409796

  7. Medical management of the acute radiation syndrome

    PubMed Central

    López, Mario; Martín, Margarita

    2011-01-01

    The acute radiation syndrome (ARS) occurs after whole-body or significant partial-body irradiation (typically at a dose of >1 Gy). ARS can involve the hematopoietic, cutaneous, gastrointestinal and the neurovascular organ systems either individually or in combination. There is a correlation between the severity of clinical signs and symptoms of ARS and radiation dose. Radiation induced multi-organ failure (MOF) describes the progressive dysfunction of two or more organ systems over time. Radiation combined injury (RCI) is defined as radiation injury combined with blunt or penetrating trauma, burns, blast, or infection. The classic syndromes are: hematopoietic (doses >2–3 Gy), gastrointestinal (doses 5–12 Gy) and cerebrovascular syndrome (doses 10–20 Gy). There is no possibility to survive after doses >10–12 Gy. The Phases of ARS are—prodromal: 0–2 days from exposure, latent: 2–20 days, and manifest illness: 21–60 days from exposure. Granulocyte-colony stimulating factor (G-CSF) at a dose of 5 μg/kg body weight per day subcutaneously has been recommended as treatment of neutropenia, and antibiotics, antiviral and antifungal agents for prevention or treatment of infections. If taken within the first hours of contamination, stable iodine in the form of nonradioactive potassium iodide (KI) saturates iodine binding sites within the thyroid and inhibits incorporation of radioiodines into the gland. Finally, if severe aplasia persists under cytokines for more than 14 days, the possibility of a hematopoietic stem cell (HSC) transplantation should be evaluated. This review will focus on the clinical aspects of the ARS, using the European triage system (METREPOL) to evaluate the severity of radiation injury, and scoring groups of patients for the general and specific management of the syndrome. PMID:24376971

  8. NASA's Risk Management System

    NASA Technical Reports Server (NTRS)

    Perera, Jeevan S.

    2013-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  9. Medication Management Assessment for Older Adults in the Community

    ERIC Educational Resources Information Center

    Orwig, Denise; Brandt, Nicole; Gruber-Baldini, Ann L.

    2006-01-01

    Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then…

  10. Application of data mining to medical risk management

    NASA Astrophysics Data System (ADS)

    Tsumoto, Shusaku; Matsuoka, Kimiko; Yokoyama, Shigeki

    2008-03-01

    This paper proposes an application of data mining to medical risk management, where data mining techniques were applied to detection, analysis and evaluation of risks potentially existing in clinical environments. We applied this technique to the following two medical domains: risk aversion of nurse incidents and infection control. The results show that data mining methods were effective to detection and aversion of risk factors.

  11. A Medical Decision Support System for the Space Station Health Maintenance Facility

    PubMed Central

    Ostler, David V.; Gardner, Reed M.; Logan, James S.

    1988-01-01

    NASA is developing a Health Maintenance Facility (HMF) to provide the equipment and supplies necessary to deliver medical care in the Space Station. An essential part of the Health Maintenance Facility is a computerized Medical Decision Support System (MDSS) that will enhance the ability of the medical officer (“paramedic” or “physician”) to maintain the crew's health, and to provide emergency medical care. The computer system has four major functions: 1) collect and integrate medical information into an electronic medical record from Space Station medical officers, HMF instrumentation, and exercise equipment; 2) provide an integrated medical record and medical reference information management system; 3) manage inventory for logistical support of supplies and secure pharmaceuticals; 4) supply audio and electronic mail communications between the medical officer and ground based flight surgeons. ImagesFigure 1

  12. Front office staff as medical educators, risk creators, and risk managers.

    PubMed

    Kapp, Marshall B

    2016-03-16

    The author describes his own negative series of encounters with the front office staff of a large specialty medical practice during a recent lengthy episode of significant medical distress. The author suggests several reasons, including legal risk management, that medical students should be exposed as part of their education to the interactions of patients with front office staffs (not just physicians) to get a fuller picture of patients' actual experiences with the health care system. PMID:27176757

  13. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

    PubMed Central

    Holm, Michelle R.; Rudis, Maria I.; Wilson, John W.

    2015-01-01

    Background In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. Design We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital. PMID:25623613

  14. Medical group management: a marketing orientation.

    PubMed

    Bopp, K D; Allcorn, S

    1986-09-01

    This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace. PMID:10301113

  15. [Physiopathologic consequences of underwater diving and medical management of divers].

    PubMed

    Méliet, J L

    1996-05-01

    Underwater diving is a very closely medically managed activity. Performing it, the human organism is under the physical laws of pressure and following consequences. The expiratory flows are significatively reduced, enhancing the risk of alveolar hypoventilation at exertion, the central nervous system is the privileged target during inopportune tissue degassing related accidents (leaving 20% of sequellae), barotraumatic injuries threaten middle and inner ear or lung (pulmonary barotrauma is the most severe accident), the toxicity of gas under pressure (i.e. oxygen, nitrogen) exposes to specific risks of loss of consciousness. Lastly, the adaptative mechanisms to immersion can be overflown, leading to pulmonary oedema. Facing these constraints, the practitioner's role begins just before the diver's activity starts by looking for contraindications to diving. It continues during tuition time by teaching him the physiopathology of accidents, their prevention and first cares. Finally, in case of accident, a specialized medical team acts in diagnosis and treatment. From these points of view, diving medicine is a multispecialty medical matter. PMID:8963716

  16. A multilingual medical thesaurus browser for patients and medical content managers.

    PubMed

    Göbel, G; Andreatta, S; Masser, J; Pfeiffer, K P

    2001-01-01

    This paper introduces a user-friendly browser interface which integrates multilingual search and browsing functionalities within medical thesauri via the internet. The tool is being developed as part of the GIN Austria Patient Information System and is based on an adapted datamodel of the MeSH thesaurus. A prototype offers the possibility to build up queries and export lists of MeSH main headings collected during browsing the relevant MeSH trees. The thesaurus browser can be used both by patients and citizens to build queries based on a controlled vocabulary to match them with existing documents within GIN and by medical information managers to find out appropriate keywords for interactive tagging or indexing of medical contents. A key component of this tool is the flexible choice of different languages of the MeSH datasource as well as of the user interface. Both can be changed independently at any point during a session. Another central aspect is the use of the UMLS Metathesaurus in combination with localized Thesaurus versions due to existing international character set problems. PMID:11604758

  17. Enabling medication management through health information technology (Health IT).

    PubMed Central

    McKibbon, K Ann; Lokker, Cynthia; Handler, Steve M; Dolovich, Lisa R; Holbrook, Anne M; O'Reilly, Daria; Tamblyn, Robyn; J Hemens, Brian; Basu, Runki; Troyan, Sue; Roshanov, Pavel S; Archer, Norman P; Raina, Parminder

    2011-01-01

    from 428 articles across the seven key questions. Study quality varied according to phase of medication management. Substantially more studies, and studies with stronger comparative methods, evaluated prescribing and monitoring. Clinical decision support systems (CDSS) and computerized provider order entry (CPOE) systems were studied more than any other application of MMIT. Physicians were more often the subject of evaluation than other participants. Other health care professionals, patients, and families are important but not studied as thoroughly as physicians. These nonphysicians groups often value different aspects of MMIT, have diverse needs, and use systems differently. Hospitals and ambulatory clinics were well-represented in the literature with less emphasis placed on long-term care facilities, communities, homes, and nonhospital pharmacies. Most studies evaluated changes in process and outcomes of use, usability, and knowledge, skills, and attitudes. Most showed moderate to substantial improvement with implementation of MMIT. Economics studies and those with clinical outcomes were less frequently studied. Those articles that did address economics and clinical outcomes often showed equivocal findings on the effectiveness and cost-effectiveness of MMIT systems. Qualitative studies provided evidence of strong perceptions, both positive and negative, of the effects of MMIT and unintended consequences. We found little data on the effects of forms of medications, conformity, standards, and open source status. Much descriptive literature discusses implementation issues but little strong evidence exists. Interest is strong in MMIT and more groups and institutions will implement systems in the next decades, especially with the Federal Government's push toward more health IT to support better and more cost-effective health care. CONCLUSIONS MMIT is well-studied, although on closer examination of the literature the evidence is not uniform across phases of medication

  18. Management Systems in Education.

    ERIC Educational Resources Information Center

    Wagner, Ivan D.

    Management systems have been adapted for educational administration in response to the need for quality of educational opportunity, collective bargaining, school district consolidation, decreasing enrollments, accountability laws, limited financial resources, and participatory decision-making. Management systems adapted, not adopted, from business…

  19. Waste management system

    NASA Technical Reports Server (NTRS)

    Sauer, R. L.; Jorgensen, G. K.

    1975-01-01

    The function of the waste management system was to control the disposition of solid and liquid wastes and waste stowage gases. The waste management system consisting of a urine subsystem and a fecal subsystem is described in detail and its overall performance is evaluated. Recommendations for improvement are given.

  20. Metadata management staging system

    Energy Science and Technology Software Center (ESTSC)

    2013-08-01

    Django application providing a user-interface for building a file and metadata management system. An evolution of our Node.js and CouchDb metadata management system. This one focuses on server functionality and uses a well-documented, rational and REST-ful API for data access.

  1. Management Information System Project.

    ERIC Educational Resources Information Center

    Foley, Walter J.; Harr, Gordon G.

    The Management Information System (MIS) described in this report represents a plan to utilize modern management techniques to facilitate the goal of a learner-responsive school system. The MIS component is being developed to meet the need for the coordination of the resources of staff, facilities, and time with the long range planning and…

  2. Management Information Systems.

    ERIC Educational Resources Information Center

    Crump, Kelvin

    An Australian university architect studying management information systems programs at academic institutions in the United States visited 26 universities and colleges and nine educational and professional associations, including extended visits at the University of Wisconsin and the National Center of Higher Education Management Systems. During…

  3. Lithium battery management system

    DOEpatents

    Dougherty, Thomas J.

    2012-05-08

    Provided is a system for managing a lithium battery system having a plurality of cells. The battery system comprises a variable-resistance element electrically connected to a cell and located proximate a portion of the cell; and a device for determining, utilizing the variable-resistance element, whether the temperature of the cell has exceeded a predetermined threshold. A method of managing the temperature of a lithium battery system is also included.

  4. Medical Management of Pediatric Malignant Bowel Obstruction in a Patient with Burkitt's Lymphoma and Ataxia Telangiectasia Using Continuous Ambulatory Drug Delivery System.

    PubMed

    Ghoshal, Arunangshu; Salins, Naveen; Damani, Anuja; Deodhar, Jayita; Muckaden, M A

    2016-01-01

    Malignant bowel obstruction (MBO) is commonly seen in patients with advanced abdominal cancers. The incidence of pediatric MBO in a patient with Burkitt's lymphoma and ataxia telangiectasia is rare, with no published case reports till now. Conservative management of inoperable MBO results in relief of symptoms and improves quality of life. An 11-year-old boy with Burkitt's lymphoma and ataxia telangiectasia was referred to pediatric palliative care with MBO. The objective of this report is to demonstrate conservative management of pediatric MBO using continuous ambulatory drug delivery system. The patient was initiated on continuous ambulatory drug delivery (CADD) system for symptom relief. MBO was reversed with conservative management and the child was discharged on self-collapsible portable elastomeric continuous infusion pump under the supervision of a local family physician. The child remained comfortable at home for 4 weeks until his death. His parents were satisfied with the child's symptom control, quality of life, and were able to care for the child at home. In a resource-limited setting, managing patients at home using elastomeric continuous infusion pumps instead of expensive automated CADD is a practical pharmacoeconomic approach. PMID:26862790

  5. Improving the medical records department processes by lean management

    PubMed Central

    Ajami, Sima; Ketabi, Saeedeh; Sadeghian, Akram; Saghaeinnejad-Isfahani, Sakine

    2015-01-01

    Background: Lean management is a process improvement technique to identify waste actions and processes to eliminate them. The benefits of Lean for healthcare organizations are that first, the quality of the outcomes in terms of mistakes and errors improves. The second is that the amount of time taken through the whole process significantly improves. Aims: The purpose of this paper is to improve the Medical Records Department (MRD) processes at Ayatolah-Kashani Hospital in Isfahan, Iran by utilizing Lean management. Materials and Methods: This research was applied and an interventional study. The data have been collected by brainstorming, observation, interview, and workflow review. The study population included MRD staff and other expert staff within the hospital who were stakeholders and users of the MRD. Statistical Analysis Used: The MRD were initially taught the concepts of Lean management and then formed into the MRD Lean team. The team then identified and reviewed the current processes subsequently; they identified wastes and values, and proposed solutions. Results: The findings showed that the MRD units (Archive, Coding, Statistics, and Admission) had 17 current processes, 28 wastes, and 11 values were identified. In addition, they offered 27 comments for eliminating the wastes. Conclusion: The MRD is the critical department for the hospital information system and, therefore, the continuous improvement of its services and processes, through scientific methods such as Lean management, are essential. Originality/Value: The study represents one of the few attempts trying to eliminate wastes in the MRD. PMID:26097862

  6. Prescriptions for medical research. I--Management within the Medical Research Council.

    PubMed Central

    Gillett, R; Harrow, J

    1993-01-01

    In their submission to the government in advance of the white paper on science policy in the United Kingdom the Medical Research Council commends the MRC's own approach to managing directly funded research. But a series of semi-structured interviews with the directors of some of the MRC's units suggests a gap between the MRC's model of managed research and the reality. Although such units are theoretically managed from MRC head office (and units are charged an overhead for this), in practice each unit runs its own affairs. Between major reviews average contact time with the head office contact person is seven hours a year. The first paper argues that a purchaser-provider split would recognise the benefits of decentralisation and allow units to bid for research funds from several sources, the successful ones guaranteeing their survival through a rolling series of research programmes. The second paper criticises the MRC's cumbersome peer review system. Reliance on outside experts atrophies the scientific skills of head office staff and builds delays into decision making. A purchaser-provider model would allow the head office scientific staff to act like commercial research and development managers, commissioning research, and using the outcome, rather than peer review, as a criterion for continued funding. PMID:8324441

  7. Medical and Surgical Management of Carney Complex.

    PubMed

    Siordia, Juan A

    2015-07-01

    Carney complex is a rare, autosomal dominant genetic disorder that consists of multiple myxomatous lesions and endocrine abnormalities, including skin lesions, cardiac myxomas, primary pigmented nodular adrenocortical disease, and acromegaly. This review discusses the medical and surgical treatment of patients with Carney complex. PMID:25996461

  8. Understanding Patient Portal Use: Implications for Medication Management

    PubMed Central

    Mayberry, Lindsay Satterwhite; Wallston, Kenneth A; Johnson, Kevin B; Elasy, Tom A

    2013-01-01

    Background The Internet can be leveraged to provide disease management support, including medication adherence promotion that, when tailored, can effectively improve adherence to medications. The growing adoption of patient portals represents an opportunity to support medication management and adherence more broadly, but virtually no data exist about the real and potential impact of existing portals on these outcomes. Objective We sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants’ ideas for improving portal functionality for medication management and adherence support. Methods A total of 75 adults with type 2 diabetes participated in a mixed-methods study involving focus groups, a survey, and a medical chart review. We used quantitative data to identify differences between portal users and nonusers, and to test the relationship between the frequency of portal use and glycemic control among users. We used qualitative methods to understand how and why participants use a portal and their ideas for improving its medication management functionality. Results Of the enrolled participants, 81% (61/75) attended a focus group and/or completed a survey; portal users were more likely than nonusers to participate in that capacity (Fisher exact test; P=.01). Users were also more likely than nonusers to be Caucasian/white (Fisher exact test; P<.001), have higher incomes (Fisher exact test; P=.005), and be privately insured (Fisher exact test; P<.001). Users also tended to have more education than nonusers (Mann–Whitney U; P=.05), although this relationship was not significant at P<.05. Among users, more frequent use of a portal was associated with better A1C (Spearman rho =–0.30; P=.02). Reasons for nonuse included not knowing about the portal (n=3), not having access to a computer (n=3), or having a family member serve as

  9. Movement Disorders: A Brief Guide in Medication Management.

    PubMed

    Julius, Anthony; Longfellow, Katelan

    2016-07-01

    Movement disorders can be challenging to manage and often use a specific set of medications. Because it is a complex and broad field within neurology, many providers are unfamiliar with the classes of medications. This paper details medications used for specific conditions, explains why these medications are helpful, and shares pearls and pitfalls related to each agent, focusing on parameters such as dose titration, side effect profiles, and specific drug-drug interactions and challenges. We focus on the most commonly encountered movement disorders, including essential tremor, Parkinson's disease, rapid eye movement sleep behavior disorder, and restless leg syndrome. PMID:27235613

  10. The medical physics specialization system in Poland.

    PubMed

    Bulski, Wojciech; Kukołowicz, Paweł; Skrzyński, Witold

    2016-07-01

    This paper presents the situation of the profession of medical physicists in Poland. The official recognition of the profession of medical physicist in Polish legislation was in 2002. In recent years, more and more Universities which have Physics Faculties introduce a medical physics specialty. At present, there are about 15 Universities which offer such programmes. These Universities are able to graduate about 150 medical physicists per year. In 2002, the Ministry of Health introduced a programme of postgraduate specialization in medical physics along the same rules employed in the specialization of physicians in various branches of medicine. Five institutions, mostly large oncology centres, were selected as teaching institutions, based on their experience, the quality of the medical physics professionals, staffing levels, equipment availability, lecture halls, etc. The first cycle of the specialization programme started in 2006, and the first candidates completed their training at the end of 2008, and passed their official state exams in May 2009. As of January 2016, there are 196 specialized medical physicists in Poland. Another about 120 medical physicists are undergoing specialization. The system of training of medical physics professionals in Poland is well established. The principles of postgraduate training and specialization are well defined and the curriculum of the training is very demanding. The programme of specialization was revised in 2011 and is in accordance with EC and EFOMP recommendations. PMID:27378393