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Last update: August 15, 2014.
1

Survey of electronic veterinary medical record adoption and use by independent small animal veterinary medical practices in Massachusetts.  

PubMed

Objective-To estimate the proportion of independent small animal veterinary medical practices in Massachusetts that use electronic veterinary medical records (EVMRs), determine the purposes for which EVMRs are used, and identify perceived barriers to their use. Design-Survey. Sample-100 veterinarians. Procedures-213 of 517 independent small animal veterinary practices operating in Massachusetts were randomly chosen for study recruitment. One veterinarian at each practice was invited by telephone to answer a hardcopy survey regarding practice demographics, medical records type (electronic, paper, or both), purposes of EVMR use, and perceived barriers to adoption. Surveys were mailed to the first 100 veterinarians who agreed to participate. Practices were categorized by record type and size (large [? 5 veterinarians], medium [3 to 4 veterinarians], or small [1 to 2 veterinarians]). Results-84 surveys were returned; overall response was 84 of 213 (39.4%). The EVMRs were used alone or together with paper records in 66 of 82 (80.5%) practices. Large and medium-sized practices were significantly more likely to use EVMRs combined with paper records than were small practices. The EVMRs were most commonly used for ensuring billing, automating reminders, providing cost estimates, scheduling, recording medical and surgical information, and tracking patient health. Least common uses were identifying emerging infectious diseases, research, and insurance. Eleven veterinarians in paper record-only practices indicated reluctance to change, anticipated technological problems, time constraints, and cost were barriers to EVMR use. Conclusions and Clinical Relevance-Results indicated EVMRs were underutilized as a tool for tracking and improving population health and identifying emerging infectious diseases. Efforts to facilitate adoption of EVMRs for these purposes should be strengthened by the veterinary medical, human health, and public health professions. PMID:25029312

Krone, Lauren M; Brown, Catherine M; Lindenmayer, Joann M

2014-08-01

2

AVMA guide for veterinary medical waste management.  

PubMed

Lawmakers have enacted a variety of laws and regulations to ensure proper disposal of certain potentially infectious or otherwise objectionable waste. The veterinary medical profession supports scientifically based regulations that benefit public health. In 1988, Congress passed the Medical Waste Tracking Act, a federal program that mandates tracking certain regulated waste. Several types of waste generated in the typical clinical veterinary medical practice are considered regulated veterinary medical waste. Discarded needles, syringes, and other sharps; vaccines and vials that contained certain live or attenuated vaccines; cultures and stocks of infectious agents and culture plates; research animals that were exposed to agents that are infectious to human beings and their associated waste; and other animal waste that is known to be potentially harmful to human beings should be handled as regulated veterinary medical waste. Regulated veterinary medical waste should be handled with care. It should be decontaminated prior to disposal. The most popular, effective methods of decontamination are steam sterilization (autoclaving) and incineration. Chemical decontamination is appropriate for certain liquid waste. Waste should be packaged so that it does not spill. Sharps require rigid puncture- and leak-resistant containers that can be permanently sealed. Regulated veterinary medical waste that has not been decontaminated should be labeled with the universal biohazard symbol. Generators retain liability for waste throughout the entire disposal process. Therefore, it is essential to ensure that waste transporters and disposal facilities comply with state and federal requirements. Veterinary practices should maintain a written waste management program and accurate records of regulated veterinary medical waste disposal. Contingency planning and staff training are other important elements of a veterinary medical waste management program. The guide includes a model veterinary medical waste management program; however, it does not address all the variations in state and local regulations. Veterinarians should obtain copies of state and local laws and regulations and modify AVMA's model plan to create an individualized practice plan that complies with federal, state, and local laws and regulations. State and local veterinary medical organizations should monitor state and local regulation to influence decisions that affect veterinarians and to keep their members informed of changing requirements. Veterinarians and veterinary medical organizations must stay involved so that regulations do not unfairly burden the veterinary medical profession. PMID:2674089

Brody, M D

1989-08-15

3

Implications for Veterinary Medical Education: Postprofessional Education.  

ERIC Educational Resources Information Center

Concern about delivery of veterinary medical services to animal agriculture and implications for postprofessional veterinary medical education are discussed. The individual needs and goals of livestock producers, practicing veterinarians, and veterinary academicians are so varied that actual delivery of veterinary medical services is difficult to…

Kahrs, Robert F.

1980-01-01

4

American Veterinary Medical Association (AVMA)  

NSDL National Science Digital Library

The American Veterinary Medical Association is a highly recognized not-for-profit organization specializing in animal-related issues. Whether you have questions about a pet, wild animal, or the latest animal vaccination news, you can find updated information at avma.org on these and various other topics. AVMA is divided into sections for the public, for members, and links to scientific resources. The research findings performed by AVMA are widely available to the public, and include both scientific and medical material. It includes access to the Journal of the American Veterinary Medicine Association and the American Journal of Veterinary Research. AVMA is an excellent resource for veterinary students, instructors and pet owners alike.

2007-02-22

5

American Veterinary Medical Association  

MedlinePLUS

... with pet bearded dragons. Pet Week National Pet Week is Next Week We've got resources to help veterinary practices ... Externs on the Hill MyVeterinarian.com National Pet Week Animal Health SmartBrief WebMD® Pet Health Community Help | ...

6

21 CFR 530.5 - Veterinary records.  

Code of Federal Regulations, 2013 CFR

...and Drugs 6 2013-04-01 2013-04-01 false Veterinary records. 530.5 Section 530.5 Food and Drugs...EXTRALABEL DRUG USE IN ANIMALS General Provisions § 530.5 Veterinary records. (a) As a condition of extralabel...

2013-04-01

7

Evolution of a veterinary medical library.  

PubMed Central

Planning a new library and developing a book and journal collection for the College of Veterinary Medicine at Iowa State University are described. The Veterinary Medical Library is a self-contained unit (6,800 square feet) for print material within the Veterinary Medical Building. Seating for 140 patrons is available. The collection is designed to provide basic materials for teaching and research in veterinary and comparative medicine. Indexing and abstracting tools permit access to local, state, and national resources as well. At present the collection totals over 17,000 volumes and over 500 serial titles. A working collection of 25,000 volumes will be maintained in the Veterinary Medical Library, and the University Library will continue to function as the principal backup source. Images

Peterson, S R

1979-01-01

8

Outcomes Assessment in Veterinary Medical Education.  

ERIC Educational Resources Information Center

Describes the Virginia-Maryland Regional College of Veterinary Medicine's use of outcomes assessment (OA) as part of the accreditation review process for the American Veterinary Medical Association. Discusses its nine OA survey instruments and use of resulting data during accreditation. (EV)

Black, Leslie S.; Turnwald, Grant H.; Meldrum, James B.

2002-01-01

9

Veterinary Medical Genetics: A Developing Discipline.  

ERIC Educational Resources Information Center

Areas that will influence the development of veterinary medical genetics as a clinical discipline are discussed, some critical research areas of immediate concern are suggested, and misconceptions held by many practicing veterinarians which must be corrected at the level of veterinary education are identified. (JMD)

Womack, James E.; Templeton, Joe W.

1978-01-01

10

Maximizing Financial Resources in Veterinary Medical Teaching Hospitals.  

ERIC Educational Resources Information Center

The University of California at Davis Veterinary Medical Teaching Hospital created a healthier environment with inexpensive business procedures. Reported are: removal of billing responsibilities from faculty, separation of discharge functions from receptionist's functions, billing system/medical records system, and use of credit cards and…

Walker, Terry S.

1979-01-01

11

Teaching Nutrition in the Veterinary Medical Curriculum  

ERIC Educational Resources Information Center

The author describes why many of the present or older approaches to teaching nutrition in the veterinary medical curriculum are unsatisfactory, and presents a new approach that is integrated into the general curriculum. Such a program at Colorado State University is detailed. (LBH)

Lewis, Lon D.

1976-01-01

12

Attitude of Swedish veterinary and medical students to animal experimentation  

Microsoft Academic Search

Nearly all veterinary and medical students (94 per cent) found it morally acceptable to use animals in research and believed it to be a necessity in order to treat human diseases. In contrast with the medical students a substantial proportion of veterinary students (40 per cent) considered themselves animal rights activists. Unlike the medical curriculum, the veterinary curriculum contains a

J. Hagelin; J. Hau; H. E. Carlsson

2000-01-01

13

Center for Medical, Agricultural, and Veterinary Entomology  

NSDL National Science Digital Library

The Center for Medical, Agricultural, and Veterinary Entomology (CMAVE) operates under the auspices of the USDA Agricultural Research Service. CMAVE "conducts research aimed at reducing or eliminating the harm caused by insects to crops, stored products, livestock and humans. Research is directed not only at the insects themselves but at pathogens they may transmit and at identifying inherent protective mechanisms in plants." The Center's website links to information about CMAVE researchers and research units. The site also lists CMAVE publications from 1991 to the present year. Reprints may be requested directly from the author(s), or from the CMAVE Secretary. Site visitors will also find links to employment listings from the USDA.

2008-10-02

14

Center for Medical, Agricultural, and Veterinary Entomology  

NSDL National Science Digital Library

The Center for Medical, Agricultural, and Veterinary Entomology (CMAVE) operates under the auspices of the USDA Agricultural Research Service. CMAVE "conducts research aimed at reducing or eliminating the harm caused by insects to crops, stored products, livestock and humans. Research is directed not only at the insects themselves but at pathogens they may transmit and at identifying inherent protective mechanisms in plants." The Center's website links to information about CMAVE researchers and research units. The site also lists CMAVE publications from 1991 to the present year. Reprints may be requested directly from the author(s), or from the CMAVE Secretary. Site visitors will also find links to employment listings from the USDA.

15

Student Perceptions of the First Year of Veterinary Medical School.  

ERIC Educational Resources Information Center

A brief survey was conducted of nearly 900 first-year students in 14 U.S. veterinary medical schools in order to gather impressions of the first year of veterinary medical education. Although some students reported that conditions were stressful, the majority did not feel that they were inordinately so. Overall, most students were quite positive…

Powers, Donald E.

2002-01-01

16

American Veterinary Medical Association Media Library  

NSDL National Science Digital Library

The American Veterinary Medical Association's Media Library website is filled with free audio and video media on different topics. The categories under which the topics are organized are "Podcasts", "Timely Audio News", "PSAs", and "Latest Videos". The topics range from highly technical to suitability for a layperson, from livestock concerns to "America's Top Ten Cat Cities". Visitors can see a lengthier list of each of the categories by clicking on "More Podcasts", "More News", etc. at the bottom of the page. In the "Timely Audio News" category are several Spanish Language versions of basic pet care articles, such as "The Benefits of Spaying or Neutering Your Pets" and "Does Your Pet need a Rabies Shot?" At the bottom of the homepage is the section called "Audio Features" that contains over 50 audio files on topics that include equine, pet safety, dog bites, birds, and exotic pets.

17

Connecting knowledge resources to the veterinary electronic health record: opportunities for learning at point of care.  

PubMed

Electronic health records (EHRs) provide clinical learning opportunities through quick and contextual linkage of patient signalment, symptom, and diagnosis data with knowledge resources covering tests, drugs, conditions, procedures, and client instructions. This paper introduces the EHR standards for linkage and the partners-practitioners, content publishers, and software developers-necessary to leverage this possibility in veterinary medicine. The efforts of the American Animal Hospital Association (AAHA) Electronic Health Records Task Force to partner with veterinary practice management systems to improve the use of controlled vocabulary is a first step in the development of standards for sharing knowledge at the point of care. The Veterinary Medical Libraries Section (VMLS) of the Medical Library Association's Task Force on Connecting the Veterinary Health Record to Information Resources compiled a list of resources of potential use at point of care. Resource details were drawn from product Web sites and organized by a metric used to evaluate medical point-of-care resources. Additional information was gathered from questions sent by e-mail and follow-up interviews with two practitioners, a hospital network, two software developers, and three publishers. Veterinarians with electronic records use a variety of information resources that are not linked to their software. Systems lack the infrastructure to use the Infobutton standard that has been gaining popularity in human EHRs. While some veterinary knowledge resources are digital, publisher sites and responses do not indicate a Web-based linkage of veterinary resources with EHRs. In order to facilitate lifelong learning and evidence-based practice, veterinarians and educators of future practitioners must demonstrate to veterinary practice software developers and publishers a clinically-based need to connect knowledge resources to veterinary EHRs. PMID:22023919

Alpi, Kristine M; Burnett, Heidi A; Bryant, Sheila J; Anderson, Katherine M

2011-01-01

18

Implications for Veterinary Medical Education: Paraprofessional Education.  

ERIC Educational Resources Information Center

The emergence of the veterinary technician as an extension of the veterinarian's capability into animal agriculture is discussed. Some aspects reviewed include: technician education, current restrictions imposed by practice acts, general acceptance by the consumer, and effective relationships for veterinary technicians working under the…

Lukens, Roger

1980-01-01

19

77 FR 15033 - Privacy Act Systems of Records; APHIS Veterinary Services User Fee System  

Federal Register 2010, 2011, 2012, 2013

...proposed is the APHIS Veterinary Services User Fee System...the Chief Information Officer, VS, APHIS, 2150...records, entitled APHIS Veterinary Services User Fee System...the Chief Information Officer-Veterinary Services, Animal...

2012-03-14

20

Veterinary Medical Education and a Changing Culture.  

ERIC Educational Resources Information Center

Asserts that veterinary medicine needs greater participation by minority groups to incorporate their worldview into the field. Discusses how this community-oriented view is at odds with the manner in which the academy typically assesses performance, and why teaching and service should therefore be more readily and effectively evaluated and…

Coffman, James R.

2002-01-01

21

Veterinary Homeopathy: The Implications of Its History for Unorthodox Veterinary Concepts and Veterinary Medical Education.  

ERIC Educational Resources Information Center

The history of veterinary homeopathy, its future and implications are discussed. The need for investigation into the validity of both allopathic and homeopathic claims is stressed and it is suggested that maintenance of quality is the key factor in any approach. (BH)

Coulter, Dwight B.

1979-01-01

22

Validation of computerized Swedish dog and cat insurance data against veterinary practice records  

Microsoft Academic Search

Large computerized medical databases offer great potential for epidemiological research. However, data-quality issues must be addressed. This study evaluated the agreement between veterinary practice records and computerized insurance data in a large Swedish claims database. For the year 1995, the company insured over 320?000 dogs and cats. A total of 470 hard-copy records were sampled from claims for health care

Agneta Egenvall; Brenda N Bonnett; Pekka Olson; Åke Hedhammar

1998-01-01

23

Attitude of Swedish veterinary and medical students to animal experimentation.  

PubMed

Nearly all veterinary and medical students (94 per cent) found it morally acceptable to use animals in research and believed it to be a necessity in order to treat human diseases. In contrast with the medical students a substantial proportion of veterinary students (40 per cent) considered themselves animal rights activists. Unlike the medical curriculum, the veterinary curriculum contains a two-week course in laboratory animal medicine, and a higher proportion of the students who had not been through this course was opposed to the use of animals in research than of the students who had completed the course. The course modified the views of half the students; more than 26 per cent of them became more positive towards animal use in research after the course, whereas 3 per cent became more negative. PMID:10909909

Hagelin, J; Hau, J; Carlsson, H E

2000-06-24

24

75 FR 77607 - Privacy Act of 1974; Proposed New System of Records; Veterinary Medicine Loan Repayment Program  

Federal Register 2010, 2011, 2012, 2013

...Proposed New System of Records; Veterinary Medicine Loan Repayment Program AGENCY: National...records notice titled, ``Veterinary Medicine Loan Repayment Program Records System...select applicants for the Veterinary Medicine Loan Repayment Program...

2010-12-13

25

USDA Center for Medical, Agricultural and Veterinary Entomology  

NSDL National Science Digital Library

A bibliography of publications from the USDA Center for Medical, Agricultural and Veterinary Entomology. Cataloged by year and searchable by peer-reviewed journal publications only or all publications. Links to each publication give reference details along with an interpretive summary as well as the technical abstract.

0002-11-30

26

Effective Learning & Teaching in Medical, Dental & Veterinary Education.  

ERIC Educational Resources Information Center

This collection of papers includes: (1) "Opportunities in Medical, Dental and Veterinary (MDV) Educational Development" (John Sweet); (2) "Culture, Collegiality, and Collaborative Learning" (George Brown, Madeline Rohin, and Michael Manogue); (3) "Communication Skills: On Being Patient-Centered" (Jeff Wilson); (4) "Curriculum" (John Sweet); (5)…

Sweet, John, Ed.; Huttly, Sharon, Ed.; Taylor, Ian, Ed.

27

Medical records seized.  

PubMed

Police in San Jose, CA, seized medical records at a medical marijuana clinic to see if doctors recommended use of the drug. The seizure at Santa Clara County Medical Cannabis Center raised concerns among physicians, who fear their medical licenses may be revoked. Patients were equally concerned that their confidentiality could be compromised. Police said if doctors refuse to confirm that they have recommended marijuana to a patient, the patient will be asked to sign a release. If the patient refuses, other corroboration will be sought. California voters legalized the medical use of marijuana in 1996; however, Federal and State officials continue to try to block implementation of the law. PMID:11365306

1998-04-17

28

Access to Medical Records.  

ERIC Educational Resources Information Center

Although confidentiality with regard to medical records is supposedly protected by the American Medical Associaton's principles of Ethics and the physician-patient privilege, there are a number of laws that require a physician to release patient information to public authorities without the patient's consent. These exceptions include birth and…

Cooper, Nancy

29

The larvae of some blowflies of medical and veterinary importance.  

PubMed

Diagnostic features are described as a series of couplets that enable separation of the third instar larvae of the following pairs of closely related forms of blowflies of medical and veterinary importance: Chrysomya chloropyga (Wiedemann) and Ch.putoria (Wiedemann), Chrysomya albiceps (Wiedemann) and Ch.rufifacies (Macquart), Cochliomyia hominivorax (Coquerel) and Co.macellaria (Fabricius), Lucilia sericata (Mergen) and L. cuprina (Wiedemann), Calliphora augur (Fabricius) and C. stygia (Fabricius). PMID:2979525

Erzinclioglu, Y Z

1987-04-01

30

Human Health Hazards of Veterinary Medications: Information for Emergency Departments  

Microsoft Academic Search

Background: There are over 5000 approved prescription and over-the-counter medications, as well as vaccines, with labeled indications for veterinary patients. Of these, there are several products that have significant human health hazards upon accidental or intentional exposure or ingestion in humans: carfentanil, clenbuterol (Ventipulmin), ketamine, tilmicosin (Micotil), testosterone\\/estradiol (Component E-H and Synovex H), dinoprost (Lutalyse\\/Prostamate), and cloprostenol (Estromate\\/EstroPlan). The hazards

Elaine Blythe Lust; Claudia Barthold; Mark A. Malesker; Tammy O. Wichman

2011-01-01

31

Role of Veterinary Medical Civic Action in the Low Intensity Conflict Environment.  

National Technical Information Service (NTIS)

This study examines the use of veterinary medical civic action as a means to achieve internal defense and development objectives in the low-intensity conflict environment. It considers veterinary programs as an alternative available to Third World countri...

D. R. Ragland

1988-01-01

32

Index-Catalogue of Medical and Veterinary Zoology. Subjects: Trematoda and Trematode Diseases. Part 11. Hosts: Genera A-L,  

National Technical Information Service (NTIS)

The catalog is based on records published in the Index-Catalog of Medical and Veterinary Zoology. Subjects: Trematoda and Trematode Diseases. Host names, with few exceptions, are listed as given by the author of the record. When there is a question of ide...

M. A. Doss M. M. Farr

1969-01-01

33

PROVIDES: A Complete Veterinary Medical Information System  

PubMed Central

The desirable attributes of a computer-based diagnostic aid are proposed. These include ease of use, ready accessibility, sound reasoning, completeness, the ability to justify its recommendations, and a system for updating. These principles are illustrated by examples from the authors' diagnostic system (PROVIDES). PROVIDES is a computer-aided diagnosis and medical information system designed for in-office use on a wide variety of microcomputers using the MS-DOS or PC-DOS operating systems. It is organized by the clinical problems frequently encountered in practice. Relevant historical, physical, and routine laboratory findings are collected through a series of menus. These findings are used to generate a ranked differential diagnostic list. Up-to-date information on diagnostic tests, recommended treatments, and expected outcomes is available for each suggested disease. Imagesp265-ap267-a

Pollock, Roy V.H.; Fredericks, Thomas A.

1988-01-01

34

Outpatient Medical Records  

PubMed Central

Dissatisfied with some functional aspects of the problem-oriented medical records used by their medical group, a committee of member physicians redesigned their office charts. Applying techniques of systematic layout planning, employed regularly as a tool of industrial engineering, these clinicians devised what they feel to be outpatient document with unique features. The resulting product forms a cohesive unit, eliminates duplication and provides many medicolegal safeguards.

Cook, Galen B.

1977-01-01

35

Beyond the Medical Record  

PubMed Central

Background Studies before and since the 1999 Institute of Medicine report have noted the limitations of using medical record reporting for reliably quantifying and understanding medical error. Quantitative macro analyses of large datasets should be supplemented by small-scale qualitative studies to provide insight into micro-level daily events in clinical and hospital practice that contribute to errors and adverse events and how they are reported. Design The study design involved semistructured face-to-face interviews with residents about the medical errors in which they recently had been involved and included questions regarding how those errors were acknowledged. Objective This paper reports the ways in which medical error is or is not reported and residents' responses to a perceived medical error. Participants Twenty-six residents were randomly sampled from a total population of 85 residents working in a 600-bed teaching hospital. Measurements Outcome measures were based on analysis of cases residents described. Using Ethnograph and traditional methods of content analysis, cases were categorized as Documented, Discussed, and Uncertain. Results Of 73 cases, 30 (41.1%) were formally acknowledged and Documented in the medical record; 24 (32.9%) were addressed through Discussions but not documented; 19 cases (26%) cases were classified as Uncertain. Twelve cases involved medication errors, which were acknowledged in different categories. Conclusions The supervisory discussion, the informal discussion, and near-miss contain important information for improving clinical care. Our study also shows the need to improve residents' education to prepare them to recognize and address medical errors.

Rosenthal, Marilynn M; Cornett, Patricia L; Sutcliffe, Kathleen M; Lewton, Elizabeth

2005-01-01

36

Basic list of veterinary medical serials, third edition: using a decision matrix to update the core list of veterinary journals  

PubMed Central

Objective: This paper presents the methods and results of a study designed to produce the third edition of the “Basic List of Veterinary Medical Serials,” which was established by the Veterinary Medical Libraries Section in 1976 and last updated in 1986. Methods: A set of 238 titles were evaluated using a decision matrix in order to systematically assign points for both objective and subjective criteria and determine an overall score for each journal. Criteria included: coverage in four major indexes, scholarly impact rank as tracked in two sources, identification as a recommended journal in preparing for specialty board examinations, and a veterinary librarian survey rating. Results: Of the 238 titles considered, a minimum scoring threshold determined the 123 (52%) journals that constituted the final list. The 36 subject categories represented on the list include general and specialty disciplines in veterinary medicine. A ranked list of journals and a list by subject category were produced. Conclusion: Serials appearing on the third edition of the “Basic List of Veterinary Medical Serials” met expanded objective measures of quality and impact as well as subjective perceptions of value by both librarians and veterinary practitioners.

Ugaz, Ana G; Boyd, C. Trenton; Croft, Vicki F; Carrigan, Esther E; Anderson, Katherine M

2010-01-01

37

Veterinary Medical Education in Florida. Report and Recommendations of the Postsecondary Education Planning Commission, Report No. 3, 1987.  

ERIC Educational Resources Information Center

A report on veterinary medical education in Florida and the need for veterinary care in Florida is presented. Overviews of the veterinary profession and veterinary medical education are also given, including the areas of history, careers in the field, licensure, salaries, animal disease research, accreditation, curriculum, enrollment, educational…

Florida State Postsecondary Education Commission, Tallahassee.

38

Medical narratives in electronic medical records  

Microsoft Academic Search

In this article, we describe the state of the art and directions of current development and research with respect to the inclusion of medical narratives in electronic medical-record systems. We used information about 20 electronic medical-record systems as presented in the literature. We divided these systems into `classical' systems that matured before 1990 and are now used in a broad

Huibert J Tange; Arie Hasman; Pieter F de Vries Robbé; Harry C Schouten

1997-01-01

39

Extent of Computerization: Medical Record Departments and Medical Records  

PubMed Central

In 1985 and then again in 1987, attendees at the American Medical Record Association (AMRA) annual meeting were surveyed to determine the extent of computer utilization in medical record departments. The results indicated that over 90 percent of respondents used a computer for at least one application. The degree of usage for the various applications is important for understanding the capabilities of medical record services, planning continuing education programs, product development and marketing strategies, and system implementation timetables. This study also sought information on the extent of computerization of the medical record. Findings indicate that over 40 percent of respondents' hospitals had at least one component of their medical records computerized.

Amatayakul, M. K.

1988-01-01

40

Learning-To-Communicate and Communicating-To-Learn in Veterinary Medicine: A Survey of Writing, Speaking, and Reading in Veterinary Medical Curricula.  

ERIC Educational Resources Information Center

Finds that communication tasks assigned in veterinary medical courses accord well with the communication tasks expected to be performed by practicing veterinarians. Concludes that the merging of research and practice in the education of veterinary medical students may offer lessons for the education of professional practitioners in technical…

Thompson, Isabelle; Hendrix, Charles M.

2000-01-01

41

Reading Your Medical Record  

MedlinePLUS

... Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard ... practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher ...

42

Problem-Oriented Medical Record.  

National Technical Information Service (NTIS)

This bibliography on the Problem-Oriented Medical Record (POMR) is limited to selected journal articles from June 1964 through July 1973. The POMR format for recording health care data was adopted by the Veterans Administration Department of Medicine and ...

1973-01-01

43

Perspectives on Veterinary Medical Education: The Tuskegee Experience.  

ERIC Educational Resources Information Center

The extent to which Veterinary Aptitude Test (VAT) scores are valid predictors of veterinary student performance and the effect of a summer enrichment program were assessed for Tuskegee Institute and Auburn University students. In addition, attention was directed to predictors of specialty choices and patterns of specialty choices and employment…

Adams, E. W.; Habtemariam, T.

44

Index-Catalogue of Medical and Veterinary Zoology. Supplement 24, Part 7: Hosts.  

National Technical Information Service (NTIS)

The Index-Catalogue of Medical and Veterinary Zoology provides in-depth coverage of the world's literature on human and animal parasitology. It covers parasitic protozoa, helminths, certain arthropods (ticks, mites, insects, copepods, isopods, linguatulid...

S. J. Edwards M. W. Hood J. H. Shaw J. D. Rayburn M. D. Kirby

1982-01-01

45

Index-Catalogue of Medical and Veterinary Zoology. Supplement 24, Part 5. Arthropoda and Miscellaneous Phyla.  

National Technical Information Service (NTIS)

The Index-Catalogue of Medical and Veterinary Zoology provides in-depth coverage of the world's literature on human and animal parasitology. It covers parasitic protozoa, helminths, certain arthropods (ticks, mites, insects, copepods, isopods, linguatulid...

S. J. Edwards M. W. Hood J. H. Shaw J. D. Rayburn M. D. Kirby

1982-01-01

46

Index-Catalogue of Medical and Veterinary Zoology. Supplement 24, Part 4. Namatoda and Acanthocephala.  

National Technical Information Service (NTIS)

The Index-Catalogue of Medical and Veterinary Zoology provides in-depth coverage of the world's literature on human and animal parasitology. It covers parasitic protozoa, helminths, certain arthropods (ticks, mites, insects, copepods, isopods, linguatulid...

S. J. Edwards M. W. Hood J. H. Shaw J. D. Rayburn M. D. Kirby

1982-01-01

47

Mandatory Continuing Veterinary Medical Education Requirements in the United States and Canada.  

ERIC Educational Resources Information Center

Lists by state and province the current continuing veterinary medical education (CVME) requirements in the United States and Canada and provides additional analysis and comment on CVME requirements. (EV)

Moore, Dale A.; Klingborg, Donald J.; Wright, Teressa

2003-01-01

48

The Northwest Regional Program in Veterinary Medical Education: An Overview  

ERIC Educational Resources Information Center

Results of a four-year cooperative effort to develop the Washington-Oregon-Idaho Regional Program in Veterinary Medicine (WOI) are summarized. Special admissions policies, curriculum, administrative procedures, and funding approaches are reviewed. (LBH)

Bustad, L. K.; And Others

1977-01-01

49

Predictors of success in a UK veterinary medical undergraduate course.  

PubMed

Admission procedures for veterinary undergraduate training programs often include an interview as well as assessment of previous academic performance. In addition to pre-course factors, within-course factors such as performance in earlier years may play a role in determining success in the veterinary course. This study investigated the relationship between pre-course factors and within-course factors as predictors of success within the course. The study population consisted of six first-year cohorts, five second-year cohorts, four third-year cohorts, three fourth-year cohorts, and two fifth-year cohorts. There were a total of 1,347 students from the five-year Bachelor of Veterinary Medicine (BVetMed) program at the Royal Veterinary College (RVC). Data from these cohorts consisted of pre-entry demographic (sex, age, and nationality) and admission variables and within-course assessments. Logistic regression was used to examine the relationship between predictors and outcome. The study confirmed the value of previous academic performance in selecting students for the veterinary degree course but the value of interviews in the selection process was less clear. Within-course examination results were associated with later course outcome and high marks in continuous assessments were associated with overall success in the course. The study supports selection of students on the basis of previous academic performance but not interview scores. Continuous assessment and within-course examination results may be of value in identifying those students most likely to fail and therefore, those who need to be monitored and advised more closely. PMID:23187031

Muzyamba, Morris Chivwaba; Goode, Nigel; Kilyon, Margaret; Brodbelt, Dave

2012-01-01

50

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Medical records. 701.122 Section 701...Privacy Program § 701.122 Medical records. (a) Health Information...DON activities shall disclose medical records to the individual to whom...

2013-07-01

51

Index-Catalogue of Medical and Veterinary Zoology. Special Publication Number 6. Subject: Nematoda and Nematode Diseases. Part 2. Supergenera, Genera, Species, and Subspecies: C-E.  

National Technical Information Service (NTIS)

The purpose of this section of the Index-Catalogue of Medical and Veterinary Zoology is to make available the bibliographic records on Nematoda and nematode diseases of animals that have accumulated in the parasite files of the Index-Catalogue during the ...

M. A. Doss D. T. Hanfman

1983-01-01

52

Index-Catalogue of Medical and Veterinary Zoology. Special Publication No. 6. Subject: Nematoda and Nematode Diseases. Part 1. Supergenera, Genera, Species, and Subspecies: A-B.  

National Technical Information Service (NTIS)

The purpose of the section of the Index-Catalogue of Medical and Veterinary Zoology is to make available the bibliographic records on nematoda and nematode diseases of animals that have accumulated in the parasite files of the Index-Catalogue during the p...

M. A. Doss D. T. Hanfman

1981-01-01

53

A study of depression and anxiety, general health, and academic performance in three cohorts of veterinary medical students across the first three semesters of veterinary school.  

PubMed

This study builds on previous research on predictors of depression and anxiety in veterinary medical students and reports data on three veterinary cohorts from two universities through their first three semesters of study. Across all three semesters, 49%, 65%, and 69% of the participants reported depression levels at or above the clinical cut-off, suggesting a remarkably high percentage of students experiencing significant levels of depression symptoms. Further, this study investigated the relationship between common stressors experienced by veterinary students and mental health, general health, and academic performance. A factor analysis revealed four factors among stressors common to veterinary students: academic stress, transitional stress, family-health stress, and relationship stress. The results indicated that both academic stress and transitional stress had a robust impact on veterinary medical students' well-being during their first three semesters of study. As well, academic stress negatively impacted students in the areas of depression and anxiety symptoms, life satisfaction, general health, perception of academic performance, and grade point average (GPA). Transitional stress predicted increased depression and anxiety symptoms and decreased life satisfaction. This study helped to further illuminate the magnitude of the problem of depression and anxiety symptoms in veterinary medical students and identified factors most predictive of poor outcomes in the areas of mental health, general health, and academic performance. The discussion provides recommendations for considering structural changes to veterinary educational curricula to reduce the magnitude of academic stressors. Concurrently, recommendations are suggested for mental health interventions to help increase students' resistance to environmental stressors. PMID:23187027

Reisbig, Allison M J; Danielson, Jared A; Wu, Tsui-Feng; Hafen, McArthur; Krienert, Ashley; Girard, Destiny; Garlock, Jessica

2012-01-01

54

The O3-Vet project: a veterinary electronic patient record based on the web technology and the ADT-IHE actor for veterinary hospitals.  

PubMed

A veterinary electronic patient record, compliant with the IT standards (HL7, DICOM and IHE), was developed at the School of Veterinary Medicine, University of Milan (Italy) in order to improve the veterinary hospital workflows, making the stored clinical data more homogenous and sharable, thereby increasing the integration with current and future software applications. The system was developed by open-source software in order to reduce the implementation and maintenance costs and to make the system sharable with other veterinary hospitals or research centers without additional costs. The system was tested from May to October 2006. Results show that the majority of the veterinarians involved in the test agreed on the advantages obtained by the use of application software concerning the availability of all the useful clinical data [71.4%], the quality of the diagnostic procedures [78.58%] and the efficiency [85.58%] of hospital activities. PMID:17531346

Zaninelli, M; Tangorra, F M; Castano, S; Ferrara, A; Ferro, E; Brambilla, P G; Faverzani, S; Chinosi, S; Scarpa, P; Di Giancamillo, M; Zani, D; Zepponi, A; Saccavini, C

2007-07-01

55

Information Methods of Human and Veterinary Medical Scientists (HVMS) in Borno State, Nigeria.  

ERIC Educational Resources Information Center

Describes results of a survey of human and veterinary medical scientists in Borno State (Nigeria) that was conducted to determine their information-seeking behavior and to examine sources of information used. Problems in information gathering are discussed, including lack of relevant sources, and suggestions for improvements in information…

Nweke, Ken M. C.

1995-01-01

56

Index-Catalogue of Medical and Veterinary Zoology, Supplement 15. Authors: A to Z,  

National Technical Information Service (NTIS)

The report is a revision of the Author Catalogue of the Index-Catalogue of Medical and Veterinary Zoology, consisting of Parts 1-18, was published during the period 1932-1952. Beginning in 1953, a series of supplements designed to publish the backlog was ...

J. M. Humphrey D. B. Segal

1965-01-01

57

Index-Catalogue of Medical and Veterinary Zoology. Supplement 19, Part 1. Authors A to Z,  

National Technical Information Service (NTIS)

A revision of the Author Catalog of the Index-Catalog of Medical and Veterinary Zoology, consisting of Parts 1 to 18, was published during the period 1932-52. Beginning in 1953, a series of supplements designed to publish the backlog was initiated. Since ...

D. B. Segal J. M. Humphrey S. J. Edwards M. D. Kirby M. L. Walker

1974-01-01

58

Risk factors for delays between intake and veterinary approval for adoption on medical grounds in shelter puppies and kittens  

PubMed Central

To maximize their capacity to save lives and optimize resource allocation, animal shelters need to identify highly adoptable animals that are unlikely to be delayed on medical grounds before they can be made available for adoption. In this retrospective cohort study, our objective was to identify risk factors for delays from intake to approval for adoption on medical grounds in shelter puppies and kittens. Shelter medical records from 2008 for 335 puppies and 370 kittens were selected randomly at a large metropolitan adoption-guarantee shelter. Data including signalment, source shelter, intake veterinary examination findings, clinical history and days from intake until approval by a veterinarian for adoption on medical grounds were extracted from shelter records and analyzed using multivariate Cox regression. Puppies and kittens with clinical signs of respiratory or gastrointestinal disease at intake took significantly longer to receive approval for adoption on medical grounds (puppies - respiratory p<0.0001; gastrointestinal p<0.0001; kittens - respiratory p<0.0001; gastrointestinal p=0.002). Stray kittens were more likely to be delayed than owner-relinquished kittens or those transferred from other shelters (p<0.01). Older kittens were less likely to be delayed (p<0.0001). Administration of oral or parenteral antibiotics to puppies and kittens with respiratory and/or ocular signs within 24 hours of intake significantly reduced time to approval on medical grounds for adoption (puppies p=0.02; kittens p=0.03). The analyses suggested that puppies and kittens with respiratory or gastrointestinal signs on intake are more likely to experience delays between intake and veterinary approval for adoption on medical grounds. Prompt antimicrobial treatment of animals with respiratory and/or ocular signs may decrease length of stay in the shelter.

Litster, Annette; Allen, Joselyn; Mohamed, Ahmed; He, Shuang

2011-01-01

59

Risk factors for delays between intake and veterinary approval for adoption on medical grounds in shelter puppies and kittens.  

PubMed

To maximize their capacity to save lives and optimize resource allocation, animal shelters need to identify highly adoptable animals that are unlikely to be delayed on medical grounds before they can be made available for adoption. In this retrospective cohort study, our objective was to identify risk factors for delays from intake to approval for adoption on medical grounds in shelter puppies and kittens. Shelter medical records from 2008 for 335 puppies and 370 kittens were selected randomly at a large metropolitan adoption-guarantee shelter. Data including signalment, source shelter, intake veterinary examination findings, clinical history and days from intake until approval by a veterinarian for adoption on medical grounds were extracted from shelter records and analyzed using multivariate Cox regression. Puppies and kittens with clinical signs of respiratory or gastrointestinal disease at intake took significantly longer to receive approval for adoption on medical grounds (puppies - respiratory p<0.0001; gastrointestinal p<0.0001; kittens - respiratory p<0.0001; gastrointestinal p=0.002). Stray kittens were more likely to be delayed than owner-relinquished kittens or those transferred from other shelters (p<0.01). Older kittens were less likely to be delayed (p<0.0001). Administration of oral or parenteral antibiotics to puppies and kittens with respiratory and/or ocular signs within 24h of intake significantly reduced time to approval on medical grounds for adoption (puppies p=0.02; kittens p=0.03). The analyses suggested that puppies and kittens with respiratory or gastrointestinal signs on intake are more likely to experience delays between intake and veterinary approval for adoption on medical grounds. Prompt antimicrobial treatment of animals with respiratory and/or ocular signs may decrease length of stay in the shelter. PMID:21621287

Litster, Annette; Allen, Joselyn; Mohamed, Ahmed; He, Shuang

2011-08-01

60

Library use and information-seeking behavior of veterinary medical students.  

PubMed Central

Veterinary medical students at Iowa State University were assessed for general use of the veterinary library and for their information-seeking behavior. The library was most frequently used for studying and for making photocopies of materials. The typical respondent relied on course textbooks and handouts for current information on unfamiliar topics, instead of using indexes or abstracts for guidance to recent literature. Light use of library information resources raises the concern that students are developing an inadequate base of retrieval skills for finding information on new procedures, diseases and drugs. No differences were found between students with and without formal bibliographic instruction in their approaches to seeking information or in library use.

Pelzer, N L; Leysen, J M

1988-01-01

61

Veterinary medical student well-being: depression, stress, and personal relationships.  

PubMed

Existing research consistently connects higher relationship satisfaction with improved psychological and physical functioning. Investigations focusing on relational satisfaction within veterinary medicine have been sparse. This study evaluated 240 veterinary medical students at Kansas State University. Results indicate that students within higher-functioning relationships are more likely to report fewer depressive symptoms, lower stress associated with balancing their school and home lives, less relationship conflict, better physical health, and improved ability to cope with academic expectations, while at the same time experiencing more stress from being behind in studies. Based on these findings, Colleges of Veterinary Medicine (CVMs) are encouraged to institute policies and programs which foster relationship-building for students. PMID:23975073

Hafen, McArthur; Ratcliffe, G Cole; Rush, Bonnie R

2013-01-01

62

Veterinary medical education for modern food systems: past, present, and brainstorming a future.  

PubMed

Concepts presented here were derived from breakout sessions constituted by the 90 attendees of the Veterinary Medical Education for Modern Food Systems symposium, held in Kansas City, Missouri, USA, in October 2005. The attendees were food-animal educators, veterinary faculty, college deans and administrators, and veterinarians employed in government, industry, and private practice. Discussions at these breakout sessions focused on four primary areas: (1) determining the data needed to document the current demand for food-supply veterinarians (FSVs); (2) defining the information/skills/abilities needed within veterinary school curricula to address the current demands on FSVs; (3) outlining pre-DVM educational requirements needed to support FSVs; and (4) considering the role of post-DVM programs in meeting the demand for FSVs. PMID:17220491

Morishita, Teresa Y; Kahrs, Robert F; Prasse, Keith W; Maccabe, Andrew; Dierks, Richard

2006-01-01

63

32 CFR 321.6 - Medical records.  

Code of Federal Regulations, 2013 CFR

... 2013-07-01 2013-07-01 false Medical records. 321.6 Section 321.6 National Defense...SECURITY SERVICE PRIVACY PROGRAM § 321.6 Medical records. General. Medical records that are part of DSS records systems...

2013-07-01

64

28 CFR 79.5 - Requirements for medical documentation, contemporaneous records, and other records or documents.  

Code of Federal Regulations, 2013 CFR

...Requirements for medical documentation, contemporaneous records, and other records...Requirements for medical documentation, contemporaneous records, and other records... (a) All medical documentation, contemporaneous records,...

2013-07-01

65

Medical Services: Nursing Records and Reports.  

National Technical Information Service (NTIS)

Contents: (1) Documentation of daily patient acuity classification on DA Form 4677 (Clinical Record--Therapeutic Documentation Care Plan (Non-Medication)) (chap 2); (2) Documentation of the nursing discharge summary, DA Form 3888-3 (Medical Record--Nursin...

1991-01-01

66

Javelin diagrams: applications in veterinary medical decision analysis  

Microsoft Academic Search

This paper introduces javelin diagrams as an innovative way for depicting the results of medical decision analyses. The methods were used to determine whether, and at which values, blood lactate in Belgian White and Blue or maximum tidal volumes in Holstein calves should be measured before deciding to treat or not a calf suffering from the bovine respiratory disease complex.

Johann C. Detilleux

2004-01-01

67

Index-Catalogue of Medical and Veterinary Zoology. Supplement 24, Part 6, Sections A-B: Subject Headings.  

National Technical Information Service (NTIS)

The Index-Catalogue of Medical and Veterinary Zoology provides in-depth coverage of the world's literature on human and animal parasitology. It covers parasitic protozoa, helminths, certain arthropods (ticks, mites, insects, copepods, isopods, linguatulid...

S. J. Edwards M. W. Hood J. H. Shaw J. D. Rayburn M. D. Kirby

1982-01-01

68

Improving response rates: introducing an anonymous longitudinal survey research protocol for veterinary medical students.  

PubMed

With the Journal of Veterinary Medical Education's recent summer 2005 theme issue on stress, the mental-health concerns of veterinary medical students has been brought to the forefront of the field. Since it is anticipated that research on this topic will continue and that educational institutions may implement changes based upon these results, it is of the utmost importance that this research be of the highest quality. Of particular concern with human-subject inquiries are response rates and confidentiality. In order to accommodate these concerns, an example of a survey research protocol that promotes high response rates and minimizes threats to internal validity influenced by student mistrust in assurances of confidentiality is presented. Specifically, the protocol is designed to ensure anonymity and to preserve the ability to track students longitudinally through the use of anonymous longitudinal identifiers. This protocol was tested with the first-year class of veterinary medical students at Kansas State University in October 2004 and March 2005. The two data collection periods yielded 90% and 76% response rates, respectively. The matching rate of participants, according to the anonymous longitudinal identifiers from Time 1 to Time 2, was 88%. PMID:17446648

Reisbig, Allison M J; Hafen, McArthur; White, Mark B; Rush, Bonnie R

2007-01-01

69

Medical Services: Department of Defense Veterinary/Medical Laboratory Food Safety and Quality Assurance Program.  

National Technical Information Service (NTIS)

This consolidated regulation on Food Safety Evaluation Programs prescribes: policies and functions of the veterinary laboratory service; and specialized requirements and microbiological standards for answering food safety and quality assurance for potenti...

1995-01-01

70

Why a shared care record is an official medical record.  

PubMed

The literature describes three categories of health records: the Official Medical Records held by healthcare providers, Personal Health Records owned by patients, and--a possible in between case--the Shared Care Record. New complications and challenges arise with electronic storage of this latter class of record; for instance, an electronic shared care record may have multiple authors, which presents challenges regarding the roles and responsibilities for record-keeping. This article discusses the definitions and implementations of official medical records, personal health records and shared care records. We also consider the case of a New Zealand pilot of developing and implementing a shared care record in the National Shared Care Planning Programme. The nature and purpose of an official medical record remains the same whether in paper or electronic form. We maintain that a shared care record is an official medical record; it is not a personal health record that is owned and controlled by patients, although it is able to be viewed and interacted with by patients. A shared care record needs to meet the same criteria for medico-legal and ethical duties in the delivery of shared care as pertain to any official medical record. PMID:24162635

Gu, Yulong; Orr, Martin; Warren, Jim; Humphrey, Gayl; Day, Karen; Tibby, Sarah; Fitzpatrick, Jo

2013-10-18

71

Identification Codes for Medical Records  

PubMed Central

Identification codes for filing of medical records may be generated from “wild” variables such as name, birth date, and place of birth. In designing a scheme for a particular application, it is important to determine the probability of generating identical codes for different people. A simplified method of computing this probability is derived in the text. It is also shown that for a population of any reasonable size an identification system predicated on the occurrence of no redundancies whatsoever is generally impractical because of the large number of identification variables it would require. A better solution would be to establish an expected ratio of redundancy, and to build methods coping with redundancy into the system.

Yoder, Richard D.; Dreyfus, Ronald H.; Saltzberg, Bernard

1966-01-01

72

Analyses and decreasing patterns of veterinary antianxiety medications in soils.  

PubMed

An ultrasonic-assisted extraction method was developed to detect 16 antianxiety medications in soil samples using liquid chromatography-high resolution mass spectrometry (LC-HRMS), Orbitrap mass spectrometer. The determination method resulted in satisfactory sensitivity, linearity, recovery, repeatability, and within-laboratory reproducibility. Acepromazine, azaperone, and xylazine were incubated in control, amended, and sterilized soils. The amendment with powdered blood meal affected the relatively fast dissipations of acepromazine, azaperone, and xylazine in the soils. Dissipation kinetics of acepromazine were consistent with bi-phasic kinetics (first-order multi compartment) and the other couples were fit to single first-order kinetics. A hydroxylated acepromazine was identified from soil samples using Orbitrap mass spectrometry. According to sorption batch experiments, the adsorption of acepromazine and azaperone was greatly high, whereas that of xylazine was relatively low. Xylazine was persistent in the incubated soils, and acepromazine demonstrated fast initial dissipation; hence, xylazine could have a potential harmful effect on the environment. To the best of our knowledge, this is the first report on the dissipation and adsorption-desorption patters of animal pharmaceutical tranquilizers and ?, ?-blockers. PMID:24857899

Choi, Jeong-Heui; Lamshöft, Marc; Zühlke, Sebastian; Abd El-Aty, A M; Rahman, Md Musfiqur; Kim, Sung Woo; Shim, Jae-Han; Spiteller, Michael

2014-06-30

73

[Veterinary medical offer for udder health and milking hygiene: results in Rheinland-Pfalz].  

PubMed

A sanitation programme was installed by veterinary medical officers on 261 dairy farms. All farms had been selected because of problems with somatic cell counts in milk for a long period of time. Quarter milk samples were taken from all lactating cows, and management factors (including milking equipment, -hygiene, housing and feeding) were assessed. Contagious mastitis pathogens like Sc. agalactiae and Staphylococci represented the main bacteriological problem in 79% of the herds. Only minor problems were caused by environmental pathogens like esculin-positive Streptococci and Coliforms. The sanitation programmes were mainly based on improvements with milking hygiene and techniques. Recommendations for antibiotic therapy were also given. Farmers and veterinary surgeons were entirely responsible for the implementation of these programmes on the farm. Success was controlled by monitoring somatic cell counts in bulk milk four months before to 18 months after the veterinary medical officer visited the farm. As early as one month after the visit cell counts decreased significantly (p < 0.01) and continued decreasing during the second (p < 0.05) and following months. Somatic cell counts of bulk milk stabilised on a significantly lower level for all over the period monitored. PMID:8999591

Luhofer, G; Klawonn, W; Labohm, R; Hess, R G

1996-10-01

74

Library use and information-seeking behavior of veterinary medical students.  

PubMed

Veterinary medical students at Iowa State University were assessed for general use of the veterinary library and for their information-seeking behavior. The library was most frequently used for studying and for making photocopies of materials. The typical respondent relied on course textbooks and handouts for current information on unfamiliar topics, instead of using indexes or abstracts for guidance to recent literature. Light use of library information resources raises the concern that students are developing an inadequate base of retrieval skills for finding information on new procedures, diseases and drugs. No differences were found between students with and without formal bibliographic instruction in their approaches to seeking information or in library use. PMID:3224224

Pelzer, N L; Leysen, J M

1988-10-01

75

Implementation of electronic medical records  

PubMed Central

Abstract Objective To apply the diffusion-of-innovations theory to the examination of factors that are perceived by family physicians as influencing the implementation of electronic medical records (EMRs). Design Qualitative study with 2 focus groups 18 months after EMR implementation; participants also took part in a concurrent quantitative study examining EMR implementation and preventive services. Setting Toronto, Ont. Participants Twelve community-based family physicians. Methods We employed a semistructured interview guide. The interviews were audiotaped and transcribed verbatim; 2 researchers independently categorized and coded the transcripts and then met to compare and contrast their findings, category mapping, and interpretations. Findings were then mapped to an existing theoretical framework. Main findings Multiple barriers to EMR implementation were described. These included lack of relative advantage for many processes, high complexity of the system, low compatibility with physician needs and past experiences, difficulty with adaptation of the EMR to the organization and adaptation of the organization to the EMR, and lack of organizational slack. Positive factors were the presence of a champion and relative advantages for some processes. Conclusion Early EMR implementation experience is consistent with theoretical concepts associated with implementation of innovations. A problematic implementation process helps to explain, at least in part, the lack of improvement in preventive services in our quantitative results.

Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

2011-01-01

76

Automated anesthesia surgery medical record system  

Microsoft Academic Search

Manual recording of physiological data in patients receiving anesthesia or intensive care infrequently meets medical requirements\\u000a or legal documentation standards. Automated recording allows the generation of reliable data that can be integrated into the\\u000a patient's medical record. Such a system is beginning to function at University Hospital at Stony Brook, New York. Bedside\\u000a medical devices (pulse oximeters, non-invasive blood pressure

J. S. Gage; S. Subramanian; J. F. Dydro; P. J. Poppers

1991-01-01

77

Computerised linking of medical records: methodological guidelines  

Microsoft Academic Search

OBJECTIVES--To report on the development of computer assisted methods for linking medical records and record abstracts. DESIGN--The methods include file blocking, to put records in an order which makes searching efficient; matching, which is the process of comparing records to determine whether they do or do not relate to the same person; linkage, which is the process of assembling correctly

L Gill; M Goldacre; H Simmons; G Bettley; M Griffith

1993-01-01

78

From theory to practice: integrating instructional technology into veterinary medical education.  

PubMed

Technology has changed the landscape of teaching and learning. The integration of instructional technology into teaching for meaningful learning is an issue for all educators to consider. In this article, we introduce educational theories including constructivism, information-processing theory, and dual-coding theory, along with the seven principles of good practice in undergraduate education. We also discuss five practical instructional strategies and the relationship of these strategies to the educational theories. From theory to practice, the purpose of the article is to share our application of educational theory and practice to work toward more innovative teaching in veterinary medical education. PMID:23975076

Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; Herman, Cheryl; Miesner, Matt; Renter, David; Gehring, Ronette

2013-01-01

79

[Ecology of river mollusks of medical and veterinary importance in 3 sites in La Habana province].  

PubMed

An ecological research study was carried out in freshwater mollusk populations of medical and veterinary importance, in order to determine the biotic and abiotic factors that affect their dynamics. It was observed that the principal abiotic factors influencing abundance of mollusks were total hardness, salinity, acidity, alkalinity and CO2 concentration. Both aquatic plants and specific relations among mollusk groups were the principal biotic factors that affected the molluskan fauna. Species like Fossaria cubensis and Tarebia granifera appeared affected when the site diversity increased whereas the tiarid Melanoides tuberculata prevailed in almost all the ecosystems. PMID:23427449

Vázquez Perera, Antonio Alejandro; Gutiérrez Amador, Alfredo

2007-01-01

80

An admissions system to select veterinary medical students with an interest in food animals and veterinary public health.  

PubMed

Interest in the areas of food animals (FA) and veterinary public health (VPH) appears to be declining among prospective students of veterinary medicine. To address the expected shortage of veterinarians in these areas, the Utrecht Faculty of Veterinary Medicine has developed an admissions procedure to select undergraduates whose aptitude and interests are suited to these areas. A study using expert meetings, open interviews, and document analysis identified personal characteristics that distinguished veterinarians working in the areas of FA and VPH from their colleagues who specialized in companion animals (CA) and equine medicine (E). The outcomes were used to create a written selection tool. We validated this tool in a study among undergraduate veterinary students in their final (sixth) year before graduation. The applicability of the tool was verified in a study among first-year students who had opted to pursue either FA/VPH or CA/E. The tool revealed statistically significant differences with acceptable effect sizes between the two student groups. Because the written selection tool did not cover all of the differences between the veterinarians who specialized in FA/VPH and those who specialized in CA/E, we developed a prestructured panel interview and added it to the questionnaire. The evaluation of the written component showed that it was suitable for selecting those students who were most likely to succeed in the FA/VPH track. PMID:19435984

Haarhuis, Jan C M; Muijtjens, Arno M M; Scherpbier, Albert J J A; van Beukelen, Peter

2009-01-01

81

Dutch Electronic Medical Record - Complexity Perspective  

Microsoft Academic Search

Along with the global community, the Dutch health care system is pioneering in transitioning to electronic medical records. Although certain studies have been conducted on the Dutch experience of implementing its national Electronic Medical Record system, a historical account of this decade long initiative is largely lacking. More importantly, the study of specific challenges and the ways they are treated

Joseph Barjis

2010-01-01

82

Basic Workshops for Medical Record Clerical Personnel.  

ERIC Educational Resources Information Center

This curriculum guide is an outline of the content for basic workshop training sessions of hospital medical record personnel. Following a two-page topical outline of five content areas, there is a detailed presentation of this content as follows: (1) the medical record and its contribution to patient care (Joint Commission for Accreditation of…

Intermountain Regional Medical Program, Salt Lake City, UT.

83

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:24795413

2014-05-01

84

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:24993713

2014-07-01

85

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:24903173

2014-06-01

86

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:24700007

2014-04-01

87

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:24578431

2014-03-01

88

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:24097881

2013-10-01

89

Interprofessional initiatives between the human health professions and veterinary medical students: a scoping review.  

PubMed

Abstract This article presents the findings of a scoping review designed to identify the extent, nature and range of literature on interprofessional education (IPE) initiatives between the human health professions and veterinary medical students, which is particularly important to advance One Health education and research. Nine published articles were identified. The websites of six universities were searched in order to collect further information. Interventions vary widely with regards to their structure and delivery, their objectives, the participants involved, and outcome measures. Healthcare professional programmes focus upon interprofessional collaborative practice in the human healthcare setting. By contrast, postgraduate programmes focus upon topics under the One Health paradigm but make little mention of interprofessional collaboration. Evidence of the impact of interventions on team processes at the human, animal, and environmental interface is extremely limited. In order to enhance our understanding of what constitutes effective IPE between veterinary medical students and the human health professions, guide intervention development, and the development of outcome measures, there is a need to further explore, define, differentiate and validate some of the terms and concepts used to describe interprofessional interventions. PMID:24621114

Courtenay, Molly; Conrad, Pat; Wilkes, Michael; La Ragione, Roberto; Fitzpatrick, Noel

2014-07-01

90

Library use and information-seeking behavior of veterinary medical students revisited in the electronic environment.  

PubMed

Veterinary medical students at Iowa State University were surveyed in January of 1997 to determine their general use of the Veterinary Medical Library and how they sought information in an electronic environment. Comparisons were made between this study and one conducted a decade ago to determine the effect of the growth in electronic resources on student library use and information-seeking behavior. The basic patterns of student activities in the library, resources used to find current information, and resources anticipated for future education needs remained unchanged. The 1997 students used the library most frequently for photocopying, office supplies, and studying coursework; they preferred textbooks and handouts as sources of current information. However, when these students went beyond textbooks and handouts to seek current information, a major shift was seen from the use of print indexes and abstracts in 1987 towards the use of computerized indexes and other electronic resources in 1997. Almost 60% of the students reported using the Internet for locating current information. Overall use of electronic materials was highest among a group of students receiving the problem-based learning method of instruction. Most of the students surveyed in 1997 indicated that electronic resources would have some degree of importance to them for future education needs. The electronic environment has provided new opportunities for information professionals to help prepare future veterinarians, some of whom will be practicing in remote geographical locations, to access the wealth of information and services available on the Internet and Web. PMID:9681170

Pelzer, N L; Wiese, W H; Leysen, J M

1998-07-01

91

Use of Veterinary Records To Teach Laboratory Thinking Skills in Biology.  

ERIC Educational Resources Information Center

Describes a laboratory protocol using clinical veterinary data that teaches the cognitive, analytical, communication, and interpersonal skills necessary for students in a biology core laboratory course. (WRM)

Woolverton, Christopher J.

1999-01-01

92

Exploiting Domain Thesaurus for Medical Record Retrieval.  

National Technical Information Service (NTIS)

InfoLab at the University of Delaware participated in the TREC 2012 Medical Records Track. This paper explains our method and describes experiment results. One limitation of existing keyword matching based retrieval functions is the problem of vocabulary ...

H. Fang M. A. Callejas Y. Wang

2012-01-01

93

Automation of the problem oriented medical record  

NASA Technical Reports Server (NTRS)

An improved ambulatory care delivery system developed for the Navy is examined. The system is centered around the concepts of problem oriented medical records and expanded use of paramedical personnel.

Schall, D. W.

1971-01-01

94

The current status of animal use and alternatives in Korean veterinary medical schools.  

PubMed

Two new Korean laws regulating animal welfare and the humane use of animals in science came into effect in 2008 and 2009. Both these laws impose ethical committee review prior to the performance of animal experiments in research, testing and education. This study briefly summarises the new Korean laws, and investigates the current status regarding the numbers of animals used, the alternatives to animals which are used, the curricula relating to the humane use of animals, and ethical review practices in Korean veterinary education. Approximately 4,845 animals, representing 20 different species, were used in veterinary medical education in Korea in 2007. Korea has begun to introduce formal courses on animal welfare for the humane treatment of animals used in experiments, and an ethical protocol review system prior to animal use in education. Korea is moving toward better animal welfare, by incorporating practices consistent with international standards. The information presented represents the first such data gathered in Korea, which should prove useful for monitoring the implementation of replacement, reduction, and refinement measures in animal use for education purposes. PMID:20602538

Lee, Gwi Hyang; Choe, Byung In; Kim, Jin Suk; Hart, Lynette A; Han, Jin Soo

2010-06-01

95

Problem-Oriented Medical Record (POMR) Study.  

National Technical Information Service (NTIS)

The purpose of this study was to evaluate the problem-oriented medical record (POMR) and to determine the feasibility of its use within health care facilities of the Army Medical Department (AMEDD). It was determined that the POMR is being utilized to som...

J. A. Hubbart A. D. Mangelsdorff

1978-01-01

96

Foundations for an Electronic Medical Record  

Microsoft Academic Search

: Given the many efforts currently under way to develop standards for medicalrecords, it is important to step back and re-examine the fundamental principles which shouldunderlie a model of the electronic record. This paper presents an analysis based on theexperience in developing the PEN & PAD prototype clinical workstation. The fundamentalcontention is that the requirements for a medical record must

A. L. Rector; W. A. Nolan; S. Kay

1991-01-01

97

Activity and biological effects of neem products against arthropods of medical and veterinary importance.  

PubMed

Botanical insecticides are relatively safe and degradable, and are readily available sources of biopesticides. The most prominent phytochemical pesticides in recent years are those derived from neem trees, which have been studied extensively in the fields of entomology and phytochemistry, and have uses for medicinal and cosmetic purposes. The neem products have been obtained from several species of neem trees in the family Meliaceae. Six species in this family have been the subject of botanical pesticide research. They are Azadirachta indica A. Juss, Azadirachta excelsa Jack, Azadirachta siamens Valeton, Melia azedarach L., Melia toosendan Sieb. and Zucc., and Melia volkensii Gürke. The Meliaceae, especially A. indica (Indian neem tree), contains at least 35 biologically active principles. Azadirachtin is the predominant insecticidal active ingredient in the seed, leaves, and other parts of the neem tree. Azadirachtin and other compounds in neem products exhibit various modes of action against insects such as antifeedancy, growth regulation, fecundity suppression and sterilization, oviposition repellency or attractancy, changes in biological fitness, and blocking development of vector-borne pathogens. Some of these bioactivity parameters of neem products have been investigated at least in some species of insects of medical and veterinary importance, such as mosquitoes, flies, triatomines, cockroaches, fleas, lice, and others. Here we review, synthesize, and analyze published information on the activity, modes of action, and other biological effects of neem products against arthropods of medical and veterinary importance. The amount of information on the activity, use, and application of neem products for the control of disease vectors and human and animal pests is limited. Additional research is needed to determine the potential usefulness of neem products in vector control programs. PMID:10412110

Mulla, M S; Su, T

1999-06-01

98

Medical records: past, present, and future.  

PubMed Central

This paper considers the lessons learnt during the development of the electronic medical record for patient care. It is not a definitive history of medical records but an assessment of what has been learnt, what has to be learnt and how we can move forward. It considers the needs for structured intelligent records that help in individual patient care, the need to provide functionality that fits with the requirements of the clinician-patient interaction and the need to take into account the human factors that affect clinician's uptake of such systems. It outlines the issues of free form input as opposed to controlled input that have to be resolved.

Hayes, G. M.

1996-01-01

99

Virtual medical scribes: making electronic medical records work for you.  

PubMed

There is increasing buzz around the term "medical scribe" in healthcare today. Medical scribes help meet the growing electronic medical record (EMR) data entry challenge healthcare providers face. Medical scribes reduce providers' paperwork burden, increase a medical practice's net margins, and reduce stress levels for doctors and their staff. They do this by charting patient encounters in real-time during patient examinations, thus reducing significantly the data entry workload that EMRs place on providers. Medical scribes can work onsite or offsite from a HIPAA-secure location, the latter being known as "virtual medical scribes." This article explores the uses and benefits of scribes to give you the background to employ them effectively in your clinic or hospital. PMID:24228379

Brady, Kevin; Shariff, Afser

2013-01-01

100

38 CFR 46.6 - Medical quality assurance records confidentiality.  

Code of Federal Regulations, 2013 CFR

... 2013-07-01 false Medical quality assurance records confidentiality. 46...Miscellaneous § 46.6 Medical quality assurance records confidentiality. Note that medical quality assurance records that are confidential...

2013-07-01

101

29 CFR 1410.5 - Special procedures: Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Special procedures: Medical records. 1410.5 Section 1410.5 Labor ...PRIVACY § 1410.5 Special procedures: Medical records. (a) If medical records are requested for inspection which,...

2013-07-01

102

10 CFR 35.2080 - Records of mobile medical services.  

Code of Federal Regulations, 2010 CFR

...2009-01-01 2009-01-01 false Records of mobile medical services. 35.2080 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2080 Records of mobile medical services. (a) A...

2009-01-01

103

10 CFR 35.2080 - Records of mobile medical services.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Records of mobile medical services. 35.2080 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2080 Records of mobile medical services. (a) A...

2010-01-01

104

22 CFR 215.6 - Special procedures: Medical records.  

Code of Federal Regulations, 2013 CFR

... false Special procedures: Medical records. 215.6 Section 215.6...215.6 Special procedures: Medical records. If the Assistant Director...directly to the individual of medical records maintained by the...

2013-04-01

105

32 CFR 319.7 - Special procedures: Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Special procedures: Medical records. 319.7 Section 319.7 National Defense...PRIVACY PROGRAM § 319.7 Special procedures: Medical records. Medical records, requested pursuant to § 319.5 of this...

2013-07-01

106

37 CFR 102.26 - Special procedures: Medical records.  

Code of Federal Regulations, 2013 CFR

... false Special procedures: Medical records. 102.26 Section 102...102.26 Special procedures: Medical records. (a) No response to any request for access to medical records by an individual will be...

2013-07-01

107

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Condition: Medical records. 494.170 Section 494...Administration § 494.170 Condition: Medical records. The dialysis facility must...information. (1) Current medical records and those of discharged...

2013-10-01

108

49 CFR 386.48 - Medical records and physicians' reports.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Medical records and physicians' reports. ...Rules and Hearings § 386.48 Medical records and physicians' reports. ...reports, test results, and other medical records that a party intends to...

2013-10-01

109

44 CFR 6.31 - Special requirements for medical records.  

Code of Federal Regulations, 2013 CFR

...false Special requirements for medical records. 6.31 Section 6.31...31 Special requirements for medical records. (a) A system manager...individual for access to those official medical records which belong to the...

2013-10-01

110

29 CFR 1611.6 - Special procedures: Medical records.  

Code of Federal Regulations, 2013 CFR

... false Special procedures: Medical records. 1611.6 Section 1611...1611.6 Special procedures: Medical records. In the event the Commission...pursuant to § 1611.3 for access to medical records (including...

2013-07-01

111

A model of medical record storage.  

PubMed

A model is developed to describe the growth of a medical records store subject to rules for microfilming or disposing of record files when they have not been used within a given period of time. Separate projections are given for the number of files in the system and for the volume of file contents. The model allows different microfilm policies to be compared and aids the long term planning of storage facilities. PMID:10260228

Nimmo, A W

1983-05-01

112

Prevalence of disorders recorded in dogs attending primary-care veterinary practices in England.  

PubMed

Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P?=?0.001), obesity (P?=?0.006) and skin mass lesion (P?=?0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P?=?0.002), overgrown nails (P?=?0.004), degenerative joint disease (P?=?0.005), obesity (P?=?0.001) and lipoma (P?=?0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein. PMID:24594665

O Neill, Dan G; Church, David B; McGreevy, Paul D; Thomson, Peter C; Brodbelt, Dave C

2014-01-01

113

Intelligent Consumer-Centric Electronic Medical Record  

Microsoft Academic Search

Web-based, consumer-centric electronic medical records (CEMRs) are currently undergoing widespread deployment. Existing CEMRs, however, have limited intelligence and cannot satisfy users' many needs. This paper proposes the concept of intelligent CEMR. We introduce and extend expert system and web search technology into the CEMR domain. The resulting intelligent CEMRs can automatically provide users with personalized healthcare information to facilitate their

Gang Luo; Selena B. Thomas; Chunqiang Tang

2009-01-01

114

Medical Terminology of the Circulatory System. Medical Records. Instructional Unit for the Medical Transcriber.  

ERIC Educational Resources Information Center

Developed as a result of an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis…

Gosman, Minna L.

115

Intelligent consumer-centric electronic medical record.  

PubMed

Web-based, consumer-centric electronic medical records (CEMRs) are currently undergoing widespread deployment. Existing CEMRs, however, have limited intelligence and cannot satisfy users' many needs. This paper proposes the concept of intelligent CEMR. We introduce and extend expert system and web search technology into the CEMR domain. The resulting intelligent CEMRs can automatically provide users with personalized healthcare information to facilitate their daily activities. We use automatic home medical product recommendation as a concrete application to demonstrate the benefits offered by intelligent CEMRs. PMID:19745280

Luo, Gang; Thomas, Selena B; Tang, Chunqiang

2009-01-01

116

Providing an information prescription in veterinary medical clinics: a pilot study  

PubMed Central

Objective: The study assesses the impact on client behavior and attitudes toward receiving an information prescription as part of a veterinary office visit. Methods: A random sample of veterinary clinics from a Western US metropolitan area was asked to distribute an information prescription in addition to their customary veterinary services. All clients, regardless of the reason for their visit, were presented with an information prescription: a handout that included the uniform resource locator (URL) to a general veterinary medicine website and several tips to help their clients make more informed choices about where to seek pet health information online. Results: Nearly 40% of clients who reported that they remembered receiving the information prescription accessed the website at least once. Of the clients who reported accessing the suggested website, 86.3% reported finding it “very helpful” or “somewhat helpful.” Nearly all the clients (87.9%) reported feeling the information on the site helped them make better decisions for their pets. Most clients reported that it helped them talk to their veterinarians (89.9%) and added to the information they received during their veterinary visits (83.5%). Conclusions: Clients appreciate and utilize veterinary prescriptions, suggesting that this is a tool that both veterinarians and librarians can use to improve animal health and client relations. Implications: The value placed on reliable Internet information by veterinary clients suggests several opportunities for librarians to become more proactive in partnering with veterinarians to facilitate the education of pet owners.

Kogan, Lori R.; Schoenfeld-Tacher, Regina; Gould, Lauren; Viera, Ann R.; Hellyer, Peter W.

2014-01-01

117

Veterinary medicines and competition animals: the question of medication versus doping control.  

PubMed

In racing and other equine sports, it is possible to increase artificially both the physical capability and the presence of a competitive instinct, using drugs, such as anabolic steroids and agents stimulating the central nervous system. The word doping describes this illegitimate use of drugs and the primary motivation of an equine anti-doping policy is to prevent the use of these substances. However, an anti-doping policy must not impede the use of legitimate veterinary medications and most regulatory bodies in the world now distinguish the control of illicit substances (doping control) from the control of therapeutic substances (medication control). For doping drugs, the objective is to detect any trace of drug exposure (parent drug or metabolites) using the most powerful analytical methods (generally chromatographic/mass spectrometric techniques). This so-called "zero tolerance rule" is not suitable for medication control, because the high level of sensitivity of current screening methods allows the detection of totally irrelevant plasma or urine concentrations of legitimate drugs for long periods after their administration. Therefore, a new approach for these legitimate compounds, based upon pharmacokinetic/pharmacodynamic (PK/PD) principles, has been developed. It involves estimating the order of magnitude of the irrelevant plasma concentration (IPC) and of the irrelevant urine concentration (IUC) in order to limit the impact of the high sensitivity of analytical techniques used for medication control. The European Horserace Scientific Liaison Committee (EHSLC), which is the European scientific committee in charge of harmonising sample testing and policies for racehorses in Europe, is responsible for estimating the IPCs and IUCs in the framework of a Risk Analysis. A Risk Analysis approach for doping/medication control involves three sequential steps, namely risk assessment, risk management, and risk communication. For medication control, the main task of EHLSC in the risk management procedure is the establishment of harmonised screening limits (HSL). The HSL is a confidential instruction to laboratories from racing authorities to screen in plasma or urine for the presence of drugs commonly used in equine medication. The HSL is derived from the IPC (for plasma) or from the IUC (for urine), established during the risk assessment step. The EHSLC decided to keep HSL confidential and to inform stakeholders of the duration of the detection time (DT) of the main medications when screening is performed with the HSL. A DT is the time at which the urinary (or plasma) concentration of a drug, in all horses involved in a trial conducted according to the EHSLC guidance rules, is shown to be lower than the HSL when controls are performed using routine screening methods. These DTs, as issued by the EHSLC (and adopted by the Fédération Equestre Internationale or FEI) provide guidance to veterinarians enabling them to determine a withdrawal time (WT) for a given horse under treatment. A WT should always be longer than a DT because the WT takes into account the impact of all sources of animal variability as well as the variability associated with the medicinal product actually administered in order to avoid a positive test. The major current scientific challenges faced in horse doping control are those instances of the administration of recombinant biological substances (EPO, GH, growth factors etc.) having putative long-lasting effects while being difficult or impossible to detect for more than a few days. Innovative bioanalytical approaches are now addressing these challenges. Using molecular tools, it is expected in the near future that transcriptional profiling analysis will be able to identify some molecular "signatures" of exposure to doping substances. The application of proteomic (i.e. the large scale investigation of protein biomarkers) and metabolomic (i.e. the study of metabolite profiling in biological samples) techniques also deserve attention for establishing possible unique fingerprints of drug

Toutain, Pierre-Louis

2010-01-01

118

Healthcare Stakeholders' Perspectives on the Use of Online Medical Records  

Microsoft Academic Search

We sought to study medical stakeholders' attitudes toward patient's access to their own medical records via a secure Internet application. We run a quantitative survey among stakeholders focusing on the possibility of providing online medical records for better communication in the healthcare sector. We found that patients varied in their views on using online medical records and having an option

N. Lambrou; S. Mustapha

2006-01-01

119

Medical records in family practice. A review.  

PubMed

The organisation of general practice in England is outlined and the independent contractor basis of the family practioner emphasised. Data from family practice, like data from hospital practice, may be used for clinical management, practice management, or research. Examples of applications in each of these fields are given. The basic records used in family practice--the medical record envelope, the prescription form and the claim for sickness benefit--are described. Some practices record morbidity (E Book or Diagnostic Index), some record systematically details of their activities (L Book or Activities Ledger) and some maintain age and sex registers and other registers of their patients; all these developments are outlined. Attention is drawn to the introduction of problem orientated records and to the use of computers in family practice, but these innovations are not discussed. Outstanding issues are the same as those in hospital record systems--accuracy, definitions, coverage, confidentiality, clerical support and costs, and the use made of the information. PMID:1085489

Warren, M D

1976-01-01

120

Mining free-text medical records.  

PubMed

Text mining projects can be characterized along four parameters: 1) the demands of the market in terms of target domain and specificity and depth of queries; 2) the volume and quality of text in the target domain; 3) the text mining process requirements; and 4) the quality assurance process that validates the extracted data. In this paper, we provide lessons learned and results from a large-scale commercial project using Natural Language Processing (NLP) for mining the transcriptions of dictated clinical records in a variety of medical specialties. We conclude that the current state-of-the-art in NLP is suitable for mining information of moderate content depth across a diverse collection of medical settings and specialties. PMID:11825190

Heinze, D T; Morsch, M L; Holbrook, J

2001-01-01

121

20 CFR 401.55 - Access to medical records.  

Code of Federal Regulations, 2013 CFR

...We have completed processing your request for notification of or access to _____'s (Name of minor) medical records. Please be informed that if any medical record was found pertaining to that individual, it has been sent to your designated...

2013-04-01

122

Personal health records as portal to the electronic medical record.  

PubMed

This topic review discusses the evolving clinical challenges associated with the implementation of electronic personal health records (PHR) that are fully integrated with electronic medical records (EMR). The benefits of facilitating patient access to the EMR through web-based, PHR-portals may be substantial; foremost is the potential to enhance the flow of information between patient and healthcare practitioner. The benefits of improved communication and transparency of care are presumed to be a reduction in clinical errors, increased quality of care, better patient-management of disease, and better disease and symptom comprehension. Yet PHR databases allow patients open access to newly-acquired clinical data without the benefit of concurrent expert clinical interpretation, and therefore may create the potential for greater patient distress and uncertainty. With specific attention to neuro-oncology patients, this review focuses on the developing conflicts and consequences associated with the use of a PHR that parallels data acquisition of the EMR in real-time. We conclude with a discussion of recommendations for implementing fully-integrated PHR for neuro-oncology patients. PMID:24477621

Cahill, Jennifer E; Gilbert, Mark R; Armstrong, Terri S

2014-03-01

123

Recovery of staphylococci from computer keyboards in a veterinary medical centre and the effect of routine cleaning.  

PubMed

Computers play a vital role in veterinary clinics for grading, examining results, updating records, giving discharge instructions and maintaining billing information. Few studies have documented the degree of contamination or practical methods to disinfect computer equipment within the veterinary clinic setting. The intent of the present study was to characterise the frequency of recovery of Staphylococcus species from computer keyboards from a veterinary teaching hospital setting and to evaluate the effect of daily cleaning. From three keyboards in a treatment area, three in a dermatology area and one in office 70 environmental samples were cultured for Staphylococcus. As an indirect measure to assess cleanliness, samples were collected and tested using the 3M Clean-Trace Luminometer (relative light units [RLU]). Of the 25 Staphylococcus recovered 13 were Staphylococcus species, seven Staphylococcus pseudintermedius, four Staphylococcus aureus and one mixed colony of both Staphylococcus species and S pseudintermedius. The median RLU was 2098 (range 132 to 11,590). Routine cleaning decreased the recovering of Staphylococcus and the RLU values. In summary, the study results demonstrate the value of routine cleaning of keyboards and the need for on-going and regular education of staff and students about good hand hygiene. PMID:22447457

Bender, J B; Schiffman, E; Hiber, L; Gerads, L; Olsen, K

2012-04-21

124

Student versus Faculty Attitudes toward the Veterinary Medical Profession and Education.  

ERIC Educational Resources Information Center

Surveyed and interviewed first-year students and faculty in veterinary medicine at the Swedish University of Agricultural Sciences on attitudes toward education and practice. Students placed emphasis on specific knowledge and practical skills, while faculty spoke in favor of basic theory; students also wanted integrated exams. Both agreed that…

Hoppe, Astrid; Trowald-Wigh, Gunilla

2000-01-01

125

The Role of Research in the Achievement of Excellence in Academic Veterinary Medical Programs  

ERIC Educational Resources Information Center

The significance of research to veterinary medicine is discussed with regard to: (1) individual professional development of faculty members; (2) creation of an exciting atmosphere that stimulates others to greater productivity; (3) attraction of students to academia; and (4) contributions to new knowledge in disciplines. (LBH)

Ewing, S. A.

1977-01-01

126

[Essence of scientific and technical achievements and the nature of the effect of veterinary medical research].  

PubMed

An attempt is made at elucidating the essence of veterinary scientific and technological achievements and the character of the effect of their implementation. On the basis of a structural analysis veterinary scientific investigations are grouped as: theoretical-fundamental, scientific-applicative and scientific-technological elaborations. Starting out from the character of the effect that is achieved through their application, the scientific works, as well as the scientific and technological achievements in the field of veterinary medicine, are categorized as follows: cognitive (New knowledge), technical and technological (medico-biological), socio-sanitary, economic and those having a mixed effect (cognitive- medico-biological, medico-biological-socio-sanitary, socio-sanitary and economic, etc. The identification of the various types of effects requires the elaboration of respective criteria, as well as a system of indexes for their characterization, a qualitative and a quantitative determination, as necessary conditions for determining the effectiveness of research veterinary works and that of research technological achievement. PMID:7233814

Iliev, I; Kostadinov, I

1980-01-01

127

Current and Projected Modes of Delivery of Veterinary Medical Services to Animal Agriculture: Diagnostic Laboratory Services.  

ERIC Educational Resources Information Center

The veterinary diagnostic laboratory's prime role has been diagnosis and/or laboratory findings to assist a diagnosis. Interpretation and evaluation and more involvement with decision-making in monitoring groups of animals and their health status are seen as future roles for diagnostic laboratories. (MLW)

Seaton, Vaughn A.

1980-01-01

128

Defining the Attributes Expected of Graduating Veterinary Medical Students, Part 2: External Evaluation and Outcomes Assessment.  

ERIC Educational Resources Information Center

Examined whether graduates of the University of California's veterinary program were meeting 62 attributes previously determined to represent desired educational outcomes. Found positive results, along with a need to improve outcomes in private practice management, work expectations, and surgical capabilities. (EV)

Walsh, Donal A.; Osburn, Bennie I.; Schumacher, Richard L.

2002-01-01

129

The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards: Completeness of medication in hospital medical records  

Microsoft Academic Search

Aims Accurate recording of medication histories in hospital medical records (HMR) is important when patients are admitted to the hospital. Lack of registration of drugs can lead to unintended discontinuation of drugs and failure to detect drug related problems. We investigated the comprehensiveness of medication histories in HMR with regard to prescription drugs by comparing the registration of drugs in

Hong Sang Lau; Christa Florax; Arijan J. Porsius; Anthonius De Boer

2001-01-01

130

Paperless medical records: reinventing the patient experience.  

PubMed

At North Shore Magnetic Imaging Center, the patient paper medical record system was becoming very cumbersome, and it served as a source of frustration for everyone involved: patients, technologists, radiologists, and staff members. The center's mapping of a typical patient experience indicated that, from the initial phone call scheduling an exam to a completed visit (claim processed and payment received), a record could be handled by as many as 20 sets of hands! In June 2002, the center's growth and a concern that patients were losing a one-on-one experience with the medical staff led to an evaluation of workflow processes existing at that time. The evaluation began with a survey of staff members, center management, radiologists, and referring physicians. Their responses indicated 3 common themes: stress, overload, and frustration over systems in place. Comments from the survey were grouped into 3 areas: Continue to Do, Stop Doing, and Start Doing. The Start Doing responses provided solid objectives. The center set out to establish a breakthrough project that included all stakeholders--patients, staff, management, and radiologists. The Reinvention Project had 2 primary goals: move to a paperless environment and increase the level of patient care. The project was divided into internal and external teams. The internal team, called the Reinvention Team, was responsible for the actual hands-on aspects of the process. There were numerous external teams; each had defined roles and specific outcomes for achievement. The external teams' responsibilities included implementing an Internet protocol telephone system; researching voice recognition; restructuring job descriptions, training manuals, and performance evaluations; and conducting a patient-centered focus group. PMID:15259685

Tobey, Mary Ellen

2004-01-01

131

Automated de-identification of free-text medical records  

Microsoft Academic Search

BACKGROUND: Text-based patient medical records are a vital resource in medical research. In order to preserve patient confidentiality, however, the U.S. Health Insurance Portability and Accountability Act (HIPAA) requires that protected health information (PHI) be removed from medical records before they can be disseminated. Manual de-identification of large medical record databases is prohibitively expensive, time-consuming and prone to error, necessitating

Ishna Neamatullah; Margaret M Douglass; Li-wei H Lehman; Andrew Reisner; Mauricio Villarroel; William J Long; Peter Szolovits; George B Moody; Roger G Mark; Gari D Clifford

2008-01-01

132

Electronic medical records in colorectal surgery.  

PubMed

Electronic medical records (EMRs) are being widely implemented today, either as stand-alone applications in smaller practices or as systems-based integrated network solutions in larger health care organizations. Advantages include rapid accessibility, worldwide availability, ease of storage, and secure transfer of protected health information (PHI). Computerized physician order entry (CPOE) and decision-support capabilities such as the triggering of an alarm when multiple medications with known interactions are ordered, as well as the seemingly endless possibilities for electronic integration and extraction of PHI for clinical and research purposes, have created opportunities and pitfalls alike. Risks include breaches of confidentiality with a need to implement tighter measures for electronic security. These measures contrast efforts required for the realization of common data formats that have national and even international compatibility. EMRs provide a common platform that could potentially allow for the integration and administration of clinical care, research, and quality metrics, thus promoting optimal outcomes for patients. Technical and medicolegal difficulties need to be overcome in the years to come so that the safe use of PHI can be ensured while still maintaining the benefits and convenience of modern EMR systems. PMID:24436643

Turina, Matthias; Kiran, Ravi P

2013-03-01

133

Anonymization of Longitudinal Electronic Medical Records  

PubMed Central

Electronic medical record (EMR) systems have enabled healthcare providers to collect detailed patient information from the primary care domain. At the same time, longitudinal data from EMRs are increasingly combined with biorepositories to generate personalized clinical decision support protocols. Emerging policies encourage investigators to disseminate such data in a deidentified form for reuse and collaboration, but organizations are hesitant to do so because they fear such actions will jeopardize patient privacy. In particular, there are concerns that residual demographic and clinical features could be exploited for reidentification purposes. Various approaches have been developed to anonymize clinical data, but they neglect temporal information and are, thus, insufficient for emerging biomedical research paradigms. This paper proposes a novel approach to share patient-specific longitudinal data that offers robust privacy guarantees, while preserving data utility for many biomedical investigations. Our approach aggregates temporal and diagnostic information using heuristics inspired from sequence alignment and clustering methods. We demonstrate that the proposed approach can generate anonymized data that permit effective biomedical analysis using several patient cohorts derived from the EMR system of the Vanderbilt University Medical Center.

Tamersoy, Acar; Loukides, Grigorios; Nergiz, Mehmet Ercan; Saygin, Yucel; Malin, Bradley

2013-01-01

134

Perspectives on electronic medical records adoption: electronic medical records (EMR) in outcomes research  

PubMed Central

Health information technology (HIT) is engineered to promote improved quality and efficiency of care, and reduce medical errors. Healthcare organizations have made significant investments in HIT tools and the electronic medical record (EMR) is a major technological advance. The Department of Veterans Affairs was one of the first large healthcare systems to fully implement EMR. The Veterans Health Information System and Technology Architecture (VistA) began by providing an interface to review and update a patient’s medical record with its computerized patient record system. However, since the implementation of the VistA system there has not been an overall substantial adoption of EMR in the ambulatory or inpatient setting. In fact, only 23.9% of physicians were using EMRs in their office-based practices in 2005. A sample from the American Medical Association revealed that EMRs were available in an office setting to 17% of physicians in late 2007 and early 2008. Of these, 17% of physicians with EMR, only 4% were considered to be fully functional EMR systems. With the exception of some large aggregate EMR databases the slow adoption of EMR has limited its use in outcomes research. This paper reviews the literature and presents the current status of and forces influencing the adoption of EMR in the office-based practice, and identifies the benefits, limitations, and overall value of EMR in the conduct of outcomes research in the US.

Belletti, Dan; Zacker, Christopher; Mullins, C Daniel

2010-01-01

135

The Regenstrief Medical Record System: a quarter century experience  

Microsoft Academic Search

Entrusted with the records for more than 1.5 million patients, the Regenstrief Medical Record System (RMRS) has evolved into a fast and comprehensive data repository used extensively at three hospitals on the Indiana University Medical Center campus and more than 30 Indianapolis clinics. The RMRS routinely captures laboratory results, narrative reports, orders, medications. radiology reports, registration information, nursing assessments, vital

Clement J. McDonald; J. Marc Overhage; William M. Tierney; Paul R. Dexter; Douglas K. Martin; Jeffrey G. Suico; Atif Zafar; Gunther Schadow; Lonnie Blevins; Tull Glazener; Jim Meeks-Johnson; Larry Lemmon; Jill Warvel; Brian Porterfield; Jeff Warvel; Pat Cassidy; Don Lindbergh; Anne Belsito; Mark Tucker; Bruce Williams; Cheryl Wodniak

1999-01-01

136

Privacy of medical records: IT implications of HIPAA  

Microsoft Academic Search

Increasingly, medical records are being stored in computer databases that allow for efficiencies in providing treatment and in the processing of clinical and financial services. Computerization of medical records has also diminished patient privacy and, in particular, has increased the potential for misuse, especially in the form of nonconsensual secondary use of personally identifiable records. Organizations that store and use

David Baumer; Julia Brande Earp; Fay Cobb Payton

2000-01-01

137

Implementing an Ambulatory Electronic Medical Record and Improving Shared Access.  

National Technical Information Service (NTIS)

This projects purpose was to implement an ambulatory Electronic Medical Record (EMR) across multiple and varied healthcare settings in a medically underserved region of east central Illinois. Sarah Bush Lincoln Health Center (SBLHC), a not-for-profit comm...

M. A. DeLuca

2009-01-01

138

Medical records department and balanced scorecard approach  

PubMed Central

Context: The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. Aims: The main goal of this study was to assess the MRD performance with BSC approach in a hospital. Materials and Methods: This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. Statistical Analysis Used: To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. Results: The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. Conclusions: The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital.

Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid

2013-01-01

139

Electronic medical records: a path forward.  

PubMed

Health systems are moving to implement comprehensive electronic medical record (EMR) systems, or significant pieces of them, in the belief that EMR can be integrated into clinical practice and lead to improved patient outcomes and enhanced safety. There are substantial roadblocks to implementing EMR, including significant cost, the competency needed to implement, the political environment, organization infrastructure and culture, and how organization leaders understand return on investment. Complicating factors include the drive to implement EMR to meet meaningful use standards to qualify for a federal incentive program and recently publicized studies that question the value equation of the EMR as it relates to patient care improvements. We offer our experiences on the successful implementation of the EMR across the large health systems we lead. We offer practical advice and tips on how to achieve successful implementation, evidence that successful implementations improve patient care and safety, and a glimpse of how EMR is a significant foundation in a future of collaborative models that provide continuum-based care. PMID:21961380

Bernd, David L; Fine, Peter S

2011-01-01

140

12 CFR 1403.6 - Special procedures for medical records.  

Code of Federal Regulations, 2013 CFR

...1403.6 Section 1403.6 Banks and Banking FARM CREDIT SYSTEM INSURANCE CORPORATION PRIVACY ACT REGULATIONS ...records. Medical records in the custody of the Farm Credit System Insurance Corporation which are not subject to...

2013-01-01

141

What Does the Medical Record Reveal about Functional Status?  

PubMed Central

OBJECTIVE Functional status measures are potent independent predictors of hospital outcomes and mortality. The study objective was to compare medical record with interview data for functional status. SUBJECTS AND METHODS Subjects were 525 medical patients, aged 70 years or older, hospitalized at an academic medical center. Patient interviews determined status for 7 basic activities of daily living (BADLs) and 7 instrumental activities of daily living (IADLs). Medical records were reviewed to assess documentation of BADLs and IADLs. RESULTS Most medical records contained no documentation of individual BADLs and IADLs (61% to 98% of records lacking documentation), with the exception of walking (24% of medical records lacking documentation). Impairment prevalence was lower in medical records than at interview for all BADLs and IADLs, and agreement between interview and medical record was poor (? < 0.40 for individual BADLs and IADLs). Sensitivity of the medical record for BADL and IADL impairment was poor (range 95% to 44%), using the interview as a reference standard. Sensitivity and specificity of the medical record for detection of BADL and IADL impairment changed substantially when records with nondocumentation of functional status were excluded or were assumed to be equivalent to independence. CONCLUSIONS The results suggest that the medical record is a poor source of data on many functional status measures, and that assuming that nondocumentation of functional status is equivalent to independence may be unwarranted. Given the prognostic importance of functional status measures, the results highlight the importance of developing reliable and efficient means of obtaining functional status information on hospitalized older patients.

Bogardus, Sidney T; Towle, Virginia; Williams, Christianna S; Desai, Mayur M; Inouye, Sharon K

2001-01-01

142

The Literature of Veterinary Medicine. CE 60.  

ERIC Educational Resources Information Center

This course guide outlines the objectives and content for a professional continuing education course on the literature of veterinary medicine. Topics covered include: (1) an introduction to veterinary medicine as a discipline, including comparison with other medical sciences, veterinary medicine education, licensure, animal models, veterinary

Kerker, Ann E.; Malamud, Judie

143

Index-Catalogue of Medical and Veterinary Zoology. Subjects: Trematoda and Trematode Diseases. Part 6. Supergenera and Genera N-Q,  

National Technical Information Service (NTIS)

The section of the 'Index-Catalog of Medical and Veterinary Zoology' is a revision of Stiles' and Hassall's 'Trematoda and Trematode Diseases'. (U.S. Public Health Service, Hygienic Laboratory Bulletin No. 37). The period covered is from the genesis of th...

M. A. Doss K. F. Roach M. M. Farr V. L. Breen

1967-01-01

144

Index-Catalogue of Medical and Veterinary Zoology. Subjects: Trematoda and Trematode Diseases. Part 5. Supergenera and Genera H-M,  

National Technical Information Service (NTIS)

The section of the 'Index-Catalog of Medical and Veterinary Zoology' is a revision of Stiles' and Hassall's 'Trematoda and Trematode Diseases' (U.S. Public Health Service, Hygienic Laboratory Bulletin No. 37). The period covered is from the genesis of the...

M. A. Doss K. F. Roach M. M. Farr V. L. Breen

1966-01-01

145

Report on Health Manpower and Programs in Ohio: Part Two. Allied Health, Area Health Education Centers, Dentistry, Emergency Medical Services, Nursing, Optometry, Pharmacy, Podiatry, and Veterinary Medicine.  

ERIC Educational Resources Information Center

Information on health occupations educational programs in Ohio and current and projected employment needs for health professionals are presented. The following health fields are examined: allied health, dentistry, emergency medical service, nursing, optometry, pharmacy, podiatry, and veterinary medicine. Issues and trends affecting each field are…

Ohio Board of Regents, Columbus.

146

A place for microfilm in medical records.  

PubMed

Since man started keeping records, his problem has always been that the numbers grow, seemingly unchecked. In some industrial and commercial situations it is reasonable to throw out old records once they have reached a certain age-even income tax and VAT records do not have to be retained for more than seven years. PMID:10112835

Vasili, S A

1991-05-01

147

Veterinary medical considerations for the use of nonhuman primates in space research  

NASA Technical Reports Server (NTRS)

The validity of biomedical research using animal subjects is highly dependent on the use of 'normal' and healthy animals. The current costs of research programs dictate that a minimum number of animals and test replicates be used to obtain the desired data. The use of healthy and standardized animals increases the probability of obtaining valid data while also permitting greater economy by reducing the between-individual variation, thus allowing the use of fewer animals. Areas of concern when planning animal payloads include constraints of the flight on candidate species selection, screening for physiological and psychological normalcy, procedures for routine care and quarantine of new animals and those returning from space, ground-based studies to determine experimental protocol, selection of instrumentation, stress during transportation for flight operations, housing and care facilities at launch and recovery sites, and the overall veterinary program.

Simmonds, R. C.

1977-01-01

148

Sensitive and specific polymerase chain reaction detection of Toxoplasma gondii for veterinary and medical diagnosis.  

PubMed Central

A polymerase chain reaction (PCR) method was developed for the detection of Toxoplasma gondii. A universal- and a T. gondii-specific primer was used to amplify a region of the small subunit ribosomal RNA gene. This approach allows for a theoretical detection limit of 0.01 zoite of T. gondii per sample assayed. Experiments showed that this PCR method could detect 0.1 pg of T. gondii DNA, which represents about one organism. Polymerase chain reaction tests using DNAs of cat, dog, swine, cattle, human, Sarcocystis cruzi, Eimeria ahsata, E. vermiformis, and Escherichia coli indicated no cross-reaction with nucleic acids of hosts, related coccidia, or bacteria. Data on the sensitivity and specificity suggest that this PCR assay could be extremely useful for the diagnosis of toxoplasmosis in human and veterinary medicine, as well as for food safety surveys. Images Fig. 1. Fig. 2.

MacPherson, J M; Gajadhar, A A

1993-01-01

149

Paperless practice - electronic medical records at island health  

Microsoft Academic Search

A computerised general medical practice using electronic medical records is described. Issues including security, confidentiality, shared access to records, use of knowledge bases and decision support are discussed. The practice has electronic data interchange links with local hospitals and health authorities. The practice has demonstrated increased clinical effectiveness, improved primary care team working and cost savings on administrative and clerical

Chris Dobbing

2001-01-01

150

Technology Acceptance of Electronic Medical Records by Nurses  

ERIC Educational Resources Information Center

The purpose of this study was to evaluate the Technology Acceptance Model's (TAM) relevance of the intention of nurses to use electronic medical records in acute health care settings. The basic technology acceptance research of Davis (1989) was applied to the specific technology tool of electronic medical records (EMR) in a specific setting…

Stocker, Gary

2010-01-01

151

“Clinical Archive”: A computerized medical record of patients in apheresis  

Microsoft Academic Search

Today the medical records of sick or injured persons who need apheresis treatment are not always the same in the various Transfusional Centres for lack of dedicated software.The Transfusion Centre of Bari Policlinic has tried to define and create a computerized medical record in order to have a valid tool to better report information both during clinical treatment and after

Emilio Galtieri; Luciano Cazzato; Giovanni Poliseno; Nicola Paglionico; Donato Dimonte

2008-01-01

152

Practicing nephrology with a computerized medical record  

Microsoft Academic Search

The practice of medicine revolves around the collection, interpretation, and dissemination of data about patients. Clinical decisions are based upon information gathered from the patient in light of medical knowledge which has been gained from the physician's experiences while taking care of other patients. The didactic portion of medical education includes the transfer of the profession's cumulative clinical experience to

William W Stead; Leland E Garrett; William E Hammond

1983-01-01

153

[Audit: medical record documentation among advanced cancer patients].  

PubMed

Medical record documentation of cancer inpatients is a core component of continuity of care. The main goal of the study was an assessment of medical record documentation in a palliative care unit (PCU) using a targeted clinical audit based on deceased inpatients' charts. Stage 1 (2010): a clinical audit of medical record documentation assessed by a list of items (diagnosis, prognosis, treatment, power of attorney directive, advance directives). Stage 2 (2011): corrective measures. Stage 3 (2012): re-assessment with the same items' list after six month. Forty cases were investigated during stage 1 and 3. After the corrective measures, inpatient's medical record documentation was significantly improved, including for diagnosis (P?=?0.01), diseases extension and treatment (P?medical record documentation for advanced directives (P?=?0.145). PMID:24556159

Perceau, Elise; Chirac, Anne; Rhondali, Wadih; Ruer, Murielle; Chabloz, Claire; Filbet, Marilène

2014-02-01

154

Designing online mobile medical records in obstetrics-gynecology subsystem  

Microsoft Academic Search

The needs for better and faster medical service has force us to create a system that able to serve it. Nowadays, there are many medical records applications have been developed to serve the needs, but most of them still handle the needs in common management of a hospital or medical institution, whereas the subsystems are also needed to be handled

Eko Handoyo; R Rizal Isnanto; Anung Prastyo Pribadi

2009-01-01

155

How to Realize Labor Savings with a Computerized Medical Record  

PubMed Central

The implementation of a computerized medical record system is generally associated with an increase in labor expense. This paper presents an application of a computerized medical record that has achieved labor savings by reducing the cost of data entry and maximizing the use of each piece of data in the record. The portion of the system which manipulates laboratory data is used as an example.

Stead, William W.; Hammond, W. Edward

1980-01-01

156

Course of Study: Medical Record Clerk Training Program. Student Manual for Medical Record Personnel in Small Rural Hospitals in Colorado.  

National Technical Information Service (NTIS)

A training program for medical record clerks in small, rural hospitals is provided. The objective of this program is to impart basic knowledge and develop the skills for medical record personnel and to develop an attitude in trained clerks which will lead...

1968-01-01

157

Implementation of an Electronic Medical Records System.  

National Technical Information Service (NTIS)

Delivery of excellent primary care--central to overall medical care-- demands that providers have the necessary information when they provide care. This paper argues that provider and patient information and decision support needs can be satisfied only if...

C. B. Fletcher

2008-01-01

158

38 CFR 17.905 - Medical records.  

Code of Federal Regulations, 2013 CFR

... 17.905 Section 17.905 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida...

2013-07-01

159

Exploring the Use of Tablet PCs in Veterinary Medical Education: Opportunity or Obstacle?  

PubMed

A tablet PC is a laptop computer with a touch screen and a digital pen or stylus that can be used for handwritten notes and drawings. The use of tablet PCs has been investigated in many disciplines such as engineering, mathematics, science, and education. The purpose of this article is to explore student and faculty attitudes toward and experiences with tablet PCs 6 years after the implementation of a tablet PC program in the College of Veterinary Medicine (CVM) at Kansas State University (K-State). This study reports that the use of tablet PCs has enhanced students' learning experiences through learner-interface interaction, learner-content interaction, learner-instructor interaction, and learner-learner interaction. This study also identifies digital distraction as the major negative experience with tablet PCs during class time. The tablet PC program provides CVM faculty the potential to pursue technology integration strategies that support expected learning outcomes and provides students the potential to develop self-monitoring and self-discipline skills that support learning with digital technologies. PMID:24855031

Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; van der Merwe, Deon

2014-01-01

160

20 CFR 30.700 - What kinds of medical records must providers keep?  

Code of Federal Regulations, 2013 CFR

...What kinds of medical records must providers keep? 30.700 Section 30...AMENDED Information for Medical Providers Medical Records and Bills ...What kinds of medical records must providers keep? Federal...

2013-04-01

161

Diagnostic Decision Support by Intelligent Medical Image Retrieval with Electronic Medical Record for Dementia Treatment Enhancement  

Microsoft Academic Search

In most hospitals, medical images such as computed tomography (CT), magnetic resonance imaging (MRI), and X-ray films are stored in Picture Archiving and Communication System (PACS). However, clinicians make differential diagnosis of patients in the Electronic Medical Record (EMR) system with references to laboratory results and the medical images reports. To establish a prototype model for intelligent access of medical

Mei-Ju SU; Heng-Shuen CHEN; Chung-Yi YANG; Sao-Jie CHEN; Robert CHEN; Wen-Jeng LEE; Po-Hsun CHENG; Ping-Kung YIP; Hon-Mon LIU; Fei-Pei LAI; Daniel RACOCEANU

2007-01-01

162

78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...  

Federal Register 2010, 2011, 2012, 2013

...Medical Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY...Association (AVMA) Guidelines for the Euthanasia of Animals: 2013 Edition (Guidelines...the updated AVMA Guidelines for the Euthanasia of Animals: 2013 Edition must be...

2013-03-22

163

32 CFR 324.13 - Access to medical and psychological records.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Access to medical and psychological records. 324.13 Section 324...Records § 324.13 Access to medical and psychological records. Individual access to medical and psychological records should be...

2013-07-01

164

[Accessing medical records for research purposes].  

PubMed

The Organic Law 15/1999 of 13 December on the Protection of Personal Data and the Law 41/2002 of 14 November regulating patient autonomy and rights and obligations of information and clinical documentation are the basic rules which govern the medical history in Spain. However, the lack of development of these laws regarding data protection in clinical research, particularly in terms of access to the medical history, repeatedly causes doubts about its construction by the Research Ethics Committees. Therefore, the aim of this paper is to analyze the rules which govern the access to the medical history for research purposes, with particular emphasis on the common problems that arise in the Committees for the ethical evaluation of these projects and finally setting a series of recommendations. The use for research purpose of genetic personal data contained in the medical history is also addressed in this paper. In this sense, a key contribution of the Law on Biomedical Research is relating to the specific regulation of the genetic personal data, both with respect to their production and access to the data as a support and regarding to its use for research purpose. PMID:24868961

Alcalde Bezhold, Guillermo; Alfonso Farnós, Iciar

2013-01-01

165

The Accuracy of Medication Data in an Outpatient Electronic Medical Record  

Microsoft Academic Search

ObjectiveTo measure the accuracy of medication records stored in the electronic medical record (EMR) of an outpatient geriatric center. The authors analyzed accuracy from the perspective of a clinician using the data and the perspective of a computer-based medical decision-support system (MDSS).DesignProspective cohort study.MethodsThe EMR at the geriatric center captures medication data both directly from clinicians and indirectly using encounter

Michael M Wagner; William R Hogan

1996-01-01

166

Interior, middle wing, medical records storage. Notice roof trusses. ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior, middle wing, medical records storage. Notice roof trusses. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

167

12 CFR 1102.104 - Special procedure: Medical records.  

Code of Federal Regulations, 2013 CFR

12 Banks and Banking 9 2013-01-01 2013-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...

2013-01-01

168

12 CFR 1102.104 - Special procedure: Medical records.  

Code of Federal Regulations, 2012 CFR

12 Banks and Banking 9 2012-01-01 2012-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...

2012-01-01

169

Biotechnology a key tool to breakthrough in medical and veterinary research  

Microsoft Academic Search

The elucidation of the structure, function and metabolism of Deoxyribonucleic acid (DNA) has led to the current global revolution in the recombinant DNA technology, with the possibility to modify these molecules in many ways for the benefit of man and animals. In this review, we considered the basic principles of genetic engineering (gene cloning), bioinformatics, and its applications in medical

2008-01-01

170

Developing the Master Educator: Cross Disciplinary Teaching Scholars Program for Human and Veterinary Medical Faculty  

ERIC Educational Resources Information Center

Objective: At the University of California, Davis (UCD), the authors sought to develop an institutional network of reflective educational leaders. The authors wanted to enhance faculty understanding of medical education's complexity, and improve educators' effectiveness as regional/national leaders. Methods: The UCD Teaching Scholars Program is a…

Srinivasan, Malathi; Pratt, Daniel D.; Collins, John; Bowe, Constance M.; Stevenson, Frazier T.; Pinney, Stephen J.; Wilkes, Michael S.

2007-01-01

171

Design elements of a telemedical medical record.  

PubMed Central

Computerized Patient Records are becoming telemedical and multimedia documents. They should accompany the patients their whole lifetime and collect data from many different sites. Special requirements are arising to fulfill these demands. A prototype of such a system was designed and implemented at the university hospital in Grosshadern, Germany to show its feasibility, discuss the design elements and demonstrate its capabilities. A Flexible data model, interpretable contents, open communication structures and physical compilation are the cornerstones of this approach that allows communication via Internet or Smart cards.

Adelhard, K.; Eckel, R.; Holzel, D.; Tretter, W.

1996-01-01

172

Medical education in the electronic medical record (EMR) era: benefits, challenges, and future directions.  

PubMed

In the last decade, electronic medical record (EMR) use in academic medical centers has increased. Although many have lauded the clinical and operational benefits of EMRs, few have considered the effect these systems have on medical education. The authors review what has been documented about the effect of EMR use on medical learners through the lens of the Accreditation Council for Graduate Medical Education's six core competencies for medical education. They examine acknowledged benefits and educational risks to use of EMRs, consider factors that promote their successful use when implemented in academic environments, and identify areas of future research and optimization of EMRs' role in medical education. PMID:23619078

Tierney, Michael J; Pageler, Natalie M; Kahana, Madelyn; Pantaleoni, Julie L; Longhurst, Christopher A

2013-06-01

173

Electronic Medical Records and Their Impact on Resident and Medical Student Education  

ERIC Educational Resources Information Center

Objective: Electronic medical records (EMRs) are becoming prevalent and integral tools for residents and medical students. EMRs can integrate point-of-service information delivery within the context of patient care. Though it may be an educational tool, little is known about how EMR technology is currently used for medical learners. Method: The…

Keenan, Craig R.; Nguyen, Hien H.; Srinivasan, Malathi

2006-01-01

174

Measuring data reliability for preventive services in electronic medical records  

PubMed Central

Background Improvements in the quality of health care services are often measured using data present in medical records. Electronic Medical Records (EMRs) contain potentially valuable new sources of health data. However, data quality in EMRs may not be optimal and should be assessed. Data reliability (are the same data elements being measured over time?) is a prerequisite for data validity (are the data accurate?). Our objective was to measure the reliability of data for preventive services in primary care EMRs during the transition to EMR. Methods Our data sources were randomly selected eligible patients’ medical records and data obtained from provincial administrative datasets. Eighteen community-based family physicians in Toronto, Ontario that implemented EMRs starting in 2006 participated in this study. We measured the proportion of patients eligible for a service (Pap smear, screening mammogram or influenza vaccination) that received the service. We compared the change in rates of selected preventive services calculated from the medical record audits with the change in administrative datasets. Results In the first year of EMR use (2006) services decreased by 8.7% more (95% CI ?11.0%–???6.4%, p?medical record audits as compared with administrative datasets. Services increased by 2.4% more (95% CI 0%–4.9%, p?=?0.05) in the medical record audits during the second year of EMR use (2007). Conclusion There were differences between the change measured through medical record audits and administrative datasets. Problems could include difficulties with organizing new data entry processes as well as continued use of both paper and EMRs. Data extracted from EMRs had limited reliability during the initial phase of EMR implementation. Unreliable data interferes with the ability to measure and improve health care quality

2012-01-01

175

75 FR 1446 - Rate of Payment for Medical Records Received Through Health Information Technology (IT) Necessary...  

Federal Register 2010, 2011, 2012, 2013

...SSA-2009-0088] Rate of Payment for Medical Records Received Through Health Information...national rate of Federal payment for medical records received through health IT...for their costs in supplying medical records through health IT in...

2010-01-11

176

28 CFR 513.44 - Fees for copies of Inmate Central File and Medical Records.  

Code of Federal Regulations, 2013 CFR

...copies of Inmate Central File and Medical Records. 513.44 Section 513...copies of Inmate Central File and Medical Records. Within a reasonable time...in the Inmate Central File and Medical Record. Fees for the copies are...

2013-07-01

177

32 CFR 310.24 - Disclosures to the public from medical records.  

Code of Federal Regulations, 2013 CFR

... false Disclosures to the public from medical records. 310.24 Section 310.24 National...310.24 Disclosures to the public from medical records. (a) Disclosures from medical records are not only governed by the...

2013-07-01

178

36 CFR 1202.42 - How are requests for access to medical records handled?  

Code of Federal Regulations, 2013 CFR

...How are requests for access to medical records handled? 1202.42 Section...How are requests for access to medical records handled? When NARA receives a request for access to medical records, if NARA believes that...

2013-07-01

179

32 CFR 1701.13 - Special procedures for medical/psychiatric/psychological records.  

Code of Federal Regulations, 2013 CFR

...procedures for medical/psychiatric/psychological records. 1701.13...procedures for medical/psychiatric/psychological records. Current...access to their medical, psychiatric...psychological testing records by...

2013-07-01

180

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2013 CFR

...Special requirements for medical/psychological records. 51-9.303-2...Special requirements for medical/psychological records. (a) The Executive...requests access to his medical or psychological record to designate a...

2013-07-01

181

32 CFR 806b.17 - Special provision for certain medical records.  

Code of Federal Regulations, 2013 CFR

...Special provision for certain medical records. 806b.17 Section 806b...Special provision for certain medical records. If a physician believes that disclosing requested medical records could harm the person's...

2013-07-01

182

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2010 CFR

...2009-01-01 false Records of dosages of...byproduct material for medical use. 35.2063...REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2063 Records of dosages of...byproduct material for medical use....

2009-01-01

183

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Records of dosages of...byproduct material for medical use. 35.2063...REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2063 Records of dosages of...byproduct material for medical use....

2010-01-01

184

32 CFR 806b.48 - Disclosing the medical records of minors.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Disclosing the medical records of minors. 806b.48 Section... § 806b.48 Disclosing the medical records of minors. Air Force personnel may disclose the medical records of minors to their...

2013-07-01

185

41 CFR 105-64.208 - What special conditions apply to release of medical records?  

Code of Federal Regulations, 2013 CFR

... What special conditions apply to release of medical records? 105-64.208 Section 105-64.208... What special conditions apply to release of medical records? Medical records containing information that may have an...

2013-07-01

186

45 CFR 5b.6 - Special procedures for notification of or access to medical records.  

Code of Federal Regulations, 2013 CFR

...for notification of or access to medical records. 5b.6 Section 5b.6...for notification of or access to medical records. (a) General. An individual...notification of or access to his medical records, including psychological...

2013-10-01

187

Effectiveness of an electronic inpatient medication record in reducing medication errors in Singapore.  

PubMed

This study examined the effectiveness of an inpatient electronic medication record system in reducing medication errors in Singaporean hospitals. This pre- and post-intervention study involving a control group was undertaken in two Singaporean acute care hospitals. In one hospital the inpatient electronic medication record system was implemented while in another hospital the paper-based medication record system was used. The mean incidence difference in medication errors of 0.06 between pre-intervention (0.72 per 1000 patient days) and post-intervention (0.78 per 1000 patient days) for the two hospitals was not statistically significant (95%, CI: [0.26, 0.20]). The mean incidence differences in medication errors relating to prescription, dispensing, and administration were also not statistically different. Common system failures involved a lack of medication knowledge by health professionals and a lack of a systematic approach in identifying correct dosages. There was no difference in the incidence of medication errors following the introduction of the electronic medication record system. More work is needed on how this system can reduce medication error rates and improve medication safety. PMID:23855683

Choo, Janet; Johnston, Linda; Manias, Elizabeth

2014-06-01

188

Concordance between medical records and interview data in correctional facilities  

PubMed Central

Background Self- administered questionnaires or interviews and medical records are often used as sources of research data; thus it is essential to evaluate their concordance and reliability. The aim of this paper was to assess the concordance between medical and behavioral data obtained from medical records and interview questionnaires in two correctional facilities. Methods Medical record and interview data were compared for 679 inmates from one male and one female maximum security prison between April 2010 and February 2013. Gender non-stratified and gender-stratified analyses were conducted in SPSS to calculate the prevalence and kappa coefficient scores (?) for medical (e.g., HIV, diabetes, hypertension) and behavioral (e.g., smoking, drug use, tattoos) conditions. Sensitivity/specificity between medical records and interview were calculated in the gender non-stratified data. Results In the gender non-stratified analysis, ? score for HIV, hepatitis C, diabetes, asthma, and history of tattoos had strong or good concordance (0.66-0.89). Hypertension, renal/kidney disease, cigarette smoking, antibiotic use in the last 6 months, and cocaine use ever were moderately correlated (0.49-0.57). Both history of any illicit drug use ever (0.36) and marijuana use ever (0.23) had poor concordance. Females had higher ? scores and prevalence rates than males overall. Medical conditions were reported more frequently in medical records and behavioral conditions had higher prevalence in interviews. Sensitivity for medical conditions in the combined facility data ranged from 50.0% to 86.0% and 48.2% to 85.3% for behavioral conditions whereas specificity ranged from 95.9% to 99.5% for medical conditions and 75.9% to 92.8% for behavioral conditions. Conclusion Levels of agreement between medical records and self-reports varied by type of factor. Medical conditions were more frequently reported by chart review and behavioral factors more frequently by self-report. Data source used may need to be chosen carefully depending upon the type of information sought.

2014-01-01

189

Medical education in an electronic health record-mediated world.  

PubMed

This paper reflects on the extent to which we are preparing learners for practice in an electronic health record (EHR)-mediated world. We are currently training the last generation to remember a world without the Internet and the first who will practice in a largely EHR-mediated practice environment. We undertook a thematic review of the literature connecting medical education with e-health using the concepts of 'electronic health record' or 'electronic medical record' as a proxy for the broader notion of e-health. Our findings are more equivocal and cautious than earlier commentators might have expected and while there are examples of good practice and successful integration, the majority of articles we reviewed raised issues and problems with the current links between EHRs and medical education. Medical professionals in particular are quite ambivalent about many of the changes brought about by EHRs, and in the absence of changes in perception and practice it is likely that the connections between medical education and e-health will continue to be problematic. We hope that this paper will lead to an improved understanding of these problems and will serve to advance the discourse on how medical education should engage with the world of e-health and the world of e-health with medical education. PMID:23464893

Ellaway, Rachel H; Graves, Lisa; Greene, Peter S

2013-04-01

190

Document-oriented approach for PACS and medical records  

NASA Astrophysics Data System (ADS)

A model encompassing both PACS and medical records domains is described, wherein the entire patient record is represented by a collection of discrete information objects. These information objects can be stored DICOM Information Object Definitions (IODs) and the proposed HL7 Patient Record Architecture documents are found to fit this model. Relevant aspects of the both the proposed DICOM Structured Reporting and HL7 Document Patient Record Architecture standards are reviewed. The mapping of DICOM IODs to HL7 PRA documents is considered, and found to be one-to-one for all the use cases considered.

Behlen, Fred M.; Alschuler, Liora; Bidgood, W. Dean

1999-07-01

191

Electronic medical records and cost efficiency in hospital medical-surgical units.  

PubMed

This study examines the impact of electronic medical records (EMRs) on cost efficiency in hospital medical-surgical units. Using panel data on California hospitals from 1998 to 2007, we employed stochastic frontier analysis (SFA) to estimate the relationships between EMR implementation and the cost inefficiency of medical-surgical units. We categorized EMR implementation into three stages based on the level of sophistication. We also examined the effects of specific EMR systems on cost inefficiency. Our SFA models addressed potential bias from unobserved heterogeneity and heteroskedasticity. EMR Stages 1 and 2, nursing documentation, electronic medication administration records, and clinical decision support were associated with significantly higher inefficiency. PMID:20812460

Furukawa, Michael F; Raghu, T S; Shao, Benjamin B M

2010-01-01

192

Design and Implementation of Mobile Electronic Medication Administration Record  

Microsoft Academic Search

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In\\u000a order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System\\u000a (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the\\u000a tasks are based

Sung-Huai Hsieh; I-Ching Hou; Ching-Ting Tan; Po-Chao Shen; Hui-Chu Yu; Sheau-Ling Hsieh; Po-Hsun Cheng; Feipei Lai

193

Engineering Veterinary Education: A Clarion Call for Reform in Veterinary Education--Let's Do It!  

ERIC Educational Resources Information Center

Supports an engineering model of tracking programs in veterinary medical education and suggests that undergraduate student quotas need to be considered in order to educate a sufficient number of new veterinary graduates in the different fields needed by society. (SLD)

Radostits, Otto M.

2003-01-01

194

42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.  

Code of Federal Regulations, 2010 CFR

...accordance with acceptable veterinary medical practices. (13...their well-being. Emergency veterinary care must also be available...recent report of the American Veterinary Medical Association Panel...the SCCC. The NCRR Project Officer must be notified of the...

2010-10-01

195

42 CFR 9.6 - Animal care, well-being, husbandry, veterinary care, and euthanasia.  

Code of Federal Regulations, 2010 CFR

...accordance with acceptable veterinary medical practices. (13...their well-being. Emergency veterinary care must also be available...recent report of the American Veterinary Medical Association Panel...the SCCC. The NCRR Project Officer must be notified of the...

2009-10-01

196

A Clinical Pharmacology Course for Veterinary Students.  

ERIC Educational Resources Information Center

A one-semester, two-credit course is described that was developed cooperatively by the colleges of pharmacy and veterinary medicine at Washington State University to help resolve an acute shortage of clinical pharmacologists in veterinary medicine and veterinary medical education. Course procedures, content, and evaluation are outlined (MSE)

Paulsen, Lynn Mulcahy

1983-01-01

197

Information integrity and privacy for computerized medical patient records  

SciTech Connect

Sandia National Laboratories and Oceania, Inc. entered into a Cooperative Research and Development Agreement (CRADA) in November 1993 to provide ``Information Integrity and Privacy for Computerized Medical Patient Records`` (CRADA No. SC93/01183). The main objective of the project was to develop information protection methods that are appropriate for databases of patient records in health information systems. This document describes the findings and alternative solutions that resulted from this CRADA.

Gallegos, J.; Hamilton, V.; Gaylor, T.; McCurley, K.; Meeks, T.

1996-09-01

198

Patient access to medical records on a psychiatric inpatient unit.  

PubMed

The authors studied the effects of patient access to medical records during hospitalization in a psychiatric unit of a community general hospital. Questionnaires were completed by about 20 staff and 88 patients, and records were compared with those from an earlier period to note any changes in the written record. Patients reported feeling better informed and more involved in their treatment, and staff said that they became more thoughtful about their notes in the chart. The availability of staff seems crucial to this process and facilitates the working alliance. PMID:420331

Stein, E J; Furedy, R L; Simonton, M J; Neuffer, C H

1979-03-01

199

NCI Community Cancer Centers Program - Electronic Medical Records  

Cancer.gov

Develop a national database of voluntarily-provided electronic medical records. Expanding the information available on people who have been screened for cancer, are at high risk, are actively being treated, and are cancer survivors will greatly contribute to the knowledge and treatment of cancer.

200

A Virtual Medical Record for Guideline-Based Decision Support  

Microsoft Academic Search

A major obstacle in deploying computer-based clinical guidelines at the point of care is the variability of electronic medical records and the consequent need to adapt guideline modeling languages, guideline knowledge bases, and execution engines to idiosyncratic data models in the deployment environment. This paper reports an approach, developed jointly by researchers at Newcastle and Stanford, where guideline models are

Peter D. Johnson; Samson W. Tu; Mark A. Musen

2001-01-01

201

An Analysis of the Medical Records Clerking Occupation.  

ERIC Educational Resources Information Center

The general purpose of the occupational analysis is to provide workable, basic information dealing with the many and varied duties performed in the medical records clerk occupation. The document opens with a brief introduction followed by a job description. The bulk of the document is presented in table form. Nine duties are broken down into a…

Ridener, Norma A.; And Others

202

Teaching Pharmacy Students to Write in the Medical Record  

Microsoft Academic Search

To practice pharmaceutical care, pharmacists will need to communicate and document their recommenda- tions in the medical record. We incorporated instruction on the principles of chart documentation into an elective on primary care therapeutics. Students developed a patient specific care plan and wrote a \\

Theresa R. Prosser; John M. Burke; Eric H. Hobson

1997-01-01

203

Image-based document management systems for medical records.  

PubMed

Using image scanning as a document capture mechanism at time of treatment or on day of discharge automates the medical record to achieve the larger objectives of simultaneous concurrent access to an electronic chart. This form of keyless document capture, although appearing labor intensive, is justified for improving business management and quality of care. Coupled with optical character recognition or barcode recognition for keyless data capture, medical information may be more easily made available for clinical research. Not merely a microfilm alternative, a medical record management system accelerates chart completion. Labor reduction is realized by eliminating filing and retrieval of active charts, loose sheet handling, photocopying, chart assembly, and chart location control. By reducing the reasons for chart completion delays, accelerated billing of Medicare accounts will occur, resulting in a reduction in receivables. Image-based document management systems accomplish the three things required of a senior manager in health care: (1) solve problems, (2) save money, and (3) make money. PMID:10116256

Massengill, S P

1992-03-01

204

Medical records in litigation: the Dalkon Shield story.  

PubMed

The Dalkon Shield was manufactured by A.H. Robins Inc. in the early and mid seventies, before it was withdrawn from sale because of the influx of lawsuits against the manufacturers. The case has become the largest tort case in history, with approximately 200,000 claimants worldwide and will not be wound up for years to come. Slater and Gordon is an Australian firm of solicitors with offices in three states. They have the largest Dalkon Shield practice in the world and represent almost 3,000 claimants. One of their most difficult tasks in preparing the cases is the gathering of medical evidence to substantiate claimants' assertions. This entails collecting relevant medical records from across the country and around the world going back almost twenty years for almost 2,000 women. The project has magnified the importance of accurate and complete documentation, kept intact and made accessible. The influence of medical record administrators is highlighted. PMID:10117045

Byrne, K

1992-02-01

205

Taking a history on veterinary education.  

PubMed

In this article, another in the series marking 125 years of Veterinary Record, Andrew Gardiner and Susan Rhind consider some common themes in the history of veterinary education. They look at how veterinary teaching and education have evolved over time and discuss what may happen in years to come. PMID:24163043

Gardiner, Andrew; Rhind, Susan

2013-10-26

206

Agreement between Medical Record Data and Patients' Accounts of Their Medical History and Treatment for Dyspepsia  

Microsoft Academic Search

We examined agreement between data abstracted from medical records and interview data for patients with dyspepsia admitted to hospital for endoscopy, to determine the extent to which health records could be used to validate self-reports of dyspepsia and the management of this condition. Results from the sample of 220 patients showed that there was poor agreement between data sources for

Johanna I Westbrook; Jean H McIntosh; R. Louise Rushworth; Geoffrey Berry; John M Duggan

1998-01-01

207

33 CFR 150.604 - Who controls access to medical monitoring and exposure records?  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Who controls access to medical monitoring and exposure records? 150.604 Section 150.604...150.604 Who controls access to medical monitoring and exposure records? If medical monitoring is performed or...

2013-07-01

208

49 CFR 382.409 - Medical review officer record retention for controlled substances.  

Code of Federal Regulations, 2013 CFR

... 2013-10-01 false Medical review officer record retention for controlled...Handling of Test Results, Records Retention, and Confidentiality § 382.409 Medical review officer record retention for...

2013-10-01

209

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...  

Code of Federal Regulations, 2013 CFR

...requirements for written medical documentation, contemporaneous records, and other records...requirements for written medical documentation, contemporaneous records, and other records...the facts, that the medical records containing a...

2013-04-01

210

Electronic medical records in long-term care.  

PubMed

Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently being effectively and widely used in the LTC facilities. PMID:20582852

Phillips, Krista; Wheeler, Chris; Campbell, Josh; Coustasse, Alberto

2010-07-01

211

Integrating all medical records to an enterprise viewer.  

PubMed

The idea behind hospital information systems is to make all of a patient's medical reports, lab results, and images electronically available to clinicians, instantaneously, wherever they are. But the higgledy-piggledy evolution of most hospital computer systems makes it hard to integrate all these clinical records. Although several integration standards had been proposed to meet this challenger, none of them is fit to Chinese hospitals. In this paper, we introduce our work of implementing a three-tiered architecture enterprise viewer in Huzhou Central Hospital to integration all existing medical information systems using limited resource. PMID:17282239

Li, Haomin; Duan, Huilong; Lu, Xudong; Zhao, Chenhui; An, Jiye

2005-01-01

212

The PING Personally Controlled Electronic Medical Record System: Technical Architecture  

PubMed Central

Despite progress in creating standardized clinical data models and interapplication protocols, the goal of creating a lifelong health care record remains mired in the pragmatics of interinstitutional competition, concerns about privacy and unnecessary disclosure, and the lack of a nationwide system for authenticating and authorizing access to medical information. The authors describe the architecture of a personally controlled health care record system, PING, that is not institutionally bound, is a free and open source, and meets the policy requirements that the authors have previously identified for health care delivery and population-wide research.

Simons, William W.; Mandl, Kenneth D.; Kohane, Isaac S.

2005-01-01

213

New software tools ease move to electronic medical records.  

PubMed

Converting a hospital to electronic medical records can save big bucks, but it's easier said than done. Huge savings await hospitals that eliminate the cost of storing, filing and retrieving charts. But making that move is more complex than simply converting written notes to an automated format. Learn how one California hospital is embarking on its journey to a paperless environment with the help of some innovative information systems technology that will take some of the pain out of the transformation. PMID:10338917

1998-11-01

214

Recording and podcasting of lectures for students of medical school.  

PubMed

Information and communication technology (ICT) becomes an important way for the knowledge transmission, especially in the field of medicine. Podcasting (mobile broadcast content) has recently emerged as an efficient tool for distributing information towards professionals, especially for e-learning contents.The goal of this work is to implement software and hardware tools for collecting medical lectures at its source by direct recording (halls and classrooms) and provide the automatic delivery of these resources for students on different type of devices (computer, smartphone or videogames console). We describe the overall architecture and the methods used by medical students to master this technology in their daily activities. We highlight the benefits and the limits of the Podcast technologies for medical education. PMID:21893751

Brunet, Pierre; Cuggia, Marc; Le Beux, Pierre

2011-01-01

215

Explaining accesses to electronic medical records using diagnosis information  

PubMed Central

Objective Ensuring the security and appropriate use of patient health information contained within electronic medical records systems is challenging. Observing these difficulties, we present an addition to the explanation-based auditing system (EBAS) that attempts to determine the clinical or operational reason why accesses occur to medical records based on patient diagnosis information. Accesses that can be explained with a reason are filtered so that the compliance officer has fewer suspicious accesses to review manually. Methods Our hypothesis is that specific hospital employees are responsible for treating a given diagnosis. For example, Dr Carl accessed Alice's medical record because Hem/Onc employees are responsible for chemotherapy patients. We present metrics to determine which employees are responsible for a diagnosis and quantify their confidence. The auditing system attempts to use this responsibility information to determine the reason why an access occurred. We evaluate the auditing system's classification quality using data from the University of Michigan Health System. Results The EBAS correctly determines which departments are responsible for a given diagnosis. Adding this responsibility information to the EBAS increases the number of first accesses explained by a factor of two over previous work and explains over 94% of all accesses with high precision. Conclusions The EBAS serves as a complementary security tool for personal health information. It filters a majority of accesses such that it is more feasible for a compliance officer to review the remaining suspicious accesses manually.

Fabbri, Daniel; LeFevre, Kristen

2013-01-01

216

Web-based electronic patient records for collaborative medical applications.  

PubMed

We developed a web-based system to interactively display electronic patient records (EPR), such as DICOM images, graphics, and structure reports and therapy records, for intranet and internet collaborative medical applications. This system has three major components, a C/S (client/server) architecture for EPR data acquisition and authoring, and a Web B/S architecture for data delivering. The Web viewer of this system integrates multi-media display modules and remote control module together to provide interactive EPR display and manipulation functions for collaborative applications. We have successfully used this system two times to provide teleconsultation for severe acute respiratory syndrome (SARS) patients in Shanghai Infection Hospital and Xinhua Hospital. During the consultation, both the physicians in infection control area and the experts outside the control area could use this system interactively to manipulate and navigate the EPR objects of the SARS patients to facilitate a more precise diagnosis. This paper gives a new approach to create and manage image-based EPR from actual patient records, and also presents a novel method to use Web technology and DICOM standard to build an open architecture for collaborative medical applications. The system can be used for both intranet and internet medical applications such as tele-diagnosis, teleconsultation, and distant learning. PMID:15755531

Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Chen, Xiaomeng; Meng, Lili; Lian, Ping

2005-01-01

217

Visualization index for image-enabled medical records  

NASA Astrophysics Data System (ADS)

With the widely use of healthcare information technology in hospitals, the patients' medical records are more and more complex. To transform the text- or image-based medical information into easily understandable and acceptable form for human, we designed and developed an innovation indexing method which can be used to assign an anatomical 3D structure object to every patient visually to store indexes of the patients' basic information, historical examined image information and RIS report information. When a doctor wants to review patient historical records, he or she can first load the anatomical structure object and the view the 3D index of this object using a digital human model tool kit. This prototype system helps doctors to easily and visually obtain the complete historical healthcare status of patients, including large amounts of medical data, and quickly locate detailed information, including both reports and images, from medical information systems. In this way, doctors can save time that may be better used to understand information, obtain a more comprehensive understanding of their patients' situations, and provide better healthcare services to patients.

Dong, Wenjie; Zheng, Weilin; Sun, Jianyong; Zhang, Jianguo

2011-03-01

218

Data-driven approach for creating synthetic electronic medical records  

PubMed Central

Background New algorithms for disease outbreak detection are being developed to take advantage of full electronic medical records (EMRs) that contain a wealth of patient information. However, due to privacy concerns, even anonymized EMRs cannot be shared among researchers, resulting in great difficulty in comparing the effectiveness of these algorithms. To bridge the gap between novel bio-surveillance algorithms operating on full EMRs and the lack of non-identifiable EMR data, a method for generating complete and synthetic EMRs was developed. Methods This paper describes a novel methodology for generating complete synthetic EMRs both for an outbreak illness of interest (tularemia) and for background records. The method developed has three major steps: 1) synthetic patient identity and basic information generation; 2) identification of care patterns that the synthetic patients would receive based on the information present in real EMR data for similar health problems; 3) adaptation of these care patterns to the synthetic patient population. Results We generated EMRs, including visit records, clinical activity, laboratory orders/results and radiology orders/results for 203 synthetic tularemia outbreak patients. Validation of the records by a medical expert revealed problems in 19% of the records; these were subsequently corrected. We also generated background EMRs for over 3000 patients in the 4-11 yr age group. Validation of those records by a medical expert revealed problems in fewer than 3% of these background patient EMRs and the errors were subsequently rectified. Conclusions A data-driven method was developed for generating fully synthetic EMRs. The method is general and can be applied to any data set that has similar data elements (such as laboratory and radiology orders and results, clinical activity, prescription orders). The pilot synthetic outbreak records were for tularemia but our approach may be adapted to other infectious diseases. The pilot synthetic background records were in the 4-11 year old age group. The adaptations that must be made to the algorithms to produce synthetic background EMRs for other age groups are indicated.

2010-01-01

219

Five benefits of call recording for medical practices.  

PubMed

Despite documentation's essential positioning in medical practices of all sizes and specialties, one aspect of patient and insurance provider interaction remains overlooked in the majority of practices: telephone-based communication. In many cases, patient and payment information exchanged via telephone is logged with little more than a note typed or written in the patient file. This leads to "he said/she said" disagreements with regard to patient service, consultations, and coding; reduced payments from insurance providers; incomplete patient records; liability exposure; and a host of other problems. In this article, call recording professional Roland Murphy explains how a call recording solution can fill the gaps in documentation, increase practice revenues, and improve patient care without excessive investment costs and while protecting patient confidentiality. PMID:20480782

Murphy, Roland

2010-01-01

220

The Effects of Promoting Patient Access to Medical Records: A Review  

Microsoft Academic Search

The Health Insurance Privacy and Portability Act (HIPPA) stipulates that patients must be permitted to review and amend their medical records. As information technology makes medical records more accessible to patients, it may become more commonplace for patients to review their records routinely.This article analyzes the potential benefits and drawbacks of facilitating patient access to the medical record by reviewing

STEPHEN E. ROSS; Chen-Tan Lin

2003-01-01

221

Use of electronic medical records in oncology outcomes research  

PubMed Central

Oncology outcomes research could benefit from the use of an oncology-specific electronic medical record (EMR) network. The benefits and challenges of using EMR in general health research have been investigated; however, the utility of EMR for oncology outcomes research has not been explored. Compared to current available oncology databases and registries, an oncology-specific EMR could provide comprehensive and accurate information on clinical diagnoses, personal and medical histories, planned and actual treatment regimens, and post-treatment outcomes, to address research questions from patients, policy makers, the pharmaceutical industry, and clinicians/researchers. Specific challenges related to structural (eg, interoperability, data format/entry), clinical (eg, maintenance and continuity of records, variety of coding schemes), and research-related (eg, missing data, generalizability, privacy) issues must be addressed when building an oncology-specific EMR system. Researchers should engage with medical professional groups to guide development of EMR systems that would ultimately help improve the quality of cancer care through oncology outcomes research.

Kanas, Gena; Morimoto, Libby; Mowat, Fionna; O'Malley, Cynthia; Fryzek, Jon; Nordyke, Robert

2010-01-01

222

21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.  

Code of Federal Regulations, 2010 CFR

...committee, Committee on the Veterinary Medical and Nonmedical...the use of antibiotics in veterinary medicine and for various...acceptability of proposed research protocols and assay methods...the Director, Center for Veterinary Medicine, Food and Drug...

2009-04-01

223

21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.  

Code of Federal Regulations, 2010 CFR

...committee, Committee on the Veterinary Medical and Nonmedical...the use of antibiotics in veterinary medicine and for various...acceptability of proposed research protocols and assay methods...the Director, Center for Veterinary Medicine, Food and Drug...

2010-04-01

224

Strategic Use of the US Army Veterinary Service in HCA/TCA Operations.  

National Technical Information Service (NTIS)

The US Army Veterinary Service is the Department of Defense Executive Agent for Veterinary Services. The Veterinary Service has responsibility for the medical care of all government owned animals, food safety and quality assurance and prevention of zoonot...

C. E. Pixley

1997-01-01

225

Making a Case in Medical Work: Implications for the Electronic Medical Record  

Microsoft Academic Search

The introduction of the electronic medical record (EMR) is widely seen by healthcare policy makers and service managers alike as a key step in the achievement of more efficient and integrated healthcare services. However, our study of inter-service work practices reveals important discrepancies between the presumptions of the role of the EMR in achieving service integration and the ways in

Mark Hartswood; Rob Procter; Mark Rouncefield; Roger Slack

2003-01-01

226

Reflecting on the ethical administration of computerized medical records  

NASA Astrophysics Data System (ADS)

This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing staff system training. Administration should develop ways to monitor staff compliance with confidentiality policies and should assess diligence in maintaining patient record confidentiality as part of staff annual performance evaluations. Ethical management of IMAC systems is the business of all members of the health care team. Computerized patient records management (including IMAC) should be scrutinized as any other clinical medial ethical issue. If hospitals include these processes in their planning for RIS, IMACS, and HIS systems, they should have time to develop institutional expertise on these questions before and as systems are installed rather than only as ethical dilemmas develop during their use.

Collmann, Jeff R.

1995-05-01

227

Integration of radiographic images with an electronic medical record.  

PubMed Central

Radiographic images are important and expensive diagnostic tests. However, the provider caring for the patient often does not review the images directly due to time constraints. Institutions can use picture archiving and communications systems to make images more available to the provider, but this may not be the best solution. We integrated radiographic image review into the Regenstrief Medical Record System in order to address this problem. To achieve adequate performance, we store JPEG compressed images directly in the RMRS. Currently, physicians review about 5% of all radiographic studies using the RMRS image review function.

Overhage, J. M.; Aisen, A.; Barnes, M.; Tucker, M.; McDonald, C. J.

2001-01-01

228

Application of an Electronic Medical Record in Space Medicine  

NASA Technical Reports Server (NTRS)

Electronic Medical Records (EMR) have been emerging over the past decade. Today, they are replacing the paper chart in clinics throughout the nation. Approximately three years ago, the NASA-JSC Flight Medicine Clinic initiated an assessment of the EMRs available on the market. This assessment included comparing these products with the particular scope of practice at JSC. In 1998, the Logician EMR from Medicalogic was selected for the JSC Flight Medicine Clinic. This presentation reviews the process of selection and implementation of the EMR into the unique practice of aerospace medicine at JSC.

McGinnis, Patrick J.

2000-01-01

229

Interventional radiology workflow management in the electronic medical record.  

PubMed

The electronic medical record (EMR) has significantly improved efficiency in many areas of radiology workflow. Following implementation of an electronic protocol selection process for cross-sectional imaging at the University of Colorado Hospital, the interventional radiology (IR) division desired to have a similar tool. Evaluation of the IR workflow demonstrated the need for a multilayered solution, which accounted for consultation, physician review, authorization and scheduling, pre-procedural nursing evaluation, physician rounding, and resource allocation and prioritization. This paper outlines the rationale for and components of this process. PMID:24425188

Gassert, Geralyn; Durham, Janette; Cain, Michael; Sachs, Peter B

2014-06-01

230

Virtual medical record implementation for enhancing clinical decision support.  

PubMed

Development of clinical decision support systems (CDS) is a process which highly depends on the local databases, this resulting in low interoperability. To increase the interoperability of CDS a standard representation of clinical information is needed. The paper suggests a CDS architecture which integrates several HL7 standards and the new vMR (virtual Medical Record). The clinical information for the CDS systems (the vMR) is represented with Topic Maps technology. Beside the implementation of the vMR, the architecture integrates: a Data Manager, an interface, a decision making system (based on Egadss), a retrieving data module. Conclusions are issued. PMID:22874164

Gomoi, Valentin-Sergiu; Dragu, Daniel; Stoicu-Tivadar, Vasile

2012-01-01

231

Applying XDS for sharing CDA-based medical records  

NASA Astrophysics Data System (ADS)

Many countries have set long-term objectives for establishing an Electronic Healthcare Records system(EHRs). Various IT Strategies note that integration of EHR systems has a high priority. Because the EHR systems are based on different information models and different technology platforms, one of the key integration problems in the realization of the EHRs for the continuity of patient care, is the inability to share patient records between various institutions. Integrating the Healthcare Enterprise (IHE) committee has defined the detailed implementations of existing standards such as DICOM, HL7, in a publicly available document called the IHE technical framework (IHE-TF). Cross-enterprise document sharing (XDS), one of IHE technical frameworks, is describing how to apply the standards into the information systems for the sharing of medical documents among hospitals. This study aims to design Clinical Document Architecture (CDA) schema based on HL7, and to apply implementation strategies of XDS using this CDA schema.

Kim, Joong Il; Jang, Bong Mun; Han, Dong Hoon; Yang, Keon Ho; Kang, Won-Suk; Jung, Haijo; Kim, Hee-Joung

2006-03-01

232

Developing Predictive Models Using Electronic Medical Records: Challenges and Pitfalls  

PubMed Central

While Electronic Medical Records (EMR) contain detailed records of the patient-clinician encounter — vital signs, laboratory tests, symptoms, caregivers’ notes, interventions prescribed and outcomes — developing predictive models from this data is not straightforward. These data contain systematic biases that violate assumptions made by off-the-shelf machine learning algorithms, commonly used in the literature to train predictive models. In this paper, we discuss key issues and subtle pitfalls specific to building predictive models from EMR. We highlight the importance of carefully considering both the special characteristics of EMR as well as the intended clinical use of the predictive model and show that failure to do so could lead to developing models that are less useful in practice. Finally, we describe approaches for training and evaluating models on EMR using early prediction of septic shock as our example application.

Paxton, Chris; Niculescu-Mizil, Alexandru; Saria, Suchi

2013-01-01

233

Patient clustering with uncoded text in electronic medical records.  

PubMed

We propose a mixture model for text data designed to capture underlying structure in the history of present illness section of electronic medical records data. Additionally, we propose a method to induce bias that leads to more homogeneous sets of diagnoses for patients in each cluster. We apply our model to a collection of electronic records from an emergency department and compare our results to three other relevant models in order to assess performance. Results using standard metrics demonstrate that patient clusters from our model are more homogeneous when compared to others, and qualitative analyses suggest that our approach leads to interpretable patient sub-populations when applied to real data. Finally, we demonstrate an example of our patient clustering model to identify adverse drug events. PMID:24551361

Henao, Ricardo; Murray, Jared; Ginsburg, Geoffrey; Carin, Lawrence; Lucas, Joseph E

2013-01-01

234

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2010 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2010-07-01

235

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2010 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2009-07-01

236

29 CFR 1915.1020 - Access to employee exposure and medical records.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Access to employee exposure and medical records. 1915.1020 Section 1915.1020 Labor ...§ 1915.1020 Access to employee exposure and medical records. Note: The requirements applicable to...

2013-07-01

237

Does the HIPAA Privacy Rule Allow Parents the Right to See Their Children's Medical Records?  

MedlinePLUS

... allow parents the right to see their children’s medical records? Answer: Yes, the Privacy Rule generally allows a parent to have access to the medical records about his or her child, as his or ...

238

29 CFR 1926.33 - Access to employee exposure and medical records.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Access to employee exposure and medical records. 1926.33 Section 1926.33 Labor Regulations...Provisions § 1926.33 Access to employee exposure and medical records. Note: The requirements applicable to...

2013-07-01

239

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2012 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2012-07-01

240

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2011 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2011-07-01

241

Improving patient care by using medical records to transmit medication orders.  

PubMed

In this retrospective report, the development, implementation, and outcomes of the first 2 years of a novel method for transmitting medical orders for outpatients at the US Public Health Service (PHS) Indian Hospital in Tuba City, Arizona are explored. During this time, pharmacy services within the Indian Health Service were eliminating the use of individual prescription order forms. Medication orders and pharmacists' notations relating to those orders were being written directly into patients' medical records. Pharmacists screened the charts for completeness of patient history information and for drug interactions or other contraindications before filling medication orders. Resulting improvements in pharmacists' communication with physicians and nurses are described and specific cases in which patient care was improved as a result of this program are documented. This program allowed greatly expanded clinical roles for pharmacists and may be used as a model for providing comprehensive pharmacy services to ambulatory patients in small hospitals, clinics, and managed health care facilities. PMID:10296354

Lipman, A G; Deffenbaugh, J H

1989-11-01

242

Records as Genre.  

ERIC Educational Resources Information Center

Reworks the concept of genre from rhetorical, dialectical, and dialogic perspectives. Redefines genre as a stabilized-for-now site of social and ideological action. Applies this definition (in a six-month ethnographic study) to a specific literary practice--medical record keeping--evolving in a specific context--a veterinary college. (SR)

Schryer, Catherine F.

1993-01-01

243

Disease-specific medical records improve the recording of processes of care in the management of type 2 diabetes mellitus.  

PubMed

A retrospective review of the medical records of 961 patients with type 2 diabetes managed in primary care in Tunisia was undertaken. Recording of process of care measurements improved from 65 to 84% for blood pressure, from 60 to 71% for fasting glucose, and from 11 to 53% for weight measurement (P<0.001 for all). The introduction of disease-specific medical records significantly improves the recording of care of patients with type 2 diabetes mellitus. PMID:16332381

Alberti, H; Boudriga, N; Nabli, M

2006-07-01

244

The Case for Continuing Education in Veterinary Colleges.  

ERIC Educational Resources Information Center

Explores why continuing veterinary medical education (CVME) programs can play a vital role in supporting the overall strategy of a veterinary college. Discusses the current and future market for CVME programs and strategies for sustainability and synergy. (EV)

Lee, David E.

2003-01-01

245

7 CFR 110.5 - Availability of records to facilitate medical treatment.  

Code of Federal Regulations, 2010 CFR

...professional, to be a medical emergency, the record information...pesticide, relating to the medical emergency, shall be provided...necessary to provide medical treatment or first...to submit pesticide poisoning incident reports...

2009-01-01

246

7 CFR 110.5 - Availability of records to facilitate medical treatment.  

Code of Federal Regulations, 2010 CFR

...professional, to be a medical emergency, the record information...pesticide, relating to the medical emergency, shall be provided...necessary to provide medical treatment or first...to submit pesticide poisoning incident reports...

2010-01-01

247

29 CFR 1904.9 - Recording criteria for cases involving medical removal under OSHA standards.  

Code of Federal Regulations, 2010 CFR

...for cases involving medical removal under OSHA standards. 1904.9 Section 1904...for cases involving medical removal under OSHA standards. (a) Basic requirement...medical surveillance requirements of an OSHA standard, you must record the case...

2009-07-01

248

29 CFR 1904.9 - Recording criteria for cases involving medical removal under OSHA standards.  

Code of Federal Regulations, 2010 CFR

...for cases involving medical removal under OSHA standards. 1904.9 Section 1904...for cases involving medical removal under OSHA standards. (a) Basic requirement...medical surveillance requirements of an OSHA standard, you must record the case...

2010-07-01

249

29 CFR 1904.9 - Recording criteria for cases involving medical removal under OSHA standards.  

Code of Federal Regulations, 2013 CFR

...for cases involving medical removal under OSHA standards. 1904.9 Section 1904...for cases involving medical removal under OSHA standards. (a) Basic requirement...medical surveillance requirements of an OSHA standard, you must record the case...

2013-07-01

250

42 CFR 480.131 - Access to medical records for the monitoring of QIOs.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Access to medical records for the monitoring of QIOs...Information § 480.131 Access to medical records for the monitoring of QIOs...monitor a QIO will have access to medical records maintained by institutions...

2013-10-01

251

"Clinical Archive": a computerized medical record of patients in apheresis.  

PubMed

Today the medical records of sick or injured persons who need apheresis treatment are not always the same in the various Transfusional Centres for lack of dedicated software. The Transfusion Centre of Bari Policlinic has tried to define and create a computerized medical record in order to have a valid tool to better report information both during clinical treatment and after for their archives. The software, called "Clinical Archives", can store clinical, therapeutic and administrative data. It has a good user interface, it is easy and intuitive in its various steps and procedures and it can always be expanded thanks to the connection online with other computerized systems (cell separators, laboratory, etc.). The software is entirely home-made and it is our intention to distribute it free to those who wish it for an analysis of its potentials and possible improvements and/or extensions. With this software we have tried to make an important contribution to the technological evolution of our scientific community in the field of Clinical Governance and Outcomes. PMID:18977176

Galtieri, Emilio; Cazzato, Luciano; Poliseno, Giovanni; Paglionico, Nicola; Dimonte, Donato

2008-12-01

252

Challenges of Self-Reported Medical Conditions and Electronic Medical Records Among Members of a Large Military Cohort.  

National Technical Information Service (NTIS)

Self-reported medical history data are frequently used in epidemiological studies. Self-reported diagnoses may differ from medical record diagnoses due to poor patient-clinician communication, self-diagnosis in the absence of a satisfactory explanation fo...

B. Smith E. J. Boyko L. K. Chu P. J. Amoroso T. C. Smith

2008-01-01

253

Detecting pregnancy use of non-hormonal category X medications in electronic medical records  

PubMed Central

Objectives To determine whether a rule-based algorithm applied to an outpatient electronic medical record (EMR) can identify patients who are pregnant and prescribed medications proved to cause birth defects. Design A descriptive study using the University of Pennsylvania Health System outpatient EMR to simulate a prospective algorithm to identify exposures during pregnancy to category X medications, soon enough to intervene and potentially prevent the exposure. A subsequent post-hoc algorithm was also tested, working backwards from pregnancy endpoints, to search for possible exposures that should have been detected. Measurements Category X medications prescribed to pregnant patients. Results The alert simulation identified 2201 pregnancies with 16?969 pregnancy months (excluding abortions and ectopic pregnancies). Of these, 30 appeared to have an order for a non-hormone category X medication during pregnancy. However, none of the 30 ‘exposed pregnancies’ were confirmed as true exposures in medical records review. The post-hoc algorithm identified 5841 pregnancies with 64 exposed pregnancies in 52?569 risk months, only one of which was a confirmed case. Conclusions Category X medications may indeed be used in pregnancy, although rarely. However, most patients identified by the algorithm as exposed in pregnancy were not truly exposed. Therefore, implementing an electronic warning without evaluation would have inconvenienced prescribers, possibly hurting some patients (leading to non-use of needed drugs), with no benefit. These data demonstrate that computerized physician order entry interventions should be selected and evaluated carefully even before their use, using alert simulations such as that performed here, rather than just taken off the shelf and accepted as credible without formal evaluation.

Schinnar, Rita; Jones, Joshua; Bilker, Warren B; Weiner, Mark G; Hennessy, Sean; Leonard, Charles E; Cronholm, Peter F; Pifer, Eric

2011-01-01

254

Medical-Concept Models and Medical Records: An Approach Based on GALENand PEN&PAD  

Microsoft Academic Search

ObjectivesTo investigate the issues raised in applying a preliminary version of the GALEN compositional concept reference (CORE) model to a series of radiographic reports, and to demonstrate that the same underlying concept model could be used in conjunction with both a detailed, fine-grained model of medical records based on that used in the PEN&PAD project and with other more conventional

A. L. Rector; A J Glowinski; W A Nowlan; Angelo Rossi-Mori

1995-01-01

255

Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation.  

PubMed

The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission. PMID:21409398

Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S

2012-08-01

256

29 CFR 1913.10 - Rules of agency practice and procedure concerning OSHA access to employee medical records.  

Code of Federal Regulations, 2010 CFR

...agency practice and procedure concerning OSHA access to employee medical records. ...AGENCY PRACTICE AND PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS ...agency practice and procedure concerning OSHA access to employee medical records....

2010-07-01

257

29 CFR 1913.10 - Rules of agency practice and procedure concerning OSHA access to employee medical records.  

Code of Federal Regulations, 2010 CFR

...agency practice and procedure concerning OSHA access to employee medical records. ...AGENCY PRACTICE AND PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS ...agency practice and procedure concerning OSHA access to employee medical records....

2009-07-01

258

Factors in Medical Student Beliefs about Electronic Health Record Use  

PubMed Central

Healthcare providers’ ongoing investment in electronic health records (EHRs) necessitates an understanding of physicians’ expectations about using EHRs. Such understanding may aid educators and administrators when utilizing scarce resources during EHR training and implementation activities. This study aimed to link individual medical student characteristics to their perceptions of EHRs’ ease of use and usefulness. This study employed a cross-sectional survey of 126 third-year medical students at a large southeastern university. Using a questionnaire designed for this study and containing previously validated items, the study team measured and related students’ expectations about EHR ease of use and usefulness to their computer self-efficacy, openness to change, personality traits, and demographic characteristics. On a seven-point scale, men reported, on average, ease-of-use scores that were 0.71 higher than women's (p < .001). Also, increased computer self-efficacy related to higher expectations of EHR ease of use (p < .01) and usefulness (p < .05). Openness-to-change scores were also associated with higher expectations of EHR ease of use (p < .01) and usefulness (p < .001). Finally, a more conscientious personality was positively associated with EHR ease of use (p < .01). Our findings suggest that medical educators and administrators may consider targeting EHR management strategies on the basis of individual differences. Enhanced training and support interventions may be helpful to women or to clinicians with lower computer self-efficacy, lower openness to change, or less conscientious personalities. Also, current and future physicians who rate higher in terms of self-efficacy, openness to change, or conscientiousness may be useful as champions of EHR use among their peers.

Harle, Christopher A.; Gruber, Laura A.; Dewar, Marvin A.

2014-01-01

259

A cost-benefit analysis of electronic medical records in primary care  

Microsoft Academic Search

PurposeElectronic medical record systems improve the quality of patient care and decrease medical errors, but their financial effects have not been as well documented. The purpose of this study was to estimate the net financial benefit or cost of implementing electronic medical record systems in primary care.

Samuel J. Wang; Blackford Middleton; Lisa A. Prosser; Christiana G. Bardon; Cynthia D. Spurr; Patricia J. Carchidi; Anne F. Kittler; Robert C. Goldszer; David G. Fairchild; Andrew J. Sussman; Gilad J. Kuperman; David W. Bates

2003-01-01

260

The adoption of electronic medical record technology in order to prevent medical errors: a matter for American public policy  

Microsoft Academic Search

This article argues that public policy should address the use of electronic medical records (EMRs) as a way to ensure patient safety in the United States. The article discusses the scope and nature of the medical error problem in the United States, causes of medical errors and the use of EMRs as a solution to the problem. Research has shown

Jacquelyn N. Crane; Frederick G. Crane

2008-01-01

261

The effect of differing Audience Response System question types on student attention in the veterinary medical classroom.  

PubMed

The purpose of this study was to evaluate the ability of specific types of multiple-choice questions delivered using an Audience Response System (ARS) to maintain student attention in a professional educational setting. Veterinary students (N=324) enrolled in the first three years of the professional curriculum were presented with four different ARS question types (knowledge base, discussion, polling, and psychological investment) and no ARS questions (control) during five lectures presented by 10 instructors in 10 core courses. Toward the end of the lecture, students were polled to determine the relative effectiveness of specific question types. Student participation was high (76.1%+/-2.0), and most students indicated that the system enhanced the lecture (64.4%). Knowledge base and discussion questions resulted in the highest student-reported attention to lecture content. Questions polling students about their experiences resulted in attention rates similar to those without use of ARS technology. Psychological investment questions, based on upcoming lecture content, detracted from student attention. Faculty preparation time for three ARS questions was shorter for knowledge base questions (22.3 min) compared with discussion and psychological investment questions (38.6 min and 34.7 min, respectively). Polling questions required less time to prepare (22.2 min) than discussion questions but were not different from other types. Faculty stated that the investment in preparation time was justified on the basis of the impact on classroom atmosphere. These findings indicate that audience response systems enhance attention and interest during lectures when used to pose questions that require application of an existing knowledge base and allow for peer interaction. PMID:20576903

Rush, Bonnie R; Hafen, McArthur; Biller, David S; Davis, Elizabeth G; Klimek, Judy A; Kukanich, Butch; Larson, Robert L; Roush, James K; Schermerhorn, Thomas; Wilkerson, Melinda J; White, Brad J

2010-01-01

262

A COMPARATIVE STUDY OF LAWS AND PROCEDURES PERTAINING TO THE MEDICAL RECORDS RETENTION IN SELECTED COUNTRIES  

PubMed Central

Introduction: The health record serves several purposes and must be retained to meet those purposes. These varied purposes influence how long health records must be kept, or their retention period. Aim: Present study aimed to recognize laws and procedures pertaining to retention of health records in selected countries and provide a proposed guideline for Iran. Methods: This was an applied and descriptive-comparative research on laws and procedures pertaining to retention of medical records in USA, United Kingdom, Australia and Iran that performed in 2011. The data were collected via library sources, websites, and consultation with specialists in and out of the country. The validity of the data was confirmed by experts. Finally, the recommendations were provided for medical record retention in Iran. Results: The study revealed that, there are complete and transparent record retention schedules in selected counties so that retention situation for adults, minors, emergency, outpatients and deaths records is clearly recommended. But in Iran, either there aren’t specific laws and procedures for medical record or they are unspecified. Conclusion: The lack of a complete, transparent and update medical record retention schedule in Iran, lead to confusion for hospitals. Some of hospitals maintain medical records more than of determined retention period and some of them destruct them before expiring of essential retention period. In order to optimize the situation of health records retention in Iran, it is necessary to review, correction and correction and completion of medical records retention schedule on the provided recommendations for kinds of medical record.

Tavakoli, Nahid; Saghaiannejad, Sakineh; Reza Habibi, Mohammad

2012-01-01

263

Electronic medical record use in pediatric primary care  

PubMed Central

Objectives To characterize patterns of electronic medical record (EMR) use at pediatric primary care acute visits. Design Direct observational study of 529 acute visits with 27 experienced pediatric clinician users. Measurements For each 20?s interval and at each stage of the visit according to the Davis Observation Code, we recorded whether the physician was communicating with the family only, using the computer while communicating, or using the computer without communication. Regression models assessed the impact of clinician, patient and visit characteristics on overall visit length, time spent interacting with families, and time spent using the computer while interacting. Results The mean overall visit length was 11:30 (min:sec) with 9:06 spent in the exam room. Clinicians used the EMR during 27% of exam room time and at all stages of the visit (interacting, chatting, and building rapport; history taking; formulation of the diagnosis and treatment plan; and discussing prevention) except the physical exam. Communication with the family accompanied 70% of EMR use. In regression models, computer documentation outside the exam room was associated with visits that were 11% longer (p=0.001), and female clinicians spent more time using the computer while communicating (p=0.003). Limitations The 12 study practices shared one EMR. Conclusions Among pediatric clinicians with EMR experience, conversation accompanies most EMR use. Our results suggest that efforts to improve EMR usability and clinician EMR training should focus on use in the context of doctor–patient communication. Further study of the impact of documentation inside versus outside the exam room on productivity is warranted.

Alessandrini, Evaline A; Forrest, Christopher B; Khan, Saira; Localio, A Russell; Gerber, Andreas

2010-01-01

264

The Effects of Promoting Patient Access to Medical Records: A Review  

PubMed Central

The Health Insurance Privacy and Portability Act (HIPPA) stipulates that patients must be permitted to review and amend their medical records. As information technology makes medical records more accessible to patients, it may become more commonplace for patients to review their records routinely. This article analyzes the potential benefits and drawbacks of facilitating patient access to the medical record by reviewing previously published research. Previous research includes analysis of clinical notes, surveys of patients and practitioners, and studies of patient-accessible medical records. Overall, studies suggest the potential for modest benefits (for instance, in enhancing doctor-patient communication). Risks (for instance, increasing patient worry or confusion) appear to be minimal in medical patients. The studies, however, were of limited quality and low statistical power to detect the variety of outcomes that may result from implementation of a patient-accessible medical record. The data from these studies lay the foundation for future research.

Ross, Stephen E.; Lin, Chen-Tan

2003-01-01

265

The Feminization of Veterinary Medicine.  

ERIC Educational Resources Information Center

In little more than a generation, veterinary medical schools have gone from enrolling a token number of women to having a higher proportion of women than men in some cases. Developments in drugs to control large animals, relatively low pay for veterinarians, and options for part-time employment have served to change the balance of sexes in the…

Gose, Ben

1998-01-01

266

Identifying Patient Smoking Status from Medical Discharge Records  

PubMed Central

The authors organized a Natural Language Processing (NLP) challenge on automatically determining the smoking status of patients from information found in their discharge records. This challenge was issued as a part of the i2b2 (Informatics for Integrating Biology to the Bedside) project, to survey, facilitate, and examine studies in medical language understanding for clinical narratives. This article describes the smoking challenge, details the data and the annotation process, explains the evaluation metrics, discusses the characteristics of the systems developed for the challenge, presents an analysis of the results of received system runs, draws conclusions about the state of the art, and identifies directions for future research. A total of 11 teams participated in the smoking challenge. Each team submitted up to three system runs, providing a total of 23 submissions. The submitted system runs were evaluated with microaveraged and macroaveraged precision, recall, and F-measure. The systems submitted to the smoking challenge represented a variety of machine learning and rule-based algorithms. Despite the differences in their approaches to smoking status identification, many of these systems provided good results. There were 12 system runs with microaveraged F-measures above 0.84. Analysis of the results highlighted the fact that discharge summaries express smoking status using a limited number of textual features (e.g., “smok”, “tobac”, “cigar”, Social History, etc.). Many of the effective smoking status identifiers benefit from these features.

Uzuner, Ozlem; Goldstein, Ira; Luo, Yuan; Kohane, Isaac

2008-01-01

267

Patient-centred care: using online personal medical records in IVF practice  

Microsoft Academic Search

BACKGROUND: Generic patient-accessible medical records have shown promise in enhancing patient-centred care for patients with chronic diseases. We sought to design, implement and evaluate a patient-accessible medical record specifically for patients undergoing a course of assisted reproduction (IVF or ICSI). METHODS: The personal medical record (PMR) database was developed using three formative evaluation steps, and its user-experience was evaluated through

W. S. Tuil; A. J. ten Hoopen; D. D. M. Braat; P. F. de Vries Robbé; J. A. M. Kremer

2006-01-01

268

Extracting medical information from narrative patient records: the case of medication-related information  

PubMed Central

Objective While essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems. This paper describes an approach to automatically extract medication information from clinical records, which was developed to participate in the i2b2 2009 challenge, as well as different strategies to improve the extraction. Design Our approach relies on a semantic lexicon and extraction rules as a two-phase strategy: first, drug names are recognized and, then, the context of these names is explored to extract drug-related information (mode, dosage, etc) according to rules capturing the document structure and the syntax of each kind of information. Different configurations are tested to improve this baseline system along several dimensions, particularly drug name recognition—this step being a determining factor to extract drug-related information. Changes were tested at the level of the lexicons and of the extraction rules. Results The initial system participating in i2b2 achieved good results (global F-measure of 77%). Further testing of different configurations substantially improved the system (global F-measure of 81%), performing well for all types of information (eg, 84% for drug names and 88% for modes), except for durations and reasons, which remain problematic. Conclusion This study demonstrates that a simple rule-based system can achieve good performance on the medication extraction task. We also showed that controlled modifications (lexicon filtering and rule refinement) were the improvements that best raised the performance.

Grouin, Cyril; Zweigenbaum, Pierre

2010-01-01

269

Remote access to medical records via the Internet: feasibility, security and multilingual considerations  

Microsoft Academic Search

This paper investigates the use of Internet technology to provide secure multilingual access to the medical records of a cardiology clinic. Information extracted from the medical record archive is used to create mini-Webs of interlinked pages that may be viewed using a standard browser. The main features of the reported project are its multilingual nature-of particular significance in Europe, the

P. J. Lees; C. E. Chronaki; E. N. Simantirakis; S. G. Kostomanolakis; S. C. Orphanoudakis; P. E. Vardas

1999-01-01

270

Notification of Abnormal Lab Test Results in an Electronic Medical Record: Do Any Safety Concerns Remain?  

Microsoft Academic Search

BackgroundFollow-up of abnormal outpatient laboratory test results is a major patient safety concern. Electronic medical records can potentially address this concern through automated notification. We examined whether automated notifications of abnormal laboratory results (alerts) in an integrated electronic medical record resulted in timely follow-up actions.

Hardeep Singh; Eric J. Thomas; Dean F. Sittig; Lindsey Wilson; Donna Espadas; Myrna M. Khan; Laura A. Petersen

2010-01-01

271

Congruence of Self-Reported Medications with Pharmacy Prescription Records in Low-Income Older Adults  

ERIC Educational Resources Information Center

Purpose: This study examined the congruence of self-reported medications with computerized pharmacy records. Design and Methods: Pharmacy records and self-reported medications were obtained for 294 members of a state pharmaceutical assistance program who also participated in ACTIVE, a clinical trial on cognitive training in nondemented elderly…

Caskie, Grace I. L.; Willis, Sherry L.

2004-01-01

272

Roles, Functions, Training, and Proficiency Tests for Medical Record Personnel: A Guide to Curriculum Management.  

ERIC Educational Resources Information Center

The curriculum management guide serves as an aid to medical record teachers and other medical record educators. It is designed to provide them with a useful tool to improve student performances by improved administration and management of programs. The guide documents one possible systematic approach to professional and vocational curriculum…

Clark, Fredric A.

273

Reliability and Validity of Estimating the NIH Stroke Scale Score from Medical Records  

Microsoft Academic Search

Background and Purpose—The aim of our study was to determine whether the National Institutes of Health Stroke Scale (NIHSS) can be estimated retrospectively from medical records. The NIHSS is a quantitative measure of stroke-related neurological deficit with established reliability and validity for use in prospective clinical research. Recently, retrospective observational studies have estimated NIHSS scores from medical records for quantitative

Scott E. Kasner; Julio A. Chalela; Jean M. Luciano; Brett L. Cucchiara; Eric C. Raps; Michael L. McGarvey; Molly B. Conroy; A. Russell Localio

274

Doctors' use of electronic medical records systems in hospitals: cross sectional survey  

Microsoft Academic Search

Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227

H. Larum; G. Ellingsen; A. Faxvaag

2001-01-01

275

Improving the Quality of Nursing Home Care and Medical-Record Accuracy with Direct Observational Technologies  

ERIC Educational Resources Information Center

Nursing home medical-record documentation of daily-care occurrence may be inaccurate, and information is not documented about important quality-of-life domains. The inadequacy of medical record data creates a barrier to improving care quality, because it supports an illusion of care consistent with regulations, which reduces the motivation and…

Schnelle, John F.; Osterweil, Dan; Simmons, Sandra F.

2005-01-01

276

Block-Suffix Shifting: Fast, Simultaneous Medical Concept Set Identification in Large Medical Record Corpora  

PubMed Central

Owing to new advances in computer hardware, large text databases have become more prevalent than ever. Automatically mining information from these databases proves to be a challenge due to slow pattern/string matching techniques. In this paper we present a new, fast multi-string pattern matching method based on the well known Aho-Chorasick algorithm. Advantages of our algorithm include: the ability to exploit the natural structure of text, the ability to perform significant character shifting, avoiding backtracking jumps that are not useful, efficiency in terms of matching time and avoiding the typical “sub-string” false positive errors. Our algorithm is applicable to many fields with free text, such as the health care domain and the scientific document field. In this paper, we apply the BSS algorithm to health care data and mine hundreds of thousands of medical concepts from a large Electronic Medical Record (EMR) corpora simultaneously and efficiently. Experimental results show the superiority of our algorithm when compared with the top of the line multi-string matching algorithms.

Liu, Ying; Lita, Lucian Vlad; Niculescu, Radu Stefan; Mitra, Prasenjit; Giles, C. Lee

2008-01-01

277

Linking human anatomy to knowledge bases: a visual front end for electronic medical records.  

PubMed

A new concept of a visual electronic medical record is presented based on developments ongoing in the Defense Advanced Research Projects Agency Virtual Soldier Project. This new concept is based on the holographic medical electronic representation (Holomer) and on data formats being developed to support this. The Holomer is being developed in two different visualization environments, one of which is suitable for prototyping the visual electronic medical record. The advantages of a visual approach as a front end for electronic medical records are discussed and specific implementations are presented. PMID:15718802

Dickson, Stewart; Pouchard, Line; Ward, Richard; Atkins, Gary; Cole, Martin; Lorensen, Bill; Ade, Alexander

2005-01-01

278

Web-based application of Community Health Center (Puskesmas) for patient electronic medical records  

Microsoft Academic Search

This research provides the design and implementation of a web-based software application of Community Health Center\\/ CHC (Pusat Kesehatan Masyarakat = Puskesmas). The application is mainly used for recording patient's personal identity and medical treatment at medical services (polyclinics) of CHC. Generally, the polyclinics at Puskesmas provides are General Medical Treatment Service (Poli Umum), Maternal and Infant Service (Poli Ibu

Mera Kartika Delimayanti; Fajar Tri Waluyanti; Riandini

2009-01-01

279

Feasibility Study for Establishing Three Medical Record Related Programs. Research Report Series Volume XIV, No. 12.  

ERIC Educational Resources Information Center

In November 1985, a survey was conducted at William Rainey Harper College (WRHC), in Illinois, to test the feasibility of establishing programs for medical record technicians, medical coders, and utilization analysts. The survey instrument was mailed to 1,232 hospitals, medical care facilities, nursing homes, physicians' and dentists' offices, and…

William Rainey Harper Coll., Palatine, IL. Office of Planning and Research.

280

The Use of Electronic Medical Records : Communication Patterns in Outpatient Encounters  

Microsoft Academic Search

ObjectiveTo assess physician–patient communication patterns associated with use of an electronic medical record (EMR) system in an outpatient setting and provide an empirical foundation for larger studies.DesignAn exploratory, observational study involving analysis of videotaped physician–patient encounters, questionnaires, and medical-record reviews.SettingGeneral internal medicine practice at an academic medical center.ParticipantsThree physicians who used an EMR system (EMR physicians) and three who used

Gregory Makoul; Raymond H Curry; Paul C Tang

2001-01-01

281

Physician Interaction with Electronic Medical Records: A Qualitative Study  

ERIC Educational Resources Information Center

The integration of EHR (Electronic Health Records) in IT infrastructures supporting organizations enable improved access to and recording of patient data, enhanced ability to make better and more-timely decisions, and improved quality and reduced errors. Despite these benefits, there are mixed results as to the use of EHR. The literature suggests…

Noteboom, Cherie Bakker

2010-01-01

282

Installing and Implementing a Computer-based Patient Record System in Sub-Saharan Africa: The Mosoriot Medical Record System  

PubMed Central

The authors implemented an electronic medical record system in a rural Kenyan health center. Visit data are recorded on a paper encounter form, eliminating duplicate documentation in multiple clinic logbooks. Data are entered into an MS-Access database supported by redundant power systems. The system was initiated in February 2001, and 10,000 visit records were entered for 6,190 patients in six months. The authors present a summary of the clinics visited, diagnoses made, drugs prescribed, and tests performed. After system implementation, patient visits were 22% shorter. They spent 58% less time with providers (p < 0.001) and 38% less time waiting (p = 0.06). Clinic personnel spent 50% less time interacting with patients, two thirds less time interacting with each other, and more time in personal activities. This simple electronic medical record system has bridged the “digital divide.” Financial and technical sustainability by Kenyans will be key to its future use and development.

Rotich, Joseph K.; Hannan, Terry J.; Smith, Faye E.; Bii, John; Odero, Wilson W.; Vu, Nguyen; Mamlin, Burke W.; Mamlin, Joseph J.; Einterz, Robert M.; Tierney, William M.

2003-01-01

283

Use of information resources by veterinary practitioners.  

PubMed Central

Veterinary practitioners are often isolated from easy access to information in medical or hospital libraries, making necessary the use of a variety of information resources. A survey was conducted to assess the extent to which various information resources were used within the veterinary profession. Most responding veterinarians were small-animal practitioners who used the veterinary literature, colleagues, diagnostic laboratories, continuing education courses, association meetings, and pharmaceutical representatives as sources of information. Books and other practitioners were the preferred information source in critical-care situations, followed closely by diagnostic laboratories and journals. For keeping up-to-date with current advances in veterinary medicine, journals, books, other practitioners, and continuing education were used. University extension services, veterinary medical libraries, and computer applications to information use were not important resources ot most of the respondents. Many veterinarians indicated that they would use library services if they knew more about them. With the trend toward computerization in veterinary practice, it is possible for libraries to help reduce the information isolation of many veterinary practices.

Pelzer, N L; Leysen, J M

1991-01-01

284

Medical Subject Headings-Supplementary Chemical Records, 1990.  

National Technical Information Service (NTIS)

Contains records of approximately 21,000 chemicals which since 1970 have been mentioned in a significant way in journals indexed in MEDLINE, the National Library of Medicine's online bibliographic database. Originally housed in a manual card file these re...

1989-01-01

285

Recording of community violence by medical and police services  

Microsoft Academic Search

Objectives: To determine the extent to which community violence that results in injury treated in emergency departments appears in official police records and to identify age\\/gender groups at particular risk of under-recording by the police.Methods: Non-confidential data for patients with assault related injury treated in the emergency departments of two hospitals in one South Wales city (Swansea) during a six

I Sutherland; V Sivarajasingam; J P Shepherd

2002-01-01

286

Veterinary medicine books recommended for academic libraries  

PubMed Central

This bibliography of in-print veterinary medical books published in English may be used as an acquisitions or evaluation tool for developing the monograph component of new veterinary medicine collections or existing science, technology, and medicine collections where veterinary medicine is in the scope of the collection. The bibliography is divided into 34 categories and consists of bibliographic information for 419 titles. The appendix contains an author/editor index. Prices for all entries are in US dollars, except where another currency is noted. The total cost of all books in the bibliography is $43,602.13 (US).

Crawley-Low, Jill

2004-01-01

287

The Merck Veterinary Manual  

NSDL National Science Digital Library

The Merck Veterinary Manual is the single most comprehensive electronic reference for animal care information. The site is funded in part by Merck & Co., Inc., which has been providing quality medical information on a not-for-profit basis for more than 100 years. Merial Limited, dedicated to producing a wide range of pharmaceuticals and vaccines to keep livestock and pets healthy and productive also funds the site. The online manual contains articles on a multitude of topics including (to name only a few), the digestive system, metabolic disorders, emergency care and management, and exotic and laboratory animals. Within each topic are subheadings for a more specific search for information. The manual is easily navigated for users and would be a valuable resource for students and instructors alike.

2007-02-13

288

MENELAS: an access system for medical records using natural language  

Microsoft Academic Search

The overall goal of Menelas is to provide better access to the information contained in natural language patient discharge summaries, through the design and implementation of a pilot system able to access medical reports through natural languages. A first, experimental version of the Menelas indexing prototype for French has been assembled. Its function is to encode free text PDSs into

Pierre Zweigenbaum

1994-01-01

289

Mini Medical Record Application: Annual Register for Flu Shot Vaccinations  

Microsoft Academic Search

This application is an Intranet-based system. A database has been established utilizing patient information on the basis of age, medical diagnosis and employment history. If a health care provider or support staff states that a patient is over 65 years of age or has been diagnosed with a chronic disease and this limits the patient’s ability to fight off infection,

Myron Hatcher; Irene Heetebry; Hossein Tabriziani

2005-01-01

290

Lasers in veterinary medicine: a review  

NASA Astrophysics Data System (ADS)

As in other facets of medical science, the use of lasers in veterinary medicine is a relatively new phenomenon. Economic aspects of the profession as well as questionable returns on investment have limited laser applications primarily to the academic community, research institutions, and specialty practices. As technology improves and efficacy is proven, costs should decrease and allow further introduction of laser surgical and diagnostic devices into the mainstream of clinical veterinary medicine.

Bartels, Kenneth E.

1994-09-01

291

Tocolytic Drugs for Use in Veterinary Obstetrics  

PubMed Central

The author presents a literature review of two tocolytic agents used in veterinary obstetrics: isoxsuprine and clenbuterol. The medical background from which these drugs emerged for human use and to which is linked their application in animal medicine is described. Each drug is reviewed according to its pharmacology, basic considerations for its clinical use and the reports on its application in the treatment and management of obstetrical disorders in veterinary medicine.

Menard, L.

1984-01-01

292

An initial operational problem oriented medical record system: for storage, manipulation and retrieval of medical data  

Microsoft Academic Search

The ultimate role of the computer in the delivery of health services has yet to be defined. There may be profound implications in terms of quality of medical care, efficiency, economics of care, and medical research. Final judgments as to advisability and economic feasibility await the implementation of prototype total medical information systems and further technical developments directed toward lowering

Jan R. Schultz; Stephen V. Cantrill; Keith G. Morgan

1971-01-01

293

Investigation of retention and destruction process of medical records in the hospitals and codifying appropriate guidelines  

PubMed Central

Introduction: One of the major issues in hospitals is the period for which the medical records are retained. Health information management professionals traditionally have performed retention and destruction functions using all media, including paper, images, optical disk, microfilm, DVD, and CD-ROM. Health information management departments must maintain a specific program to retain and destruct the records. The purpose of this paper is to investigate the retention and destruction process of medical records in the hospitals in Isfahan and codifying the appropriate guidelines. Materials and Methods: The research was conducted as a cross-sectional descriptive study in 30?hospitals in Isfahan. The data was collected using a Check List. Also 30 medical records experts’ viewpoints were obtained using the Delphi technique. Data entry and statistical analysis was performed using SPSS. Results: The findings indicated that 53.8% of the study population maintained a written policy. A 34.6% maintained a written policy to destruct medical records. And 50% announced that no instructions had been given to the hospitals by qualified authorities to destruct the medical records. Discussion: The majority of the hospitals are still unclear about the retention period of medical records, which could be due to not to mention the retention period for most medical records by the country's National Literature and lack of policy and procedure in hospitals. Conclusions: According to the legislations, hospitals are bound to retain the inpatients’ records for full 15 years but based on the findings of this research, less than half of the study population retained the inpatients’ records for the period mentioned.

Tavakoli, Nahid; Jahanbakhsh, Maryam

2013-01-01

294

A descriptive exploratory study of how admissions caused by medication-related harm are documented within inpatients' medical records  

PubMed Central

Background Adverse drug reactions, poor patient adherence and errors, here collectively referred to as medication-related harm (MRH), cause around 2.7-8.0% of UK hospital admissions. Communication gaps between successive healthcare providers exist, but little is known about how MRH is recorded in inpatients’ medical records. We describe the presence and quality of MRH documentation for patients admitted to a London teaching hospital due to MRH. Additionally, the international classification of disease 10th revision (ICD-10) codes attributed to confirmed MRH-related admissions were studied to explore appropriateness of their use to identify these patients. Methods Clinical pharmacists working on an admissions ward in a UK hospital identified patients admitted due to suspected MRH. Six different data sources in each patient’s medical record, including the discharge summary, were subsequently examined for MRH-related information. Each data source was examined for statements describing the MRH: symptom and diagnosis, identification of the causative agent, and a statement of the action taken or considered. Statements were categorised as ‘explicit’ if unambiguous or ‘implicit’ if open to interpretation. ICD-10 codes attributed to confirmed MRH cases were recorded. Results Eighty-four patients were identified over 141 data collection days; 75 met our inclusion criteria. MRH documentation was generally present (855 of 1307 statements were identified; 65%), and usually explicit (705 of 855; 82%). The causative agent had the lowest proportion of explicit statements (139 of 201 statements were explicit; 69%). For two (3%) discharged patients, the causal agent was documented in their paper medical record but not on the discharge summary. Of 64 patients with a confirmed MRH diagnosis at discharge, only six (9%) had a MRH-related ICD-10 code. Conclusions Availability of information in the paper medical record needs improving and communication of MRH-related information could be enhanced by using explicit statements and documenting reasons for changing medications. ICD-10 codes underestimate the true occurrence of MRH.

2014-01-01

295

Applying XDS for sharing CDA-based medical records  

Microsoft Academic Search

Many countries have set long-term objectives for establishing an Electronic Healthcare Records system(EHRs). Various IT Strategies note that integration of EHR systems has a high priority. Because the EHR systems are based on different information models and different technology platforms, one of the key integration problems in the realization of the EHRs for the continuity of patient care, is the

Joong Il Kim; Bong Mun Jang; Dong Hoon Han; Keon Ho Yang; Won-Suk Kang; Haijo Jung; Hee-Joung Kim

2006-01-01

296

Evaluation of a Lecture Recording System in a Medical Curriculum  

NSDL National Science Digital Library

This article describes a retrospective study of a lecture recording system that was implemented to document the students' perceptions, pattern of usage, and impact on the students' grades in three basic sciences courses (Cell Biology/Histology, Physiology, and Neurosciences). Outcomes, faculty and student experiences, and suggestions regarding use of the system are provided.

Thierry Bacro (University of South Carolina Regenerative Medicine and Cell Biology)

2010-11-01

297

Interface of Inference Models with Concept and Medical Record Models  

Microsoft Academic Search

Medical information systems and standards are increasingly based on principled models of at least three distinct sorts of\\u000a information — patient data, concepts (terminology), and guidelines (decision support). Well defined interfaces are required\\u000a between the three types of model to allow development to proceed independently. Two of the major issues to be dealt with in\\u000a the defining of such interfaces

Alan L. Rector; Peter D. Johnson; Samson W. Tu; Chris Wroe; Jeremy Rogers

2001-01-01

298

Can multilingual machine translation help make medical record content more comprehensible to patients?  

PubMed

With the development of electronic personal health records, more patients are gaining access to their own medical records. However, comprehension of medical record content remains difficult for many patients. Because each record is unique, it is also prohibitively costly to employ human translators to solve this problem. In this study, we investigated whether multilingual machine translation could help make medical record content more comprehensible to patients who lack proficiency in the language of the records. We used a popular general-purpose machine translation tool called Babel Fish to translate 213 medical record sentences from English into Spanish, Chinese, Russian and Korean. We evaluated the comprehensibility and accuracy of the translation. The text characteristics of the incorrectly translated sentences were also analyzed. In each language, the majority of the translations were incomprehensible (76% to 92%) and/or incorrect (77% to 89%). The main causes of the translation are vocabulary difficulty and syntactical complexity. A general-purpose machine translation tool like the Babel Fish is not adequate for the translation of medical records; however, a machine translation tool can potentially be improved significantly, if it is trained to target certain narrow domains in medicine. PMID:20841653

Zeng-Treitler, Qing; Kim, Hyeoneui; Rosemblat, Graciela; Keselman, Alla

2010-01-01

299

29 CFR 1910.1020 - Access to employee exposure and medical records.  

Code of Federal Regulations, 2013 CFR

...analysis need not be provided. (3) OSHA access. (i) Each employer shall...agency practice and procedure governing OSHA access to employee medical records are...in 29 CFR 1913.10. (ii) Whenever OSHA seeks access to personally...

2013-07-01

300

Method for developing national quality indicators based on manual data extraction from medical records  

PubMed Central

Developing quality indicators (QI) for national purposes (eg, public disclosure, paying-for-performance) highlights the need to find accessible and reliable data sources for collecting standardised data. The most accurate and reliable data source for collecting clinical and organisational information still remains the medical record. Data collection from electronic medical records (EMR) would be far less burdensome than from paper medical records (PMR). However, the development of EMRs is costly and has suffered from low rates of adoption and barriers of usability even in developed countries. Currently, methods for producing national QIs based on the medical record rely on manual extraction from PMRs. We propose and illustrate such a method. These QIs display feasibility, reliability and discriminative power, and can be used to compare hospitals. They have been implemented nationwide in France since 2006. The method used to develop these QIs could be adapted for use in large-scale programmes of hospital regulation in other, including developing, countries.

Couralet, Melanie; Leleu, Henri; Capuano, Frederic; Marcotte, Leah; Nitenberg, Gerard; Sicotte, Claude; Minvielle, Etienne

2013-01-01

301

Method for developing national quality indicators based on manual data extraction from medical records.  

PubMed

Developing quality indicators (QI) for national purposes (eg, public disclosure, paying-for-performance) highlights the need to find accessible and reliable data sources for collecting standardised data. The most accurate and reliable data source for collecting clinical and organisational information still remains the medical record. Data collection from electronic medical records (EMR) would be far less burdensome than from paper medical records (PMR). However, the development of EMRs is costly and has suffered from low rates of adoption and barriers of usability even in developed countries. Currently, methods for producing national QIs based on the medical record rely on manual extraction from PMRs. We propose and illustrate such a method. These QIs display feasibility, reliability and discriminative power, and can be used to compare hospitals. They have been implemented nationwide in France since 2006. The method used to develop these QIs could be adapted for use in large-scale programmes of hospital regulation in other, including developing, countries. PMID:23015098

Couralet, Melanie; Leleu, Henri; Capuano, Frederic; Marcotte, Leah; Nitenberg, Gérard; Sicotte, Claude; Minvielle, Etienne

2013-02-01

302

The iCabiNET System: Building Standard Medication Records from the Networked Home  

Microsoft Academic Search

\\u000a Electronic Health Records (EHR) are a crucial element towards the implantation of information technologies in healthcare.\\u000a One of the goals pursued with these artifacts is to prevent medicine misuse, for which EHR standards define fields to record\\u000a medical prescriptions and medication regimens. Unfortunately, the information stored in an EHR about how and when the patient\\u000a does take his\\/her medicines is

Martín López-Nores; Yolanda Blanco-Fernández; José J. Pazos-Arias; Jorge García-Duque

303

Effects of Scanning and Eliminating Paper-based Medical Records on Hospital Physicians' Clinical Work Practice  

Microsoft Academic Search

ObjectiveIt is not automatically given that the paper-based medical record can be eliminated after the introduction of an electronic medical record (EMR) in a hospital. Many keep and update the paper-based counterpart, and this limits the use of the EMR system. The authors have evaluated the physicians' clinical work practices and attitudes toward a system in a hospital that has

Hallvard Lærum; Tom H Karlsen; Arild Faxvaag

2003-01-01

304

Electronic Medical Records: A Review Comparing the Challenges in Developed and Developing Countries  

Microsoft Academic Search

Abstract , Studies on the,adaptation of Electronic Medical and,Personal Health Records ,in developing countries are scarce. There are sharp differences between,barriers ,to adaptation ,and implementation,in developing ,countries to that of developed,countries. This paper ,examines ,the challenges faced by developing ,countries toward the development, progression and sustainability of Electronic Medical ,Records. The paper ,also provides a review ,of implementation of ,varying

Sanjay P. Sood; Stacie N. Nwabueze; Victor Wacham A. Mbarika; Nupur Prakash; Samir Chatterjee; Pradeep Ray; Saroj Mishra

2008-01-01

305

[Information technology and medical record routines in hospitals in the health care region 2].  

PubMed

Structure, standard and efficient methods in paper medical records are important for a successful implementation of computerised medical records. We have conducted a survey among 26 somatic hospitals in a Norwegian region regarding present routines and use of information technology in patients records. The hospitals use six different patient administration systems, six laboratory, six radiology, and approximately 20 different specialist systems. 16 hospitals use three different electronic journal/documentation systems. Ten hospitals use the Word word processor for patient records. The full potential of word processing is not utilised. Digital dictation is seldom used; few hospitals have 24-hours service for documentation, and information technology is not used for documentation in nursing care. Four hospitals use microfilm. The survey shows that improvement is needed in order to achieve coordinated and effective use of information technology and manual routines in hospital medical records. PMID:10574055

Jacobsen, G M; Stangeland, N; Velund, T L; Blørstad, O

1999-10-20

306

[Quality of medical records in Naples (Italy) 2nd University School of Medicine].  

PubMed

To evaluate and improve the quality of medical-record keeping, in clinics and surgery departments. The evaluation involved 66 Operative Units (O.U.) of the "2nd University Hospital" in Naples (Italy). 10 medical records for each O.U. were randomly selected, for a total of 660. The quality was evaluated in all sections of medical records using the criteria of completeness, clarity and traceability of the data. The most critical issues are: unclear handwriting in almost all sections, in the whole scarse presence of a discharge letter (17.0%) in surgery (1.4%), almost total absence of the physicians signature in the clinical diary (2.3%). The completeness of medical records (presence of patient's history, physical examination, informed consent) is significantly higher in the surgery departments. The medical records are significantly righter in the clinic departments. In general, a poor quality of medical-record keeping was detected. This indicates the need to improve the quality by involving the staff in the importance of correct compilation. PMID:19014110

Agozzino, E; Esposito, S; Parmeggiani, C; Piro, A; Grippo, N; Di Palma, M A

2008-01-01

307

Organizational Learning and Large-Scale Change: Adoption of Electronic Medical Records  

ERIC Educational Resources Information Center

Despite implementation of electronic medical record (EMR) systems in the United States and other countries, there is no organizational development model that addresses medical professionals' attitudes toward technology adoption in a learning organization. The purpose of this study was to assess whether a model would change those attitudes toward…

Chavis, Virginia D.

2010-01-01

308

A Study to Delineate Roles and Functions of Medical Record Personnel: Final Report.  

ERIC Educational Resources Information Center

In order to be able to comply, and to be able to document their compliance, with federal legislation regarding health occupations education and discriminatory practices, the American Medical Record Association conducted a study to see if a data base could be built to validate proficiency tests for medical personnel. The report was prepared to…

American Medical Record Association, Chicago, IL.

309

Opportunities and Challenges in Integrating Electronic Health Records Into Undergraduate Medical Education: A National Survey of Clerkship Directors  

Microsoft Academic Search

Background: Few studies have reported on the utilization and the effect of electronic health records on the education of medical students. Purpose: The purpose of this study was to describe the current use of electronic health records by medical students in the United States and explore the opportunities and challenges of integrating electronic health records into daily teaching of medical

Maya M. Hammoud; Katherine Margo; Jennifer G. Christner; Jonathan Fisher; Shira H. Fischer; Louis N. Pangaro

2012-01-01

310

[Nature of animal husbandry in the community systems and the administrative and legal status of the veterinary medical services in agroindustrial complexes].  

PubMed

A characteristic is given of the public, private, and auxiliary system of animal breeding within the structure of the community systems. Important integrational links are stated to exist between these three categories of farms. On the base of the contractual system with private animal breeding a solid trend concerning the stock production seems to be established. In connection with the new character of animal husbandry the changes that have taken place in the territorial community structure and the implementation of the system of providing the supply of meat, milk, eggs, and fish of own resources have substantiated the necessity to stabilize the administrative and juridical statute of the veterinary service on the agro-industrial complexes with a view to guaranteeing the more effective veterinary service with all categories of farms. A suggestion is made to transfer the veterinary establishments from the agro-industrial complexes to the community systems, with responsibilities and rights of their own for the entire and dependable veterinary service in aid of the community systems. PMID:3992930

Kostadinov, I; Iliev, I

1985-01-01

311

Pragmatic strategies that enhance the reliability of data abstracted from medical records  

Microsoft Academic Search

The processes and procedures used to promote interrater reliability in the abstraction of data from medical records are described. Several proactive strategies that serve the purpose of leading to standard interpretations of clinical data are discussed. These include (a) establishment of priorities for the sources of information; (b) creation of orders of value for the likeliness of validity of recorded

Clara Eder; Judith Fullerton; Robert Benroth; Suzanne P. Lindsay

2005-01-01

312

The Barriers to Electronic Medical Record Systems and How to Overcome Them  

Microsoft Academic Search

Institutions all want electronic medical record (EMR) systems. They want them to solve their record movement problems, to improve the quality and coherence of the care process, to automate guidelines and care pathways to assist clinical research, outcomes management, and process improvement. EMRs are very difficult to construct because the existing electronic data sources, e.g., laboratory systems, pharmacy systems, and

CLEMENT J. MCDONALD

1997-01-01

313

Auditing Medical Records Accesses via Healthcare Interaction Networks  

PubMed Central

Healthcare organizations are deploying increasingly complex clinical information systems to support patient care. Traditional information security practices (e.g., role-based access control) are embedded in enterprise-level systems, but are insufficient to ensure patient privacy. This is due, in part, to the dynamic nature of healthcare, which makes it difficult to predict which care providers need access to what and when. In this paper, we show that modeling operations at a higher level of granularity (e.g., the departmental level) are stable in the context of a relational network, which may enable more effective auditing strategies. We study three months of access logs from a large academic medical center to illustrate that departmental interaction networks exhibit certain invariants, such as the number, strength, and reciprocity of relationships. We further show that the relations extracted from the network can be leveraged to assess the extent to which a patient’s care satisfies expected organizational behavior.

Chen, You; Nyemba, Steve; Malin, Bradley

2012-01-01

314

The urban underserved: Attitudes toward gaining full access to electronic medical records  

PubMed Central

Background As the use of electronic medical records (EMRs) spreads, health care organizations are increasingly offering patients online access to their medical records. Studies evaluating patient attitudes toward viewing elements of their records through secure, electronic patient portals have generally not included medically underserved patients or those with HIV/AIDS. The goal of this study was to gain insight into such patients’ attitudes toward online access to their medical records, including their doctors’ visit notes. Methods Qualitative study of four focus groups with adult patients in general adult medicine and HIV clinics at a large county hospital. Transcripts were analyzed for themes using an immersion/crystallization approach. Results Patients’ baseline understanding of the health record was limited. Perceived benefits of online access were improved patient understanding of health and disease, convenience, empowerment, and a stronger relationship with their provider. Concerns included threats to privacy, worries about being unable to understand their record, fear that the computer would replace direct provider contact, and hesitancy about potential demands on a provider’s time. Patients also recommended providing online visit reminders, links to credible health information, and assistance for paying bills. Conclusion Despite their initial lack of knowledge of the health record, focus group participants were overwhelmingly positive about the prospect of online access to medical records. However, they worried about potential loss of privacy and interference with the patient-provider relationship. As EMRs increasingly offer patients open access to their medical records, vulnerable patient groups will likely join others in desiring and adopting such change, but may need targeted support during times of transition.

Dhanireddy, Shireesha; Walker, Jan; Reisch, Lisa; Oster, Natalia; Delbanco, Thomas; Elmore, Joann

2012-01-01

315

The MOSORIOT medical record system (MMRS) phase I to phase II implementation: an outpatient computer-based medical record system in rural Kenya.  

PubMed

The authors of this paper describe the second phase of the implementation of the Mosoriot Medical Record System (MMRS) in a remote health care facility on the outskirts of Eldoret, Kenya, located in sub-Saharan Africa. We describe of the collaboration between Indiana University (IU) and the Moi University (MU), and the process that led to the development of the computer-based Mosoriot Medical Record System (MMRS) is provided. We then provide the conceptualization and initial implementation of this basic electronic medical record system. We also describe the different processes for assessing the MMRS' effects on health care, including time-motion studies and a strict implementation plan that is necessary for the successful implementation of the system. The MMRS project has many features that make it significant in the domain of CBPR systems. It may serve as a model for establishing similar, basic electronic record systems in the developed and developing world. In developing countries there are few (if any) projects that have attempted to implement such a system. This paper describes the planning, end-user education to new technologies, and time-motion studies necessary for the successful implementation of the MMRS. The system will be used to improve the quality of health data collection and subsequently patient care. It will also be used to link data from ongoing public health surveys and this can be used in public health research programs of the Moi University. PMID:11604811

Hannan, T J; Tierney, W M; Rotich, J K; Odero, W W; Smith, F; Mamlin, J J; Einterz, R M

2001-01-01

316

Architecture of portable electronic medical records system integrated with streaming media.  

PubMed

Due to increasing occurrence of accidents and illness during business trips, travel, or overseas studies, the requirement for portable EMR (Electronic Medical Records) has increased. This study proposes integrating streaming media technology into the EMR system to facilitate referrals, contracted laboratories, and disease notification among hospitals. The current study encoded static and dynamic medical images of patients into a streaming video format and stored them in a Flash Media Server (FMS). Based on the Taiwan Electronic Medical Record Template (TMT) standard, EMR records can be converted into XML documents and used to integrate description fields with embedded streaming videos. This investigation implemented a web-based portable EMR interchanging system using streaming media techniques to expedite exchanging medical image information among hospitals. The proposed architecture of the portable EMR retrieval system not only provides local hospital users the ability to acquire EMR text files from a previous hospital, but also helps access static and dynamic medical images as reference for clinical diagnosis and treatment. The proposed method protects property rights of medical images through information security mechanisms of the Medical Record Interchange Service Center and Health Certificate Authorization to facilitate proper, efficient, and continuous treatment of patients. PMID:20703752

Chen, Wei; Shih, Chien-Chou

2012-02-01

317

Method and system for determining precursors of health abnormalities from processing medical records  

DOEpatents

Medical reports are converted to document vectors in computing apparatus and sampled by applying a maximum variation sampling function including a fitness function to the document vectors to reduce a number of medical records being processed and to increase the diversity of the medical records being processed. Linguistic phrases are extracted from the medical records and converted to s-grams. A Haar wavelet function is applied to the s-grams over the preselected time interval; and the coefficient results of the Haar wavelet function are examined for patterns representing the likelihood of health abnormalities. This confirms certain s-grams as precursors of the health abnormality and a parameter can be calculated in relation to the occurrence of such a health abnormality.

Patton, Robert M; Potok, Thomas E; Beckerman, Barbara G

2013-06-25

318

Mini medical record application: annual register for flu shot vaccinations.  

PubMed

This application is an Intranet-based system. A database has been established utilizing patient information on the basis of age, medical diagnosis and employment history. If a health care provider or support staff states that a patient is over 65 years of age or has been diagnosed with a chronic disease and this limits the patient's ability to fight off infection, the need for preventive care is activated. In this situation the preventive care is the administration of an annual flu shot. For anyone over 65 years of age or with a chronic illness, a bulk mail of reminder cards with the dates of availability of injection is generated and mailed. All health care workers are notified at work of vaccination sites that they can use. In addition, should a patient have an appointment with a provider and a preventive flu injection is indicated, a reminder appears on the registration form. This reminder indicates a flu shot is needed as well as other preventive intervention. PMID:16050078

Hatcher, Myron; Heetebry, Irene; Tabriziani, Hossein

2005-06-01

319

Doctors' use of electronic medical records systems in hospitals: cross sectional survey  

PubMed Central

Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. Main outcome measures Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. Results Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. Conclusions Doctors used electronic medical records systems for far fewer tasks than the systems supported. What is already known on this topicElectronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been madeGiven the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasksWhat this study addsDoctors in Norwegian hospitals reported a low level of use of all electronic medical records systemsThe systems were mainly used for reading patient data, and doctors used the systems for less than half of the tasks for which the systems were functionalAnalyses of actual use of electronic medical records provide more information than user satisfaction or functionality of such records systems

Laerum, Hallvard; Ellingsen, Gunnar; Faxvaag, Arild

2001-01-01

320

Veterinary Clinical Trials  

MedlinePLUS

... coronoid processes Spinal cord injuries Acute disc herniations Testing pancreatic function Searchable Clinical Trials Database For Cancer In Pet Animals sponsored by the Veterinary Cooperative Oncology Group (VCOG) ...

321

Estimating vaccination coverage using parental recall, vaccination cards, and medical records.  

PubMed Central

OBJECTIVE: To compare estimates based on vaccination cards, parental recall, and medical records of the percentages of children up-to-date on vaccinations for diphtheria, tetanus, and pertussis; polio; and measles, mumps, and rubella. METHOD: The authors analyzed parent interview and medical records data from the Baltimore Immunization Study for 525 2-year-olds born from August 1988 through March 1989 to mothers living in low-income Census tracts of the city of Baltimore. RESULTS: Only one-third of children had vaccination cards; based on medical records, these children had higher up-to-date coverage at 24 months of age than did children without cards. For individual vaccines, only two-thirds of parents could provide information to calculate coverage rates; however, almost all provided enough information to estimate coverage for the primary series. For each vaccine and the series, parental recall estimates were at least 17 percentage points higher than estimates from medical records. For children without vaccination cards whose parents could not provide coverage information, up-to-date rates based on medical records were consistently lower than for children with cards or with parents who provided coverage information. CONCLUSIONS: Population-based vaccine coverage surveys that rely on vaccination cards or parental recall or both may overestimate vaccination coverage.

Bolton, P; Holt, E; Ross, A; Hughart, N; Guyer, B

1998-01-01

322

Intelligent technique for knowledge reuse of dental medical records based on case-based reasoning.  

PubMed

With the rapid development of both information technology and the management of modern medical regulation, the generation of medical records tends to be increasingly intelligent. In this paper, Case-Based Reasoning is applied to the process of generating records of dental cases. Based on the analysis of the features of dental records, a case base is constructed. A mixed case retrieval method (FAIES) is proposed for the knowledge reuse of dental records by adopting Fuzzy Mathematics, which improves similarity algorithm based on Euclidian-Lagrangian Distance, and PULL & PUSH weight adjustment strategy. Finally, an intelligent system of dental cases generation (CBR-DENT) is constructed. The effectiveness of the system, the efficiency of the retrieval method, the extent of adaptation and the adaptation efficiency are tested using the constructed case base. It is demonstrated that FAIES is very effective in terms of reducing the time of writing medical records and improving the efficiency and quality. FAIES is also proven to be an effective aid for diagnoses and provides a new idea for the management of medical records and its applications. PMID:20433059

Gu, Dong-Xiao; Liang, Chang-Yong; Li, Xing-Guo; Yang, Shan-Lin; Zhang, Pei

2010-04-01

323

Interobserver Agreement in the TOAST Classification of Stroke Based on Retrospective Medical Record Review  

PubMed Central

Background The reliability of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification system of stroke in siblings of stroke-affected probands has not been tested. Similarly, the reliability of using clinical medical records to classify ischemic stroke has not been assessed. The purpose of this study was to establish the interrater reliability of sibling stroke subtyping by applying the TOAST criteria to retrospectively obtained medical records. Methods Thirty medical records were randomly sampled from among the records of all siblings previously classified as stroke-affected by the Siblings With Ischemic Stroke Study (SWISS) Stroke Verification Committee (SVC). Blinded medical records for these individuals were sent to 6 physician reviewers who independently classified TOAST stroke subtype on the basis of record review. Results Using the ? statistic to assess interrater reliability, the overall reliability (standard error) for assigning a TOAST subtype of stroke was 0.54 (0.03). Pair-wise comparisons between the original SWISS SVC diagnoses and the diagnoses made by other reviewers exhibited moderate reliability (? range, 0.41–0.56). The ? statistics for common stroke subtypes were large vessel, 0.80 (0.06); cardioembolic, 0.80 (0.06); small vessel, 0.53 (0.06); and unknown cause, 0.40 (0.06). Conclusion We conclude that TOAST subtyping had moderate interrater reliability. Large-artery and cardioembolic subtype diagnoses seemed most reliable.

Meschia, James F.; Barrett, Kevin M.; Chukwudelunzu, Felix; Brown, W. Mark; Case, L. Douglas; Kissela, Brett M.; Brown, Robert D.; Brott, Thomas G.; Olson, Tammy S.; Rich, Stephen S.; Silliman, Scott; Worrall, Bradford B.

2007-01-01

324

Design and Implementation of Web-Based Mobile Electronic Medication Administration Record  

Microsoft Academic Search

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In\\u000a order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System\\u000a (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the\\u000a tasks are based

Sung-huai Hsieh; I-Ching Hou; Po-Hsun Cheng; Ching-Ting Tan; Po-Chao Shen; Kai-Ping Hsu; Sheau-Ling Hsieh; Feipei Lai

2010-01-01

325

A study on agent-based secure scheme for electronic medical record system.  

PubMed

Patient records, including doctors' diagnoses of diseases, trace of treatments and patients' conditions, nursing actions, and examination results from allied health profession departments, are the most important medical records of patients in medical systems. With patient records, medical staff can instantly understand the entire medical information of a patient so that, according to the patient's conditions, more accurate diagnoses and more appropriate in-depth treatments can be provided. Nevertheless, in such a modern society with booming information technologies, traditional paper-based patient records have faced a lot of problems, such as lack of uniform formats, low data mobility, slow data transfer, illegible handwritings, enormous and insufficient storage space, difficulty of conservation, being easily damaged, and low transferability. To improve such drawbacks, reduce medical costs, and advance medical quality, paper-based patient records are modified into electronic medical records and reformed into electronic patient records. However, since electronic patient records used in various hospitals are diverse and different, in consideration of cost, it is rather difficult to establish a compatible and complete integrated electronic patient records system to unify patient records from heterogeneous systems in hospitals. Moreover, as the booming of the Internet, it is no longer necessary to build an integrated system. Instead, doctors can instantly look up patients' complete information through the Internet access to electronic patient records as well as avoid the above difficulties. Nonetheless, the major problem of accessing to electronic patient records cross-hospital systems exists in the security of transmitting and accessing to the records in case of unauthorized medical personnels intercepting or stealing the information. This study applies the Mobile Agent scheme to cope with the problem. Since a Mobile Agent is a program, which can move among hosts and automatically disperse arithmetic processes, and moves from one host to another in heterogeneous network systems with the characteristics of autonomy and mobility, decreasing network traffic, reducing transfer lag, encapsulating protocol, availability on heterogeneous platforms, fault-tolerance, high flexibility, and personalization. However, since a Mobile Agent contacts and exchanges information with other hosts or agents on the Internet for rapid exchange and access to medical information, the security is threatened. In order to solve the problem, this study proposes a key management scheme based on Lagrange interpolation formulas and hierarchical management structure to make Mobile Agents a more secure and efficient access control scheme for electronic patient record systems when applied to the access of patients' personal electronic patient records cross hospitals. Meanwhile, with the comparison of security and efficacy analyses being the feasibility of validation scheme and the basis of better efficiency, the security of Mobile Agents in the process of operation can be guaranteed, key management efficacy can be advanced, and the security of the Mobile Agent system can be protected. PMID:20857325

Chen, Tzer-Long; Chung, Yu-Fang; Lin, Frank Y S

2012-06-01

326

[Design and implementation of a medical record management subsystem as a part of a telemedical system].  

PubMed

This paper introduces the work on the design and implementation of a medical record management subsystem, which is a part of a telemedicine system based on Microsoft .NET. First, an analysis is given on components and structure of medical record, together with an explanation for what is needed in a teleconsultation, how they should be organized and realized in a database, and how to deal with consultation data granularity using XML in combination with database; second, the work done during the realization stage is expatiated, including system analysis and design, database design, and system implementation. PMID:17039944

Ye, Zhi-qian; Tao, Xin-dong; Xu, Yan

2006-07-01

327

The Automatic Clinical Trial: Leveraging the Electronic Medical Record in Multi-site Cancer Clinical Trials  

PubMed Central

Submission of data into clinical trial electronic data capture (EDC) systems currently requires redundant entry of data that already exist in the electronic medical record (EMR). Being able to automatically transfer data from the EMR to the EDC would save many hours of arduous effort, especially for multi-site data-intensive oncology trials. Standardization of the way in which data is stored and retrieved in the medical record and techniques for mining data from the unstructured narrative will provide opportunities for transferring data from EMR to EDC. As different EMRs proliferate, other technology in the form of data mining or middle tier applications are certain to provide assistance in this effort.

Krueger, Judy; Crowley, John

2012-01-01

328

University of Arkansas for Medical Sciences electronic health record and medical informatics training for undergraduate health professionals*  

PubMed Central

The University of Arkansas for Medical Sciences (UAMS) is planning interprofessional training in electronic health records (EHRs) and medical informatics. Training will be integrated throughout the curricula and will include seminars on broad concepts supplemented with online modules, didactic lectures, and hands-on experiences. Training will prepare future health professionals to use EHRs, evidence-based medicine, medical decision support, and point-of-care tools to reduce errors, improve standards of care, address Health Insurance Portability and Accountability Act requirements and accreditation standards, and promote appropriate documentation to enable data retrieval for clinical research. UAMS will ensure that graduates are ready for the rapidly evolving practice environment created by the HITECH Act.

Hart, Jan K; Newton, Bruce W; Boone, Steven E

2010-01-01

329

Design and implementation of web-based mobile electronic medication administration record.  

PubMed

Patients' safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients' safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians' orders. In National Taiwan University Hospital (NTUH), the Electronic Health Record committee proposed a standard of order flows. There are objectives of the standard: first, to enhance medical procedures and enforce hospital policies; secondly, to improve the quality of medical care; third, to collect sufficient, adequate data for EHR in the near future. Among the proposed procedures, NTUH decides to establish a web-based mobile electronic medication administration record (ME-MAR) system. The system, build based on the service-oriented architecture (SOA) as well as embedded the HL7/XML standard, is installed in the Mobile Nursing Carts. It also implement accompany with the advanced techniques like Asynchronous JavaScript and XML (Ajax) or Web services to enhance the system usability. According to researches, it indicates that medication errors are highly proportion to total medical faults. Therefore, we expect the ME-MAR system can reduce medication errors. In addition, we evaluate ME-MAR can assist nurses or healthcare practitioners to administer, manage medication properly. This successful experience of developing the NTUH ME-MAR system can be easily applied to other related system. Meanwhile, the SOA architecture of the system can also be seamless integrated to NTUH or other HIS system. PMID:20703613

Hsieh, Sung-Huai; Hou, I-Ching; Cheng, Po-Hsun; Tan, Ching-Ting; Shen, Po-Chao; Hsu, Kai-Ping; Hsieh, Sheau-Ling; Lai, Feipei

2010-10-01

330

Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework  

Microsoft Academic Search

There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture,

Warren J Winkelman; Kevin J Leonard

2004-01-01

331

Combining Free Text and Structured Electronic Medical Record Entries to Detect Acute Respiratory Infections  

Microsoft Academic Search

BackgroundThe electronic medical record (EMR) contains a rich source of information that could be harnessed for epidemic surveillance. We asked if structured EMR data could be coupled with computerized processing of free-text clinical entries to enhance detection of acute respiratory infections (ARI).MethodologyA manual review of EMR records related to 15,377 outpatient visits uncovered 280 reference cases of ARI. We used

Sylvain DeLisle; Brett South; Jill A. Anthony; Ericka Kalp; Adi Gundlapallli; Frank C. Curriero; Greg E. Glass; Matthew Samore; Trish M. Perl

2010-01-01

332

Dual function seal: visualized digital signature for electronic medical record systems.  

PubMed

Digital signature is an important cryptography technology to be used to provide integrity and non-repudiation in electronic medical record systems (EMRS) and it is required by law. However, digital signatures normally appear in forms unrecognizable to medical staff, this may reduce the trust from medical staff that is used to the handwritten signatures or seals. Therefore, in this paper we propose a dual function seal to extend user trust from a traditional seal to a digital signature. The proposed dual function seal is a prototype that combines the traditional seal and digital seal. With this prototype, medical personnel are not just can put a seal on paper but also generate a visualized digital signature for electronic medical records. Medical Personnel can then look at the visualized digital signature and directly know which medical personnel generated it, just like with a traditional seal. Discrete wavelet transform (DWT) is used as an image processing method to generate a visualized digital signature, and the peak signal to noise ratio (PSNR) is calculated to verify that distortions of all converted images are beyond human recognition, and the results of our converted images are from 70 dB to 80 dB. The signature recoverability is also tested in this proposed paper to ensure that the visualized digital signature is verifiable. A simulated EMRS is implemented to show how the visualized digital signature can be integrity into EMRS. PMID:22048782

Yu, Yao-Chang; Hou, Ting-Wei; Chiang, Tzu-Chiang

2012-10-01

333

Evaluation of Unpreparedness When Issuing Copies of Medical Records in Tertiary Referral Hospitals  

PubMed Central

Objectives As a baseline study to aid in the development of proper policy, we investigated the current condition of unpreparedness of documents required when issuing copies of medical records and related factors. Methods The study was comprised of 7,203 cases in which copies of medical records were issued from July 1st, 2007 through June 30th, 2008 to 5 tertiary referral hospitals. Data from these hospitals was collected using their established electronic databases and included study variables such as unpreparedness of the required documents as a dependent variable and putative covariates. Results The rate of unpreparedness of required documents was 14.9%. Multiple logistic regression analysis revealed the following factors as being related to the high rate of unpreparedness: patient age (older patients had a higher rate), issuance channels (on admission > via out-patient clinic), type of applicant (others such as family members > for oneself > insurers), type of original medical record (utilization records on admission > other records), issuance purpose (for providing insurer > medical use), residential area of applicant (Seoul > Honam province and Jeju), and number of copied documents (more documents gave a lower rate). The rate of unpreparedness differed significantly among the hospitals; suggesting that they may have followed their own conventional protocols rather than legal procedures in some cases. Conclusions The study results showed that the level of compliance to the required legal procedure was high, but that problems occurred in assuring the safety of the medical information. A proper legislative approach is therefore required to balance the security of and access to medical information.

Moon, Myong-Mo; Seo, Sun-Won; Park, Woo-Sung; Kim, Yoon; Kim, Sung-Soo; Choi, Eun-Mi; Park, Jong; Park, Il-Soon

2010-01-01

334

"Concordance between comorbidity data from patient self-report interviews and medical record documentation"  

PubMed Central

Background Comorbidity is an important adjustment measure in research focusing on outcomes such as health status and mortality. One recurrent methodological issue concerns the concordance of comorbidity data obtained from different reporting sources. The purpose of these prospectively planned analyses was to examine the concordance of comorbidity data obtained from patient self-report survey interviews and hospital medical record documentation. Methods Comorbidity data were obtained using survey interviews and medical record entries from 525 hospitalized Acute Coronary Syndrome patients. Frequencies and descriptive statistics of individual and composite comorbidity data from both sources were completed. Individual item agreement was evaluated with simple and weighted kappas, Spearman Rho coefficients for composite scores. Results On average, patients reported more comorbidities during their patient survey interviews (mean = 1.78, SD = 1.99) than providers had documented in medical records (mean = 1.27, SD = 1.43). Higher proportions of positive responses were obtained from self-reports compared to medical records for all conditions except congestive heart failure and renal disease. Older age and higher depressive symptom levels were significantly associated with poorer levels of data concordance. Conclusion These results demonstrate that survey comorbidity data from ACS patients may not be entirely concordat with medical record documentation. In the absence of a gold standard, it is possible that hospital records did not include all pre-admission comorbidities and these patient survey interview methods may need to be refined. Self-report methods to facilitate some patients' complete recall of comorbid conditions may need to be refined by health services researchers. Trial Registration ClinicalTrials.gov NCT00416026.

Corser, William; Sikorskii, Alla; Olomu, Ade; Stommel, Manfred; Proden, Camille; Holmes-Rovner, Margaret

2008-01-01

335

How accurate are medical record data in Afghanistan's maternal health facilities? An observational validity study  

PubMed Central

Objectives Improvement activities, surveillance and research in maternal and neonatal health in Afghanistan rely heavily on medical record data. This study investigates accuracy in delivery care records from three hospitals across workshifts. Design Observational cross-sectional study. Setting The study was conducted in one maternity hospital, one general hospital maternity department and one provincial hospital maternity department. Researchers observed vaginal deliveries and recorded observations to later check against data recorded in patient medical records and facility registers. Outcome measures We determined the sensitivity, specificity, area under the receiver operator characteristics curves (AUROCs), proportions correctly classified and the tendency to make performance seem better than it actually was. Results 600 observations across the three shifts and three hospitals showed high compliance with active management of the third stage of labour, measuring blood loss and uterine contraction at 30?min, cord care, drying and wrapping newborns and Apgar scores and low compliance with monitoring vital signs. Compliance with quality indicators was high and specificity was lower than sensitivity. For adverse outcomes in birth registries, specificity was higher than sensitivity. Overall AUROCs were between 0.5 and 0.6. Of 17 variables that showed biased errors, 12 made performance or outcomes seem better than they were, and five made them look worse (71% vs 29%, p=0.143). Compliance, sensitivity and specificity varied less among the three shifts than among hospitals. Conclusions Medical record accuracy was generally poor. Errors by clinicians did not appear to follow a pattern of self-enhancement of performance. Because successful improvement activities, surveillance and research in these settings are heavily reliant on collecting accurate data on processes and outcomes of care, substantial improvement is needed in medical record accuracy.

Broughton, Edward I; Ikram, Abdul Naser; Sahak, Ihsanullah

2013-01-01

336

Nurses’ Views on Electronic Medical Records (EMR) in Turkey: An Analysis According to Use, Quality and User Satisfaction  

Microsoft Academic Search

Electronic medical records are generally used by nurses in hospitals. However, studies investigating views on and evaluations\\u000a of electronic medical records by nurses are limited in Turkey and in other countries around the world. Thus, in this study,\\u000a nurses’ views on electronic medical record systems will be investigated in terms of use, quality and user satisfaction. Our\\u000a goal was to

Mehmet Top; Ömer Gider

337

Potentially inappropriate medication prescribing in outpatient practices: Prevalence and patient characteristics based on electronic health records  

Microsoft Academic Search

Background: Some older adults receive potentially inappropriate medications (PIMs), increasing their risk for adverse events. A literature search did not find any US multicenter studies that measured the prevalence of PIMs in outpatient practices based on data from electronic health records (EHRs), using both the Beers and Zhan criteria.Objectives: The aims of the present study were to compare the prevalence

Michael D Buck; Ashish Atreja; Cherie P. Brunker; Anil Jain; Theodore T. Suh; Robert M. Palmer; David A. Dorr; C. Martin Harris; Adam B. Wilcox

2009-01-01

338

Are Persons Reporting "Near-Death Experiences" Really Near Death? A Study of Medical Records.  

ERIC Educational Resources Information Center

Examination of medical records from 40 patients who reported unusual experiences during an illness or injury revealed that only 18 patients were judged to have had serious, life-threatening conditions, while 33 believed they had been dead or near death. Findings suggest that an important precipitator of so-called near-death experience is belief…

Stevenson, Ian; And Others

1990-01-01

339

Automated extraction of clinical traits of multiple sclerosis in electronic medical records  

PubMed Central

Objectives The clinical course of multiple sclerosis (MS) is highly variable, and research data collection is costly and time consuming. We evaluated natural language processing techniques applied to electronic medical records (EMR) to identify MS patients and the key clinical traits of their disease course. Materials and methods We used four algorithms based on ICD-9 codes, text keywords, and medications to identify individuals with MS from a de-identified, research version of the EMR at Vanderbilt University. Using a training dataset of the records of 899 individuals, algorithms were constructed to identify and extract detailed information regarding the clinical course of MS from the text of the medical records, including clinical subtype, presence of oligoclonal bands, year of diagnosis, year and origin of first symptom, Expanded Disability Status Scale (EDSS) scores, timed 25-foot walk scores, and MS medications. Algorithms were evaluated on a test set validated by two independent reviewers. Results We identified 5789 individuals with MS. For all clinical traits extracted, precision was at least 87% and specificity was greater than 80%. Recall values for clinical subtype, EDSS scores, and timed 25-foot walk scores were greater than 80%. Discussion and conclusion This collection of clinical data represents one of the largest databases of detailed, clinical traits available for research on MS. This work demonstrates that detailed clinical information is recorded in the EMR and can be extracted for research purposes with high reliability.

Davis, Mary F; Sriram, Subramaniam; Bush, William S; Denny, Joshua C; Haines, Jonathan L

2013-01-01

340

Use of an Electronic Medical Record Improves the Quality of Urban Pediatric Primary Care  

Microsoft Academic Search

Objective. To evaluate the quality of pe- diatric primary care, including preventive services, be- fore and after the introduction of an electronic medical record (EMR) developed for use in an urban pediatric primary care center. Methods. A pre-postintervention analysis was used in the study. The intervention was a pediatric EMR. Routine health care maintenance visits for children <5 years old

William G. Adams; Adriana M. Mann; Howard Bauchner

2010-01-01

341

OSHA Final Rule Gives Employees the Right to See Their Exposure and Medical Records.  

ERIC Educational Resources Information Center

Provides details pertaining to the Occupational Safety and Health Administration (OSHA) ruling that gives employees, their designated representatives, and OSHA the right to examine their on-the-job medical records. Discusses the effects the ruling may have on organizations. (Author/MLF)

Hayes, Mary

1982-01-01

342

Partnering to Enhance the Nursing Curriculum: Electronic Medical Record Accessibility  

Microsoft Academic Search

The University of Saint Francis (USF) has partnered with Parkview Health System, an acute care facility, to integrate an electronic medical record (EMR) system into the undergraduate nursing curriculum at USF. Through an Internet connect account designed by Parkview Health, students and faculty have access to Parkview's EMR training system anywhere they have an Internet connection. Parkview Health has agreed

Lorie Lucas

2010-01-01

343

Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases  

Microsoft Academic Search

BACKGROUND: The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. METHODS: Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were

Ahmed I Fathelrahman

2009-01-01

344

Reliability of Birth Certificate Data: A Multi-Hospital Comparison to Medical Records Information  

Microsoft Academic Search

Objective: To examine the reliability of birth certificate data and determine if reliability differs between teaching and nonteaching hospitals. Methods: We compared information from birth certificates and medical records in 33,616 women admitted for labor and delivery in 1993–95 to 20 hospitals in Northeast Ohio. Analyses determined the agreement for 36 common data elements, and the sensitivity, specificity, and positive

David L. DiGiuseppe; David C. Aron; Lorin Ranbom; Dwain L. Harper; Gary E. Rosenthal

2002-01-01

345

Customization of electronic medical record templates to improve end-user satisfaction.  

PubMed

Since 2004, increasing importance has been placed on the adoption of electronic medical records by healthcare providers for documentation of patient care. Recent federal regulations have shifted the focus from adoption alone to meaningful use of an electronic medical record system. As proposed by the Technology Acceptance Model, the behavioral intention to use technology is determined by the person's attitude toward usage. The purpose of this quality improvement project was to devise and implement customized templates into an existent electronic medical record system in a single clinic and measure the satisfaction of the clinic providers with the system before and after implementation. Provider satisfaction with the electronic medical record system was evaluated prior to and following template implementation using the current version 7.0 of the Questionnaire for User Interaction Satisfaction tool. Provider comments and improvement in the Questionnaire for User Interaction Satisfaction levels of rankings following template implementation indicated a positive perspective by the providers in regard to the templates and customization of the system. PMID:23321480

Gardner, Carrie Lee; Pearce, Patricia F

2013-03-01

346

Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs  

Microsoft Academic Search

To broadly examine the potential health and financial benefits of health infor- mation technology (HIT), this paper compares health care with the use of IT in other indus- tries. It estimates potential savings and costs of widespread adoption of electronic medical record (EMR) systems, models important health and safety benefits, and concludes that ef- fective EMR implementation and networking could

Richard Hillestad; James Bigelow; Anthony Bower; Federico Girosi; Robin Meili; Richard Scoville; Roger Taylor

2005-01-01

347

A Comparison of the Charlson Comorbidity Index Derived from Medical Record Data and Administrative Billing Data  

Microsoft Academic Search

The objective of this article is to compare the Charlson comorbidity index derived from medical record data (Chart Index) with the same index derived from billing data (ICD-9 Index) to determine how well each predicted inpatient and 30-day mortality, length of stay, and complications among Medicare beneficiaries hospitalized for carotid endarterectomy. Economic and time constraints have increased the need for

Stephanie M. Kieszak; W. Dana Flanders; Andrzej S. Kosinski; Clanton C. Shipp; Herbert Karp

1999-01-01

348

Kaiser Permanente's experience of implementing an electronic medical record: a qualitative study  

Microsoft Academic Search

Objective To examine users' attitudes to implementation of an electronic medical record system in Kaiser Permanente Hawaii. Design Qualitative study based on semistructured interviews. Setting Four primary healthcare teams in four clinics, and four specialty departments in one hospital, on Oahu, Hawaii. Shortly before the interviews, Kaiser Permanente stopped implementation of the initial system in favour of a competing one.

J Tim Scott; Thomas G Rundall; Thomas M Vogt; John Hsu

2005-01-01

349

Incidence and types of preventable adverse events in elderly patients: population based review of medical records  

Microsoft Academic Search

Objective To determine the incidence and types of preventable adverse events in elderly patients. Design Review of random sample of medical records in two stage process by nurses and physicians to detect adverse events. Two study investigators then judged preventability. Setting Hospitals in US states of Utah and Colorado, excluding psychiatric and Veterans Administration hospitals. Subjects 15 000 hospitalised patients

Eric J Thomas; Troyen A Brennan

2000-01-01

350

Cardiomedia: a communicable multimedia medical record on Intranet and digital optical memory card  

Microsoft Academic Search

As part of French health reform, French physicians were computerised by the end of 1998. A specific Intranet network will be used to communicate medical data between the health professionals. The objectives of the Cardiomedia project were to develop and evaluate the feasibility of a coronary multimedia data record stored on an optical card and communicable on Intranet within the

D Delamarre; P Le Beux; M Bedossa; H LeBreton; A Baskurt; S Croci; M Decaix; J. C Pony

1999-01-01

351

Organizational Leader Sensemaking in Healthcare Process Changes: The Development of the Electronic Medical Records Expectation Questionnaire  

ERIC Educational Resources Information Center

Physicians play a unique role in the adoption of electronic medical records (EMR) within the healthcare organization. As leaders, they are responsible for setting the standards for this new technology within their sphere of influence while concurrently being required to learn and integrate EMR into their own workflow and process as the recipients…

Riesenmy, Kelly Rouse

2011-01-01

352

A Proposal for Electronic Medical Records in U.S. Primary Care  

PubMed Central

Delivery of excellent primary care—central to overall medical care—demands that providers have the necessary information when they give care. This paper, developed by the National Alliance for Primary Care Informatics, a collaborative group sponsored by a number of primary care societies, argues that providers’ and patients’ information and decision support needs can be satisfied only if primary care providers use electronic medical records (EMRs). Although robust EMRs are now available, only about 5% of U.S. primary care providers use them. Recently, with only modest investments, Australia, New Zealand, and England have achieved major breakthroughs in implementing EMRs in primary care. Substantial benefits realizable through routine use of electronic medical records include improved quality, safety, and efficiency, along with increased ability to conduct education and research. Nevertheless, barriers to adoption exist and must be overcome. Implementing specific policies can accelerate utilization of EMRs in the U.S.

Bates, David W.; Ebell, Mark; Gotlieb, Edward; Zapp, John; Mullins, H.C.

2003-01-01

353

The VA Hypertension Primary Care Longitudinal Cohort: Electronic medical records in the post-genomic era  

PubMed Central

The Veterans Affairs Hypertension Primary Care Longitudinal Cohort (VAHC) was initiated in 2003 as a pilot study designed to link the VA electronic medical record system with individual genetic data. Between June 2003 and December 2004, 1,527 hypertensive participants were recruited. Protected health information (PHI) was extracted from the regional VA data warehouse. Differences between the clinic and mail recruits suggested that clinic recruitment resulted in an over-sampling of African Americans. A review of medical records in a random sample of study participants confirmed that the data warehouse accurately captured most selected diagnoses. Genomic DNA was acquired non-invasively from buccal cells in mouthwash; ~ 96.5 per cent of samples contained DNA suitable for genotyping, with an average DNA yield of 5.02 ± 0.12 micrograms, enough for several thousand genotypes. The coupling of detailed medical databases with genetic information has the potential to facilitate the genetic study of hypertension and other complex diseases.

Salem, Rany M.; Pandey, Braj; Richard, Erin; Fung, Maple M.; Garcia, Erin P.; Brophy, Victoria H.; Schork, Nicholas J.; O'Connor, Daniel T.; Bhatnagar, Vibha

2011-01-01

354

Identification of Risk Drinking Women: T-ACE Screening Tool or the Medical Record  

PubMed Central

Abstract Background Risk drinking for women is defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as >7 drinks per week or >3 drinks per occasion. This study compares the T-ACE screening tool and the medical record for identification of risk drinking by 611 women receiving outpatient treatment for diabetes, hypertension, infertility, or osteoporosis in Boston, Massachusetts, between February 2005 and May 2009. Methods All subjects completed a diagnostic interview about their health habits, and medical records were abstracted. Calculations were weighted to reflect the oversampling of risk drinking women. Results T-ACE-positive women (n?=?419) had significantly more drinks per drinking day (2.1 vs. 1.6, p?medical records available, 46% acknowledged alcohol use, 25% denied use, and 29% were silent. The rates of abstinence among women were 2%, 17%, and 4%, respectively. Significantly more women were risk drinkers (63%) and had current alcohol use disorders (12%) when their medical records acknowledged alcohol use. Conclusions The main findings of this study are that neither the T-ACE nor the medical record was especially effective in identifying risk drinking by the women enrolled in the study. The identification of risky or heavy alcohol use in women, particularly if they have health problems exacerbated by alcohol, is desirable and represents an area of improvement for patients and providers alike.

Fisher, Naomi D.L.; Hornstein, Mark D.; Jones, Jennifer A.; Orav, E. John

2010-01-01

355

Veterinary Neurobiology Learning Objects  

NSDL National Science Digital Library

Provided by the University of Minnesota College of Veterinary Medicine, this page’s learning objects are available for veterinary students and faculty to enhance their understanding of animal neurobiology. Covering canine pain pathways, nociceptor response, and vestibular nerves, each individual Macromedia Flash file is available for use on the web or for download to the user’s desktop. The objects not only use interactive learning components, but also include specific, labeled diagrams of the anatomy being studied.

2007-01-05

356

Advance Data from Vital and Health Statistics, Number 393, October 26, 2007. Electronic Medical Record Use by Office-Based Physicians and Their Practices: United States, 2006.  

National Technical Information Service (NTIS)

This report presents the latest information on the use of electronic medical records in physician offices. Percentages of medical practices and physicians within the practices using electronic medical records (EMR) are presented for 2006 by selected physi...

C. W. Burt D. A. Woodwell E. S. Hing

2007-01-01

357

Knowledge and attitudes of nurses in community health centres about electronic medical records.  

PubMed

Background: Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT) can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation.Objectives: The aim of this study is to explore nurses' knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR) systems.Methods: A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs) in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis.Results: Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers.Conclusions: In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs.  PMID:24832678

O'Mahony, Don; Wright, Graham; Yogeswaran, Parimalarani; Govere, Frederick

2014-01-01

358

The Electronic Medical Record at the Medical University of South Carolina: Successful Integration of Multiple Commercial "Best of Breed" Systems  

PubMed Central

Over a 15 year period, MUSC has implemented an evolving set of commercially available “best of breed” clinical information systems throughout the enterprise. Successful systems integration efforts allow users to enter and retrieve information across a wide array of systems. Careful assessments of human impact and aggressive efforts to involve stakeholding users beginning early in systems design and implementation processes have been instrumental in securing widespread acceptance and effective use of new systems. The MUSC Electronic Medical Record (EMR) will be demonstrated, focusing particularly on its applications on the clinical “front lines.”

Afrin, Lawrence B.; Northrup, David J.; Daniels, Mark R.; Irving, Michael G.

1999-01-01

359

A retrospective cohort study on lifestyle habits of cardiovascular patients: how informative are medical records?  

PubMed Central

Background To evaluate the vigilance of medical specialists as to the lifestyle of their cardiovascular outpatients by comparing lifestyle screening as registered in medical records versus a lifestyle questionnaire (LSQ), a study was carried out at the cardiovascular outpatient clinic of the university hospital of Nijmegen, The Netherlands, between June 2004 and June 2005. Methods For 209 patients information from medical records on lifestyle habits, physician feedback, and interventions in the past year was compared to data gathered in the last month by a self-report LSQ. Results Doctors register smoking habits most consistently (90.4%), followed by alcohol use (81.8%), physical activity (50.2%), and eating habits (27.3%). Compared to the LSQ, smoking, unhealthy alcohol use, physical activity, and unhealthy eating habits are underreported in medical records by 31, 83, 54 and 97%, respectively. Feedback, advice or referral was documented in 8% for smoking, 3% for alcohol use, 12% for physical activity, and 26% for eating habits. Conclusion Lifestyle is insufficiently registered or recognized by doctors providing routine care in a cardiovascular outpatient setting. Of the unhealthy lifestyle habits that are registered, few are accompanied by notes on advice or intervention. A lifestyle questionnaire facilitates screening and interventions in target patients and should therefore be incorporated in the cardiovascular setting as a routine patient intake procedure.

Fouwels, Annemarie J; Bredie, Sebastiaan JH; Wollersheim, Hub; Schippers, Gerard M

2009-01-01

360

New advanced technologies to provide decentralised and secure access to medical records: case studies in oncology.  

PubMed

The main problem for health professionals and patients in accessing information is that this information is very often distributed over many medical records and locations. This problem is particularly acute in cancerology because patients may be treated for many years and undergo a variety of examinations. Recent advances in technology make it feasible to gain access to medical records anywhere and anytime, allowing the physician or the patient to gather information from an "ephemeral electronic patient record". However, this easy access to data is accompanied by the requirement for improved security (confidentiality, traceability, integrity, ...) and this issue needs to be addressed. In this paper we propose and discuss a decentralised approach based on recent advances in information sharing and protection: Grid technologies and watermarking methodologies. The potential impact of these technologies for oncology is illustrated by the examples of two experimental cases: a cancer surveillance network and a radiotherapy treatment plan. It is expected that the proposed approach will constitute the basis of a future secure "google-like" access to medical records. PMID:19718446

Quantin, Catherine; Coatrieux, Gouenou; Allaert, François André; Fassa, Maniane; Bourquard, Karima; Boire, Jean-Yves; de Vlieger, Paul; Maigne, Lydia; Breton, Vincent

2009-01-01

361

The Validity and Reliability of Characterizing Epilepsy Based on an External Review of Medical Records  

PubMed Central

OBJECTIVES Our goal is to validate diagnosing and characterizing epilepsy based on a medical record survey by external reviewers. METHODS We reviewed medical records from 80 patients who received antiepileptic drugs in 2009 at two hospitals. The study consisted of two steps; data abstraction by certified health record administrators and then verification by the investigators. The gold standard was the results of the survey performed by the epileptologists from their own hospital. RESULTS The specificity was more than 90.0% for diagnosis and activity, and for new-onset seizures. The sensitivity was 97.0% or more for diagnosis and activity and 66.7-75.0% for new-onset epilepsy. This method accurately classified epileptic syndromes in 90.2-92.9% of patients, causes in 85.4-92.7%, and age of onset in 78.0-81.0%. Kappa statistics for inter-rater reliability and test-retest reliability ranged from 0.641-0.975, which means substantial to near-perfect agreement in all items. CONCLUSIONS Our data suggest that epilepsy can be well identified by external review of medical records. This method may be useful as a basis for large-scale epidemiological research.

Kang, Bong Su; Cheong, Hae-Kwan; Jung, Ki-Young; Jang, Sang Hyeon; Yoo, Jae Kook; Kim, Dong Wook; Chung, Soo-Eun

2013-01-01

362

Improving the Effectiveness of Physiology Record Books as a Learning Tool for First-Year Medical Students in India  

ERIC Educational Resources Information Center

In compliance with the Medical Council of India, preclinical medical students maintain a record of their laboratory work in physiology. The physiology record books also contain a set of questions to be answered by the students. Faculty members and students had indicated that responding to these questions did not serve the intended purpose of being…

Vyas, Rashmi; Tharion, Elizabeth; Sathishkumar, Solomon

2009-01-01

363

Availability and accuracy of medical record information on language usage of cancer patients from a multi-ethnic population  

PubMed Central

Background Documentation of language usage in medical settings could be effective in identifying and addressing language barriers and would improve understanding of health disparities. Methods This study evaluated the availability and accuracy of medical records information on language for 1,664 cancer patients likely to have poor English proficiency. Accuracy was assessed by comparison to language obtained from interview-based research studies. Results For patients diagnosed at facilities where information on language was not abstracted electronically, 81.6% had language information in their medical records, most often in admissions documents. For all 37 hospitals, agreement between medical records and interview language was 79.3% overall and was greater for those speaking English than another language. Conclusions Language information is widely available in hospital medical records of cancer patients. However, for the data to be useful for research and reducing language barriers in medical care, the information must be collected in a consistent and accurate manner.

McClure, Laura A.; Glaser, Sally L.; Shema, Sarah J.; Allen, Laura; Quesenberry, Charles; John, Esther M.; Gomez, Scarlett L.

2009-01-01

364

Availability and accuracy of medical record information on language usage of cancer patients from a multi-ethnic population.  

PubMed

Documentation of language usage in medical settings could be effective in identifying and addressing language barriers and would improve understanding of health disparities. This study evaluated the availability and accuracy of medical records information on language for 1,664 cancer patients likely to have poor English proficiency. Accuracy was assessed by comparison to language obtained from interview-based research studies. For patients diagnosed at facilities where information on language was not abstracted electronically, 81.6% had language information in their medical records, most often in admissions documents. For all 37 hospitals, agreement between medical records and interview language was 79.3% overall and was greater for those speaking English than another language. Language information is widely available in hospital medical records of cancer patients. However, for the data to be useful for research and reducing language barriers in medical care, the information must be collected in a consistent and accurate manner. PMID:19685187

McClure, Laura A; Glaser, Sally L; Shema, Sarah J; Allen, Laura; Quesenberry, Charles; John, Esther M; Gomez, Scarlett L

2010-08-01

365

An analytical approach to characterize morbidity profile dissimilarity between distinct cohorts using electronic medical records  

PubMed Central

We describe a two-stage analytical approach for characterizing morbidity profile dissimilarity among patient cohorts using electronic medical records. We capture morbidities using the International Statistical Classification of Diseases and Related Health Problems (ICD-9) codes. In the first stage of the approach separate logistic regression analyses for ICD-9 sections (e.g., “hypertensive disease” or “appendicitis”) are conducted, and the odds ratios that describe adjusted differences in prevalence between two cohorts are displayed graphically. In the second stage, the results from ICD-9 section analyses are combined into a general morbidity dissimilarity index (MDI). For illustration, we examine nine cohorts of patients representing six phenotypes (or controls) derived from five institutions, each a participant in the electronic MEdical REcords and GEnomics (eMERGE) network. The phenotypes studied include type II diabetes and type II diabetes controls, peripheral arterial disease and peripheral arterial disease controls, normal cardiac conduction as measures by electrocardiography, and senile cataracts.

Schildcrout, Jonathan S.; Basford, Melissa; Pulley, Jill; Masys, Daniel R.; Roden, Dan M.; Wang, Deede; Chute, Christopher G.; Kullo, Iftikhar J.; Carrell, David; Peissig, Peggy; Kho, Abel; Denny, Joshua C.

2010-01-01

366

Integrating Clinical Practice and Public Health Surveillance Using Electronic Medical Record Systems  

PubMed Central

Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of public health interest, and automatically communicate results to health departments. We describe a model EMR-based public health surveillance platform called Electronic Medical Record Support for Public Health (ESP). The ESP platform provides live, automated surveillance for notifiable diseases, influenza-like illness, and diabetes prevalence, care, and complications. Results are automatically transmitted to state health departments.

McVetta, Jason; Lazarus, Ross; Eggleston, Emma; Haney, Gillian; Kruskal, Benjamin A.; Yih, W. Katherine; Daly, Patricia; Oppedisano, Paul; Beagan, Brianne; Lee, Michael; Kirby, Chaim; Heisey-Grove, Dawn; DeMaria, Alfred; Platt, Richard

2012-01-01

367

Image-based electronic patient records for secured collaborative medical applications.  

PubMed

We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of Digital Signature and Authentication are integrated to perform the security processing on the EPR data with integrity and authenticity. The privacy of EPR in data communication and exchanging is provided by SSL/TLS-based secure communication. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications. PMID:17282930

Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Yao, Yihong; Cai, Weihua; Jin, Jin; Zhang, Guozhen; Sun, Kun

2005-01-01

368

Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal.  

PubMed

Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal's national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in approximately 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications. PMID:24608117

Suh, Siri

2014-05-01

369

A study of general practitioners' perspectives on electronic medical records systems in NHSScotland  

PubMed Central

Background Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. Methods We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs’ perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees’ responses, using Normalisation Process Theory as the underpinning conceptual framework. Results The majority of GPs’ interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities – for example: in relation to usability, system navigation and information visualisation. Conclusion Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs’ interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors.

2013-01-01

370

Building National Electronic Medical Record Systems via the World Wide Web  

Microsoft Academic Search

Electronic medical record systems (EMRSs) currently do not lend themselves easily to cross-institutional clinical care and research. Unique system designs coupled with a lack of standards have led to this difficulty. The authors have designed a preliminary EMRS architecture (W3-EMRS) that exploits the multiplatform, multiprotocol, client-server technology of the World Wide Web. The architecture abstracts the clinical information model and

ISAAC S. KOHANE; Philip Greenspun; James Fackler; Christopher Cimino; Peter Szolovits

1996-01-01

371

Strategies to accelerate translation of research into primary care within practices using electronic medical records.  

PubMed

This research describes implementation strategies used by primary care practices using electronic medical records in a national quality improvement demonstration project, Accelerating Translation of Research into Practice, conducted within the Practice Partner Research Network. Qualitative methods enabled identification of strategies to improve 36 quality indicators. Quantitative survey results provide mean scores reflecting the integration of these strategies by practices. Nursing staff plays important roles to facilitate quality improvement within collaborative primary care practices. PMID:17873732

Nemeth, Lynne S; Wessell, Andrea M; Jenkins, Ruth G; Nietert, Paul J; Liszka, Heather A; Ornstein, Steven M

2007-01-01

372

Automated Medical Citation Records Creation for Web-Based On-Line Journals  

Microsoft Academic Search

With the rapid expansion and utilization of the Internet and Web technologies, there is an increasing number of on-line medical journals. On-line journals pose new challenges in the areas of automated document analysis and content extraction, database citation records creation, data mining, and other document related applications. New techniques are needed to capture, classify, analyze, extract, modify, and reformat Web-based

Daniel X. Le; Loc Q. Tran; Joseph Chow; Jongwoo Kim; Susan E. Hauser; Chan W. Moon; George R. Thoma

2001-01-01

373

[Computer as replacement for the current medical record? Introduction of a pilot project of the St. Gallen ophthalmology clinic].  

PubMed

Computerized data processing is more and more used in hospitals and medical offices. There are no doubts about the usefulness of a computer for administrative tasks. At our Dept. of Ophthalmology we started a pilot project to enter the medical records into the computer. The pros and cons of such an information system are discussed. Entering medical records into the computer did not prove to be definite advantage for the physician. PMID:1886389

Coester, C; Gruber, R M; Bischoff, P

1991-05-01

374

Does the Medical Record Cover the Symptoms Experienced by Cancer Patients Receiving Palliative Care? A Comparison of the Record and Patient Self-Rating  

Microsoft Academic Search

The aim of this study was to investigate the extent to which the symptoms experienced by advanced cancer patients were covered by the medical records. Fifty-eight patients participated in the study. On the day of first encounter with our palliative care department, a medical history was taken, and on this or the following day, the patients completed the EORTC Quality

Annette S Strömgren; Mogens Groenvold; Lise Pedersen; Alf K Olsen; Marianne Spile; Per Sjøgren

2001-01-01

375

Medical record information disclosure laws and policies among selected countries; a comparative study  

PubMed Central

BACKGROUND: Hospitals have responsibility for responding to legitimate demands for release of health information while protecting the confidentiality of the patient health records. There have always been challenges concerning medical records confidentiality and their disclosure and release type in medical record departments. This study investigated and compared laws and policies of disclosure of health information in Iran and selected countries and tried to identify the differences and the similarities between them. METHODS: This is a descriptive and comparative study. The scope of study included related laws and policies of disclosure of health information in selected countries such as United States, Australia, England, Malaysia and Iran. Data were gathered from systematic internet search, library resources and communication with health information professionals. Data analysis was done using comparative tables and qualitative method. RESULTS: Study results showed that legislative institutions of each country have ordained laws and policies concerning disclosure and release of health information and in turn hospitals developed policies and procedures based on these laws. In Iran, however, there are few laws and policies concerning disclosure of health information in the form of formal letters and bylaws. There are no specific written policies and procedures for disclosure of health information in the hospitals. CONCLUSIONS: It is necessary to develop legitimate and appropriate laws and policies in different levels for information utilization by hospitals, medical universities and others. Meanwhile in all of the selected countries there are ordained limitations for release of health information for protecting health information in regard to patient rights.

Yarmohammadian, Mohammad Hossein; Raeisi, Ahmad Reza; Tavakoli, Nahid; Nansa, Leila Ghaderi

2010-01-01

376

The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future.  

PubMed

The Electronic Medical Records and Genomics Network is a National Human Genome Research Institute-funded consortium engaged in the development of methods and best practices for using the electronic medical record as a tool for genomic research. Now in its sixth year and second funding cycle, and comprising nine research groups and a coordinating center, the network has played a major role in validating the concept that clinical data derived from electronic medical records can be used successfully for genomic research. Current work is advancing knowledge in multiple disciplines at the intersection of genomics and health-care informatics, particularly for electronic phenotyping, genome-wide association studies, genomic medicine implementation, and the ethical and regulatory issues associated with genomics research and returning results to study participants. Here, we describe the evolution, accomplishments, opportunities, and challenges of the network from its inception as a five-group consortium focused on genotype-phenotype associations for genomic discovery to its current form as a nine-group consortium pivoting toward the implementation of genomic medicine. PMID:23743551

Gottesman, Omri; Kuivaniemi, Helena; Tromp, Gerard; Faucett, W Andrew; Li, Rongling; Manolio, Teri A; Sanderson, Saskia C; Kannry, Joseph; Zinberg, Randi; Basford, Melissa A; Brilliant, Murray; Carey, David J; Chisholm, Rex L; Chute, Christopher G; Connolly, John J; Crosslin, David; Denny, Joshua C; Gallego, Carlos J; Haines, Jonathan L; Hakonarson, Hakon; Harley, John; Jarvik, Gail P; Kohane, Isaac; Kullo, Iftikhar J; Larson, Eric B; McCarty, Catherine; Ritchie, Marylyn D; Roden, Dan M; Smith, Maureen E; Böttinger, Erwin P; Williams, Marc S

2013-10-01

377

Patients' satisfaction with primary heath care in kuwait after electronic medical record implementation.  

PubMed

This study aimed at assessing the level of patients' satisfaction with primary heath care services after implementation of the electronic medical record system (EMR). Also, to explore the relationship of some participants' characteristics with satisfaction which are of importance in planning, managing and evaluation. A descriptive cross-sectional approach was adopted. Ten primary health care centers (out of total 78) related to the five health regions in Kuwait were randomly selected. A random sample of 200 people (at age of 18 years and above) attending the two-shift periods of the chosen centers were included. Through an exit interview, a well trained investigator interviewed them about their satisfaction with the primary heath care services provided after implementation of electronic medical record system. A structured questionnaire for measuring satisfaction was used. The response rate was 93.02% of whom 47.5% were males and 52.5% were females. The mean overall satisfaction percent score as reported by subjects was 85.6% (SD 4.9). There were statistically significant associations between mean percent satisfaction score of the participants and their age, level of education visiting the center at morning shift, and waiting less than 10 minutes before the examination. The vast majority of participants indicated that overall service at the center had greatly improved after EMR implementation. The system also helped in improvement of the physician performance, arrangement of patient's turn, dispense medication from pharmacy, written guidance of medication, accuracy and easiness of follow up for health status, time spent to retrieve medical record and that for receiving medication. However, it didn't achieve much improvement in physician selection or waiting time. The majority of interviewees (96.5%) were totally satisfied with the overall quality of service at the center, location of the center (96.5%), hours when the center is open (96.5%), thoroughness of examination and accuracy of diagnosis (97.0%), advices to avoid illness (96.0%) and outcome of medical care (97.0%). However, the lowest items of satisfaction were those related to explanation of medical procedures and tests (46.5%) and ease of seeing physician of choice (61.0%). Almost 62.0% of the interviewed persons expressed their satisfaction with overall PHC service provided after EMR implementation. The leading two items of dissatisfaction that showed by the majority of dissatisfied participants were non-compliance of physician with good practice in prescription writing (75.0%) and inability to see the same physician in every visit (72.4%). The results showed that although the overall satisfaction was relatively high, certain aspects of the service showed some degree of dissatisfaction. This study demonstrated patient acceptance and support for the electronic medical record system at the primary care setting. These findings should encourage physicians to promote the use of electronic medical record system. PMID:18706302

Al-Azmi, Saadoun F; Mohammed, Aida M; Hanafi, Manal I

2006-01-01

378

Estimating the information gap between emergency department records of community medication compared to on-line access to the community-based pharmacy records  

PubMed Central

Objective Errors in community medication histories increase the risk of adverse events. The objectives of this study were to estimate the extent to which access to community-based pharmacy records provided more information about prescription drug use than conventional medication histories. Materials and methods A prospective cohort of patients with public drug insurance who visited the emergency departments (ED) in two teaching hospitals in Montreal, Quebec was recruited. Drug lists recorded in the patients’ ED charts were compared with pharmacy records of dispensed medications retrieved from the public drug insurer. Patient and drug-related predictors of discrepancies were estimated using general estimating equation multivariate logistic regression. Results 613 patients participated in the study (mean age 63.1?years, 59.2% women). Pharmacy records identified 41.5% more prescribed medications than were noted in the ED chart. Concordance was highest for anticoagulants, cardiovascular drugs and diuretics. Omissions in the ED chart were more common for drugs that may be taken episodically. Patients with more than 12 medications (OR 2.92, 95% CI 1.71 to 4.97) and more than one pharmacy (OR 3.85, 95% CI 1.80 to 6.59) were more likely to have omissions in the ED chart. Discussion The development of health information exchanges could improve the efficiency and accuracy of information about community medication histories if they enable automated access to dispensed medication records from community pharmacies, particularly for the most vulnerable populations with multiple morbidities. Conclusions Pharmacy records identified a substantial number of medications that were not in the ED chart. There is potential for greater safety and efficiency with automated access to pharmacy records.

Tamblyn, Robyn; Poissant, Lise; Huang, Allen; Winslade, Nancy; Rochefort, Christian M; Moraga, Teresa; Doran, Pamela

2014-01-01

379

Evaluating the state of the art in coreference resolution for electronic medical records  

PubMed Central

Background The fifth i2b2/VA Workshop on Natural Language Processing Challenges for Clinical Records conducted a systematic review on resolution of noun phrase coreference in medical records. Informatics for Integrating Biology and the Bedside (i2b2) and the Veterans Affair (VA) Consortium for Healthcare Informatics Research (CHIR) partnered to organize the coreference challenge. They provided the research community with two corpora of medical records for the development and evaluation of the coreference resolution systems. These corpora contained various record types (ie, discharge summaries, pathology reports) from multiple institutions. Methods The coreference challenge provided the community with two annotated ground truth corpora and evaluated systems on coreference resolution in two ways: first, it evaluated systems for their ability to identify mentions of concepts and to link together those mentions. Second, it evaluated the ability of the systems to link together ground truth mentions that refer to the same entity. Twenty teams representing 29 organizations and nine countries participated in the coreference challenge. Results The teams' system submissions showed that machine-learning and rule-based approaches worked best when augmented with external knowledge sources and coreference clues extracted from document structure. The systems performed better in coreference resolution when provided with ground truth mentions. Overall, the systems struggled in solving coreference resolution for cases that required domain knowledge.

Bodnari, Andreea; Shen, Shuying; Forbush, Tyler; Pestian, John; South, Brett R

2012-01-01

380

ACCURACY OF BLOOD PRESSURE MEASUREMENTS REPORTED IN AN ELECTRONIC MEDICAL RECORD DURING ROUTINE PRIMARY CARE VISITS  

PubMed Central

Electronic medical records (EMRS) allow for real time access to blood pressure information on a population basis and improved identification and treatment of individuals with hypertension. Despite the potential uses of the data available from EMRs relatively little research has examined the reliability of this data. To address this gap, we examined the reliability of blood pressure taken at primary care visits and recorded in an electronic medical record with those taken at a research study visit at which standard protocols were used to measure blood pressure among all adults as well as by gender and age. Systolic blood pressure (BP) averaged 3.7 (17.3) points and diastolic BP was 2.8 (10.6) points lower in the EMR than in the study visit across age and gender groups with all differences statistically significant. For this cohort of patients with a diagnosis of hypertension there was moderate correlation between BP measurements taken in clinic and at research. However BP control for individuals, as defined by a BP of less the 140 mm Hg systolic and 90 mm Hg diastolic, differed by almost 25%. Known variability of BP and clinic procedures for measuring and recording BP may account for these differences.

Fishman, Paul A; Anderson, Melissa L.; Cook, Andrea J.; Ralston, James D.; Catz, Sheryl L.; Carlson, Jim; Larson, Eric B.; Green, Beverly B.

2011-01-01

381

Intelligent querying and exploration of multiple time-oriented medical records.  

PubMed

Querying and analyzing multiple time-oriented patient data is a key task during medical research, clinical trials or the assessment of the quality of therapy. In this paper, we present several aspects of the VISITORS system, which includes knowledge-based tools for graphical querying and exploration of multiple longitudinal patient records. We focus on the syntax and semantics of the knowledge-based aggregation query language for multiple time-oriented patient records, and on the graphical query-construction interface. The query language assumes an underlying computational method for deriving meaningful abstractions from single and multiple patient records, such as we had previously developed. The aggregation query language enables population querying using an expressive set of constraints. By using our underlying temporal mediator architecture, the time needed to answer typical temporal-abstraction aggregation queries on databases of 1000 to 10,000 patients was reasonable. PMID:17911927

Klimov, Denis; Shahar, Yuval

2007-01-01

382

FDA regulation of invasive neural recording electrodes: a daunting task for medical innovators.  

PubMed

The U.S. Food and Drug Administration (FDA) is charged with assuring the safety and effectiveness of medical devices. Before any medical device can be brought to market, it must comply with all federal regulations regarding FDA processes for clearance or approval. Navigating the FDA regulatory process may seem like a daunting task to the innovator of a novel medical device who has little experience with the FDA regulatory process or device commercialization. This review introduces the basics of the FDA regulatory premarket process, with a focus on issues relating to chronically implanted recording devices in the central or peripheral nervous system. Topics of device classification and regulatory pathways, the use of standards and guidance documents, and optimal time lines for interaction with the FDA are discussed. Additionally, this article summarizes the regulatory research on neural implant safety and reliability conducted by the FDA's Office of Science and Engineering Laboratories (OSEL) in collaboration with Defense Advanced Research Projects Agency (DARPA) Reliable Neural Technology (RE-NET) Program. For a more detailed explanation of the medical device regulatory process, please refer to several excellent reviews of the FDA's regulatory pathways for medical devices [1]-[4]. PMID:22481744

Welle, Cristin; Krauthamer, Victor

2012-03-01

383

Experiences sharing of implementing Template-based Electronic Medical Record System (TEMRS) in a Hong Kong medical organization.  

PubMed

This paper aims to investigate the efficacy and feasibility of Template-based Electronic Medical Record System (TEMRS) and factors for its successful implementation. A TEMRS was designed and implemented in one core clinic of a Hong Kong professional multi-disciplinary medical services provider with four core clinics located in different parts of Hong Kong. Eight doctors participated in the study. Surveys and interviews were conducted to acquire the users' feedback and satisfaction level. The design, development, and the factors related to the success of the implementation of TEMRS were analyzed. In the study period, 3,032 cases were collected. The most encountered diagnosis were upper respiratory tract infection (50.59%), gastroenteritis (10.19%), dermatitis (5.87%), dyspepsia (5.28%) and rhinitis (4.82%). The system gained an overall satisfaction by the users and the most satisfied areas were rapid retrieving the necessary information of patient (75%) and fasten the diagnostic selection (75%). TEMRS is an enabling system which can reduce the user resistance in new technology with its flexibility. The consideration of cost, security, human, technical, data migration and standardization issues are essential in the implementation of the TEMRS and further research should be conducted to expand the TEMRS's implementation in health care system. PMID:20703758

Ting, S L; Kwok, S K; Tsang, Albert H C; Lee, W B; Yee, K F

2011-12-01

384

A framework for intelligent visualization of multiple time-oriented medical records.  

PubMed

Management of patients, especially chronic patients, requires presentation and processing of very large amounts of time-oriented clinical data. Using regular means such as text or tables is often ineffective, thus we propose to use the visual presentation of the information in decision support, especially in the medical domain. Displaying only raw data is not sufficient, because it still requires the user to derive meaningful conclusions from large amount of data. In order to support the computation process, we provide automated mechanisms for temporal abstraction. These mechanisms perform derivation of context-specific, interval-based abstract concepts from raw time-stamped clinical data, by using a domain-specific knowledge base. Then, these abstractions can be visualized and explored. In addition, in many cases (e.g. when comparing the effect of new drugs on various groups of patients) a view of multiple records is more effective than a view of each indi-vidual record separately. We have designed and implemented a system called VISITORS (VisualizatIon of Time-Oriented RecordS) which includes several tools for intelligent visualization and exploration of raw data and abstracted concepts for multiple patient records. PMID:16779071

Klimov, Denis; Shahar, Yuval

2005-01-01

385

Evaluation of Electronic Medical Record (EMR) at Large Urban Primary Care Sexual Health Centre  

PubMed Central

Objective Despite substantial investment in Electronic Medical Record (EMR) systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. Methods We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. Results There were 9,752 doctor consultations (in 5,512 consulting hours) in the Paper Medical Record (PMR) period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio?=?1.05; 95% confidence interval, 1.02, 1.08) after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17). A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01) and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P?=?0.61). Conclusion The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided.

Huffam, Sarah; Cummings, Rosey; Chen, Marcus Y.; Sze, Jun K.; Fehler, Glenda; Bradshaw, Catriona S.; Schmidt, Tina; Berzins, Karen; Hocking, Jane S.

2013-01-01

386

Veterinary Assistant, Teachers Copy.  

ERIC Educational Resources Information Center

This study guide was developed for use by male and female vocational agriculture cooperative education students, 16 to 20 years old, preparing to become veterinary assistants. It was designed by subject-matter specialists on the basis of state advisory committee recommendations and refined after being tested in operational programs. Units, to be…

Texas A and M Univ., College Station.

387

50 Years: Veterinary Medicine.  

ERIC Educational Resources Information Center

Describes the history, research, teaching strategies, and specialties of the University of California at Davis School of Veterinary Medicine. Documents effects of changing societal attitudes toward wildlife, pets, working animals, and food animals on curriculum, the systems approach to disease, comparative genetics, biotechnology, the ecology of…

Narlesky, Lynn

1998-01-01

388

Web tools for effective retrieval, visualization, and evaluation of cardiology medical images and records  

NASA Astrophysics Data System (ADS)

To provide easy retrieval, integration and evaluation of multimodal cardiology images and data in a web browser environment, distributed application technologies and java programming were used to implement a client-server architecture based on software agents. The server side manages secure connections and queries to heterogeneous remote databases and file systems containing patient personal and clinical data. The client side is a Java applet running in a web browser and providing a friendly medical user interface to perform queries on patient and medical test dat and integrate and visualize properly the various query results. A set of tools based on Java Advanced Imaging API enables to process and analyze the retrieved cardiology images, and quantify their features in different regions of interest. The platform-independence Java technology makes the developed prototype easy to be managed in a centralized form and provided in each site where an intranet or internet connection can be located. Giving the healthcare providers effective tools for querying, visualizing and evaluating comprehensively cardiology medical images and records in all locations where they can need them- i.e. emergency, operating theaters, ward, or even outpatient clinics- the developed prototype represents an important aid in providing more efficient diagnoses and medical treatments.

Masseroli, Marco; Pinciroli, Francesco

2000-12-01

389

Identification of global data and partitioning scheme for modeling biological data within the electronic medical record.  

PubMed Central

Using "Black Box" theory we analyzed human physiology. The major physiological means of communication are the vascular and nervous systems. The fundamental partitions of physiology are the vascular capillary fields and efferent and afferent fields of the nervous system. These fields are generally associated with organs and organ systems. Such analysis leads to the conclusion that the global biological data are information carried within the vascular and nervous systems. Data elements and processes within organs are important to other organs only through their effects on these global elements. Incorporation of these concepts into medical databases would allow the partitioning of the software around physiological systems. As a result of partitioning the utility of the electronic medical record, software could be greatly expanded.

Doller, H.; Peterson, L. L.

2000-01-01

390

Using a medical simulation center as an electronic health record usability laboratory.  

PubMed

Usability testing is increasingly being recognized as a way to increase the usability and safety of health information technology (HIT). Medical simulation centers can serve as testing environments for HIT usability studies. We integrated the quality assurance version of our emergency department (ED) electronic health record (EHR) into our medical simulation center and piloted a clinical care scenario in which emergency medicine resident physicians evaluated a simulated ED patient and documented electronically using the ED EHR. Meticulous planning and close collaboration with expert simulation staff was important for designing test scenarios, pilot testing, and running the sessions. Similarly, working with information systems teams was important for integration of the EHR. Electronic tools are needed to facilitate entry of fictitious clinical results while the simulation scenario is unfolding. EHRs can be successfully integrated into existing simulation centers, which may provide realistic environments for usability testing, training, and evaluation of human-computer interactions. PMID:24249778

Landman, Adam B; Redden, Lisa; Neri, Pamela; Poole, Stephen; Horsky, Jan; Raja, Ali S; Pozner, Charles N; Schiff, Gordon; Poon, Eric G

2014-01-01

391

Electronic medical record features and seven quality of care measures in physician offices.  

PubMed

The effect of electronic medical records (EMRs) on quality of care in physicians' offices is uncertain. This study used the 2008-2009 National Ambulatory Medical Care Survey to examine the relationship between EMRs features and quality in physician offices. The relationship between selected EMRs features and 7 quality measures was evaluated by testing 25 associations in multivariate models. Significant relationships include reminders for guideline-based interventions or screening tests associated with lower odds of inappropriate urinalysis and prescription of antibiotics for upper respiratory infection (URI), prescription order entry associated with lower odds of prescription of antibiotics for URI, and patient problem list associated with higher odds of inappropriate prescribing for elderly patients. EMRs system level was associated with lower odds of blood pressure check, inappropriate urinalysis, and prescription of antibiotics for URI compared with no EMRs. The results show both positive and inverse relationships between EMRs features and quality of care. PMID:23610232

Hsiao, Chun-Ju; Marsteller, Jill A; Simon, Alan E

2014-01-01

392

Detecting earlier indicators of homelessness in the free text of medical records.  

PubMed

Early warning indicators to identify US Veterans at risk of homelessness are currently only inferred from administrative data. References to indicators of risk or instances of homelessness in the free text of medical notes written by Department of Veterans Affairs (VA) providers may precede formal identification of Veterans as being homeless. This represents a potentially untapped resource for early identification. Using natural language processing (NLP), we investigated the idea that concepts related to homelessness written in the free text of the medical record precede the identification of homelessness by administrative data. We found that homeless Veterans were much higher utilizers of VA resources producing approximately 12 times as many documents as non-homeless Veterans. NLP detected mentions of either direct or indirect evidence of homelessness in a significant portion of Veterans earlier than structured data. PMID:25000039

Redd, Andrew; Carter, Marjorie; Divita, Guy; Shen, Shuying; Palmer, Miland; Samore, Matthew; Gundlapalli, Adi V

2014-01-01

393

The "epic" challenge of optimizing antimicrobial stewardship: the role of electronic medical records and technology.  

PubMed

Antimicrobial stewardship programs (ASPs) are established means for institutions to improve patient outcomes while reducing the emergence of resistant bacteria. With the increased adoption and evolution of electronic medical records (EMRs), there is a need to assimilate the tools of ASPs into EMRs, using decision support and feedback. Third-party software vendors provide the mainstay for integration of individual institutional EMR and ASP efforts. Epic is the leading implementer of EMR technology in the United States. A collaboration of physicians and pharmacists are working closely with Epic to provide a more comprehensive platform of ASP tools that may be institutionally individualized. We review the historical relationship between ASPs and the EMR, cite examples of Epic stewardship tools from 3 academic medical centers' ASPs, discuss limitations of these Epic tools, and conclude with the current process in evolution to integrate ASP tools and decision support capacities directly into Epic's EMR. PMID:23667260

Kullar, Ravina; Goff, Debra A; Schulz, Lucas T; Fox, Barry C; Rose, Warren E

2013-10-01

394

Derivation and Validation of Automated Electronic Search Strategies to Extract Charlson Comorbidities From Electronic Medical Records  

PubMed Central

Objective To develop and validate automated electronic note search strategies (automated digital algorithm) to identify Charlson comorbidities. Patients and Methods The automated digital algorithm was built by a series of programmatic queries applied to an institutional electronic medical record database. The automated digital algorithm was derived from secondary analysis of an observational cohort study of 1447 patients admitted to the intensive care unit from January 1 through December 31, 2006, and validated in an independent cohort of 240 patients. The sensitivity, specificity, and positive and negative predictive values of the automated digital algorithm and International Classification of Diseases, Ninth Revision (ICD-9) codes were compared with comprehensive medical record review (reference standard) for the Charlson comorbidities. Results In the derivation cohort, the automated digital algorithm achieved a median sensitivity of 100% (range, 99%-100%) and a median specificity of 99.7% (range, 99%-100%). In the validation cohort, the sensitivity of the automated digital algorithm ranged from 91% to 100%, and the specificity ranged from 98% to 100%. The sensitivity of the ICD-9 codes ranged from 8% for dementia to 100% for leukemia, whereas specificity ranged from 86% for congestive heart failure to 100% for leukemia, dementia, and AIDS. Conclusion Our results suggest that search strategies that use automated electronic search strategies to extract Charlson comorbidities from the clinical notes contained within the electronic medical record are feasible and reliable. Automated digital algorithm outperformed ICD-9 codes in all the Charlson variables except leukemia, with greater sensitivity, specificity, and positive and negative predictive values.

Singh, Balwinder; Singh, Amandeep; Ahmed, Adil; Wilson, Gregory A.; Pickering, Brian W.; Herasevich, Vitaly; Gajic, Ognjen; Li, Guangxi

2012-01-01

395

Discovering medical conditions associated with periodontitis using linked electronic health records  

PubMed Central

Aim To use linked electronic medical and dental records to discover associations between periodontitis and medical conditions independent of a priori hypotheses. Materials and Methods This case-control study included 2475 patients who underwent dental treatment at the College of Dental Medicine at Columbia University and medical treatment at NewYork-Presbyterian Hospital. Our cases are patients who received periodontal treatment and our controls are patients who received dental maintenance but no periodontal treatment. Chi-square analysis was performed for medical treatment codes and logistic regression was used to adjust for confounders. Results Our method replicated several important periodontitis associations in a largely Hispanic population, including diabetes mellitus type I (OR = 1.6, 95% CI 1.30–1.99, p < 0.001) and type II (OR = 1.4, 95% CI 1.22–1.67, p < 0.001), hypertension (OR = 1.2, 95% CI 1.10–1.37, p < 0.001), hypercholesterolaemia (OR = 1.2, 95% CI 1.07–1.38, p = 0.004), hyperlipidaemia (OR = 1.2, 95% CI 1.06–1.43, p = 0.008) and conditions pertaining to pregnancy and childbirth (OR = 2.9, 95% CI: 1.32–7.21, p = 0.014). We also found a previously unreported association with benign prostatic hyperplasia (OR = 1.5, 95% CI 1.05–2.10, p = 0.026) after adjusting for age, gender, ethnicity, hypertension, diabetes, obesity, lipid and circulatory system conditions, alcohol and tobacco abuse. Conclusions This study contributes a high-throughput method for associating periodontitis with systemic diseases using linked electronic records.

Boland, Mary Regina; Hripcsak, George; Albers, David J.; Wei, Ying; Wilcox, Adam B.; Wei, Jin; Li, Jianhua; Lin, Steven; Breene, Michael; Myers, Ronnie; Zimmerman, John; Papapanou, Panos N.; Weng, Chunhua

2013-01-01

396

Attitudes towards, and utility of, an integrated medical-dental patient-held record in primary care.  

PubMed Central

BACKGROUND: The need for closer coordination between primary care medical and dental services has been recognized. AIM: To assess the attitudes of general medical practitioners (GMPs), general dental practitioners (GDPs), and patients to an integrated medical-dental patient-held record (integrated medical-dental PHR); to examine patients' use of these records, and the utility of the records for doctors and dentists. METHOD: A three-phase study was carried out: (1) postal survey of GMPs and GDPs; (2) randomized trial of patients, using postal questionnaires before and one year after the issue of integrated medical-dental PHRs to cases; (3) assessment by doctors and dentists of anonymized integrated medical-dental PHRs from this trial. The study was carried out in medical and dental practices in affluent and deprived areas in Greater Glasgow Health Board. Two hundred and thirteen GMPs, 183 GDPs, and 369 patients registered with GMPs and GDPs were surveyed. Eighteen GDPs and GMPs assessed the integrated medical-dental PHRs. RESULTS: Eighty per cent of dentists had contacted a doctor and 16% of doctors had contacted a dentist in the previous three months; 87% of dentists and 68% of doctors thought an integrated medical-dental PHR would be of some use. Twenty-one per cent of dentists and 85% of doctors had practice computers. Most patients wanted to be able to see and read their own records. Twenty-four per cent of patients said there were mistakes and 30% noticed omissions in the integrated medical-dental PHR issued. Experience of having an integrated medical-dental PHR made patients more positive towards the idea of having a patient-held record and being able to check the accuracy of records. Integrated medical-dental PHRs contained important information for half the GDPs and one-third of the GMPs. CONCLUSION: Both professionals and patients have reasonably positive attitudes towards the use of patient-held records. Among patients, the experience of having the integrated medical-dental PHR led to greater enthusiasm towards the idea. Dentists in particular would benefit from the transfer of information from doctors, but better methods are needed to ensure that patients take the integrated medical-dental PHR with them. Given the current lack of ability to easily produce an integrated medical-dental PHR, further examination of the routine issue of a copy of their medical summary, by GMPs, to all patients would be worthwhile.

Jones, R; McConville, J; Mason, D; Macpherson, L; Naven, L; McEwen, J

1999-01-01

397

Clinical challenges associated with incorporation of nonradiology images into the electronic medical record  

NASA Astrophysics Data System (ADS)

To date, the majority of Picture Archival and Communication Systems (PACS) have been utilized only for capture, storage, and display of radiology and in some cases, nuclear medicine images. Medical images for other subspecialty areas are currently stored in local, independent systems, which typically are not accessible throughout the healthcare enterprise and do not communicate with other hospital information or image management systems. It is likely that during the next few years, healthcare centers will expand PAC system capability to incorporate these multimedia data or alternatively, hospital-wide electronic patient record systems will be able to provide this function.

Siegel, Eliot L.; Reiner, Bruce I.

2001-08-01

398

Recent drug history in children visiting a pediatric emergency room and documentation in medical records  

Microsoft Academic Search

Aims  We performed a systematic analysis of which drugs, prescribed, over the counter (OTC), and\\/or natural remedies, children had\\u000a used prior to visiting a pediatric emergency room (ER), and to compare this information with the documentation of drug use\\u000a in the medical records.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A questionnaire study was performed at a pediatric ER in a Swedish university hospital during 3 weeks in April

Elin Kimland; Ylva Böttiger; Synnöve Lindemalm

399

Object-orientated DBMS techniques for time-oriented medical record.  

PubMed

In implementing time-orientated medical record (TOMR) management systems, use of a relational model played a big role. Many applications have been developed to extend query and data manipulation languages to temporal aspects of information. Our experience in developing TOMR revealed some deficiencies inside the relational model, such as: (a) abstract data type definition; (b) unified view of data, at a programming level; (c) management of temporal data; (d) management of signals and images. We identified some first topics to face by an object-orientated approach to database design. This paper describes the first steps in designing and implementing a TOMR by an object-orientated DBMS. PMID:1305700

Pinciroli, F; Combi, C; Pozzi, G

1992-01-01

400

Concordance studies between hospital discharge data and medical records for the recording of lower extremity amputation and diabetes in the Republic of Ireland  

PubMed Central

Background Hospital discharge data have been used to study trends in Lower Extremity Amputation (LEA) rates in people with and without diabetes. The aim of this study was to assess the reliability of routine hospital discharge data in the Republic of Ireland (RoI) for this purpose by determining the level of agreement between hospital discharge data and medical records for both the occurrence of LEA and diagnosis of diabetes. Methods Two concordance studies between hospital discharge data (HIPE) and medical records were performed. To determine the level of agreement for LEA occurrence, HIPE records were compared to theatre logbooks in 9 hospitals utilising HIPE over a two-year period in a defined study area. To determine the level of agreement for diabetes diagnosis, HIPE records were compared to laboratory records in each of the 4 largest hospitals utilising HIPE over a one week period in the same study area. The proportions of positive and negative agreement and Cohen’s kappa statistic of agreement were calculated. Results During a two-year study period in 9 hospitals, 216 LEAs were recorded in both data sources. Sixteen LEAs were recorded in medical records alone and 25 LEAs were recorded in hospital discharge records alone. The proportion of positive agreement was 0.91 (95% CI 0.88-0.94), the proportion of negative agreement was 0.99 (95% CI 0.98-0.99) and the kappa statistic was 0.91 (95% CI 0.88-0.94). During a one-week study period in 4 hospitals, 49 patients with diabetes and 716 patients without diabetes were recorded in both data sources. Eighteen patients had diabetes in medical records alone and 2 patients had diabetes in hospital discharge records alone. The proportion of positive agreement was 0.83 (95% CI 0.76-0.9), the proportion of negative agreement was 0.99 (95% CI 0.98-0.99) and the kappa statistic was 0.82 (95% CI 0.75-0.89). Conclusions This study detected high levels of agreement between hospital discharge data and medical records for LEA and diabetes in a defined study area. Based on these findings, we suggest that HIPE is sufficiently reliable to monitor trends in LEAs in people with and without diabetes in the RoI.

2013-01-01

401

Beyond information retrieval and electronic health record use: competencies in clinical informatics for medical education  

PubMed Central

Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search) and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area.

Hersh, William R; Gorman, Paul N; Biagioli, Frances E; Mohan, Vishnu; Gold, Jeffrey A; Mejicano, George C

2014-01-01

402

Development of a character, line and point display system. [for medical records  

NASA Technical Reports Server (NTRS)

A compact graphics terminal for use as the input to a computerized medical records system is described. The principal mode of communication between the terminal and the records system is by checklists and menu selection. However, the terminal accepts short, handwritten messages as well as conventional alphanumeric input. The terminal consists of an electronic tablet, a display, a microcomputer controller, a character generator, and a refresh memory for the display. An Intel SBC 80/10 microcomputer controls the flow of information and a 16 kilobyte memory stores the point-by-point array of information to be displayed. A specially designed interface continuously generates the raster display without the intervention of the microcomputer.

Owen, E. W.

1977-01-01

403

Medical subject headings: Supplementary chemical records, 1993. Final report, 1970-1992  

SciTech Connect

The document contains records of approximately 22,000 chemicals which since 1970 have been mentioned in a significant way in journals indexed in MEDLINE, the National Library of Medicine's online bibliographic database. Originally housed in a manual card file these records were incorporated as a subset of the MEDLARS MeSH (Medical Subject Headings) file, and became searchable online in June 1980. The present list does not include any of the chemical descriptors that are to be found in the D Category of MeSH. The publication is intended to assist indexers, and the users of Index Medicus and MEDLINE. For the indexer, it provides more specific entries than those available in the printed MeSH. It permits users of Index Medicus to locate the chemical subject headings under which citations referring to a more specific chemical can be found.

Not Available

1992-12-01

404

Three Years Experience with the Implementation of a Networked Electronic Medical Record in Haiti  

PubMed Central

Since 2005 we have been developing and implementing an electronic medical record (EMR) that supports both individual and population health care of HIV-infected patients in Haiti. Unreliable electrical power and network infrastructure, cultural differences, variable levels of experience and computer literacy, and the geographic dispersion of the team remain challenges, but the system is now implemented in about 40 sites nationwide providing antiretroviral therapy, and includes records for about 18,600 patients. The need to support countrywide monitoring and evaluation drove early architectural decisions to support linking systems under conditions of network uncertainty. We have found surprising end user acceptance of the system, with the adoption of interactive EMR usage exceeding our expectations and timeline.

Lober, William B.; Quiles, Christina; Wagner, Steve; Cassagnol, Rachelle; Lamothes, Roges; Alexis, Don Rock Pierre; Joseph, Patrice; Sutton, Perri; Puttkammer, Nancy; Kitahata, Mari M.

2008-01-01

405

Advance Directives, Proxies and Electronic Medical Records. Abstract, Executive Summary, Final Report and Appendices A, B, C, D, and F.  

National Technical Information Service (NTIS)

For 1051 chronically ill outpatients the authors performed (1) a controlled trial of reminders to discuss advance directives (ADs), and (2) prospective studies of the effects of completed AD forms, placed in patients' electronic medical records, on emerge...

W. M. Tierney

1997-01-01

406

Using Exploration and Learning for Medical Records Search: An Experiment in Identifying Cohorts for Comparative Effectiveness Research.  

National Technical Information Service (NTIS)

This paper describes an experiment performed on a medical record data set, using an information retrieval (IR) tool that applies the techniques of exploration and learning, to assist a researcher in identifying the most relevant cohorts. The paper present...

H. Hyman W. Fridy

2012-01-01

407

Association of environmental traits with the geographic ranges of ticks (Acari: Ixodidae) of medical and veterinary importance in the western Palearctic. A digital data set.  

PubMed

We compiled information on the distribution of ticks in the western Palearctic (11°W, 45°E; 29°N, 71°N), published during 1970-2010. The literature search was filtered by the tick's species name and an unambiguous reference to the point of capture. Records from some curated collections were included. We focused on tick species of importance to human and animal health, in particular: Ixodes ricinus, Dermacentor marginatus, D. reticulatus, Haemaphysalis punctata, H. sulcata, Hyalomma marginatum, Hy. lusitanicum, Rhipicephalus annulatus, R. bursa, and the R. sanguineus group. A few records of other species (I. canisuga, I. hexagonus, Hy. impeltatum, Hy. anatolicum, Hy. excavatum, Hy. scupense) were also included. A total of 10,280 records was included in the data set. Almost 42 % of published references are not adequately referenced (and not included in the data set), host is reported for only 61 % of records and a reference to time of collection is missed for 84 % of published records. Ixodes ricinus accounted for 44.3 % of total records, with H. marginatum and D. marginatus accounting for 7.1 and 8.1 % of records, respectively. The lack of homogeneity of the references and potential pitfalls in the compilation were addressed to create a digital data set of the records of the ticks. We attached to every record a coherent set of quantitative descriptors for the site of reporting, namely gridded interpolated monthly climate and remotely sensed data on vegetation (NDVI). We also attached categorical descriptors of the habitat: a standard classification of land biomes and an ad hoc classification of the target territory from remotely sensed temperature and NDVI data. A descriptive analysis of the data revealed that a principal components reduction of the environmental (temperature and NDVI) variables described the distribution of the species in the target territory. However, categorical descriptors of the habitat were less effective. We stressed the importance of building reliable collections of ticks with specific references as to collection point, host and date of capture. The data set is freely downloadable. PMID:22843316

Estrada-Peña, A; Farkas, Robert; Jaenson, Thomas G T; Koenen, Frank; Madder, Maxime; Pascucci, Ilaria; Salman, Mo; Tarrés-Call, Jordi; Jongejan, Frans

2013-03-01

408

Using a Prenatal Electronic Medical Record to Improve Documentation within an Inner-City Healthcare Network.  

PubMed

Objective?To study the impact of a prenatal electronic medical record (EMR) on the adequacy of documentation. Study Design?The authors reviewed paper prenatal records (historical control arm and contemporaneous control arm), and prenatal EMRs (study arm). A prenatal quality index (PQI) was developed to assess adequacy of documentation; the prenatal record was assigned a score (range, -1 to 2 for each element, maximum score?=?30). A PQI raw score and PQI ratio-that controlled for which elements of care were indicated for a patient-were calculated and compared between the study arm versus historical control arm and then the study arm versus contemporaneous control arm. Results?The median PQI raw score was significantly lower in the study arm compared with historical control arm; however, the PQI ratios were similar between these groups. The PQI raw score was similar in both the study arm and contemporaneous control arm; however the PQI ratio was significantly higher in the study arm when compared with the contemporaneous control arm. Conclusion?Implementation of this prenatal EMR did not have a significant impact on completeness of documentation when compared with a standardized paper prenatal record. Adequacy of documentation seems to be related to the type of practice. PMID:24000107

Ghartey, Jeny; Lee, Colleen; Weinberger, Elisheva; Nathan, Lisa M; Merkatz, Irwin R; Bernstein, Peter S

2014-06-01

409

An evaluation of patient access to their electronic medical records via the World Wide Web.  

PubMed

This paper describes initial experience with the Web-based Patient Clinical Information System (PatCIS). The system was designed to serve as a framework for the integration of applications that help patients access their electronic medical record, add data to their record, review on-line health information, and apply their own clinical data (automatically) to guideline programs that offer health advice. The architecture supports security functions and records user activities, relieving application developers from concerns about safe information practices and the evaluation process. PatCIS is being used to study the social and cognitive impact of allowing patients to have access to their health records via the Web. To date, PatCIS has grown to include 15 clinical functions and 4 dynamic links to literature (called infobuttons). Eleven patients have been enrolled since April, 1999; five have been active users. Experience shows that the PatCIS architecture supports application integration while providing adequate security and evaluation functions. Initial caution with the patient enrollment process has limited recruitment and, consequently, usage. However, experience thus far suggests that PatCIS has good usability and utility. No adverse events, including undesirable impact on doctor-patient interactions, have been reported. There do not appear to be any technical impediments to scaling up the enrollment to continue to observe patient usage. PMID:11079863

Cimino, J J; Li, J; Mendonça, E A; Sengupta, S; Patel, V L; Kushniruk, A W

2000-01-01

410

A practical approach to achieve private medical record linkage in light of public resources  

PubMed Central

Objective Integration of patients' records across resources enhances analytics. To address privacy concerns, emerging strategies such as Bloom filter encodings (BFEs), enable integration while obscuring identifiers. However, recent investigations demonstrate BFEs are, in theory, vulnerable to cryptanalysis when encoded identifiers are randomly selected from a public resource. This study investigates the extent to which cryptanalysis conditions hold for (1) real patient records and (2) a countermeasure that obscures the frequencies of the identifying values in encoded datasets. Design First, to investigate the strength of cryptanalysis for real patient records, we build BFEs from identifiers in an electronic medical record system and apply cryptanalysis using identifiers in a publicly available voter registry. Second, to investigate the countermeasure under ideal cryptanalysis conditions, we compose BFEs from the identifiers that are randomly selected from a public voter registry. Measurement We utilize precision (ie, rate of correct re-identified encodings) and computation efficiency (ie, time to complete cryptanalysis) to assess the performance of cryptanalysis in BFEs before and after application of the countermeasure. Results Cryptanalysis can achieve high precision when the encoded identifiers are composed of a random sample of a public resource (ie, a voter registry). However, we also find that the attack is less efficient and may not be practical for more realistic scenarios. By contrast, the proposed countermeasure made cryptanalysis impractical in terms of precision and efficiency. Conclusions Performance of cryptanalysis against BFEs based on patient data is significantly lower than theoretical estimates. The proposed countermeasure makes BFEs resistant to known practical attacks.

Kuzu, Mehmet; Kantarcioglu, Murat; Durham, Elizabeth Ashley; Toth, Csaba

2013-01-01

411

An evaluation of patient access to their electronic medical records via the World Wide Web.  

PubMed Central

This paper describes initial experience with the Web-based Patient Clinical Information System (PatCIS). The system was designed to serve as a framework for the integration of applications that help patients access their electronic medical record, add data to their record, review on-line health information, and apply their own clinical data (automatically) to guideline programs that offer health advice. The architecture supports security functions and records user activities, relieving application developers from concerns about safe information practices and the evaluation process. PatCIS is being used to study the social and cognitive impact of allowing patients to have access to their health records via the Web. To date, PatCIS has grown to include 15 clinical functions and 4 dynamic links to literature (called infobuttons). Eleven patients have been enrolled since April, 1999; five have been active users. Experience shows that the PatCIS architecture supports application integration while providing adequate security and evaluation functions. Initial caution with the patient enrollment process has limited recruitment and, consequently, usage. However, experience thus far suggests that PatCIS has good usability and utility. No adverse events, including undesirable impact on doctor-patient interactions, have been reported. There do not appear to be any technical impediments to scaling up the enrollment to continue to observe patient usage.

Cimino, J. J.; Li, J.; Mendonca, E. A.; Sengupta, S.; Patel, V. L.; Kushniruk, A. W.

2000-01-01

412

Comparative analysis of pharmacovigilance methods in the detection of adverse drug reactions using electronic medical records  

PubMed Central

Objective Medication  safety requires that each drug be monitored throughout its market life as early detection of adverse drug reactions (ADRs) can lead to alerts that prevent patient harm. Recently, electronic medical records (EMRs) have emerged as a valuable resource for pharmacovigilance. This study examines the use of retrospective medication orders and inpatient laboratory results documented in the EMR to identify ADRs. Methods Using 12?years of EMR data from Vanderbilt University Medical Center (VUMC), we designed a study to correlate abnormal laboratory results with specific drug administrations by comparing the outcomes of a drug-exposed group and a matched unexposed group. We assessed the relative merits of six pharmacovigilance measures used in spontaneous reporting systems (SRSs): proportional reporting ratio (PRR), reporting OR (ROR), Yule's Q (YULE), the ?2 test (CHI), Bayesian confidence propagation neural networks (BCPNN), and a gamma Poisson shrinker (GPS). Results We systematically evaluated the methods on two independently constructed reference standard datasets of drug–event pairs. The dataset of Yoon et al contained 470 drug–event pairs (10 drugs and 47 laboratory abnormalities). Using VUMC's EMR, we created another dataset of 378 drug–event pairs (nine drugs and 42 laboratory abnormalities). Evaluation on our reference standard showed that CHI, ROR, PRR, and YULE all had the same F score (62%). When the reference standard of Yoon et al was used, ROR had the best F score of 68%, with 77% precision and 61% recall. Conclusions Results suggest that EMR-derived laboratory measurements and medication orders can help to validate previously reported ADRs, and detect new ADRs.

Liu, Mei; McPeek Hinz, Eugenia Renne; Matheny, Michael Edwin; Denny, Joshua C; Schildcrout, Jonathan Scott; Miller, Randolph A; Xu, Hua

2013-01-01

413

Development of a medical record and radiographic image transmission system using a high-speed communication network.  

PubMed

A medical record and radiographic image transmission system has been developed using a high-speed communication network. The databases are designed to store and transmit the data acquired from the scanner. To maximally utilize the communication bandwidth, the medical records and radiographic images are compressed using the G3 facsimile and JPEG coding standard method, respectively. TCP/IP, OOP and Windows-based system software enable a modular design, future expandability, open system interconnectivity, and diverse image manipulation functions. PMID:10384462

Kim, N H; Yoo, S K; Kim, K M; Kang, Y T; Bae, S H; Kim, S R

1998-01-01

414

Identifying patients with medically unexplained physical symptoms in electronic medical records in primary care: a validation study  

PubMed Central

Background When medically unexplained physical symptoms (MUPS) become persistent, it may have major implications for the patient, the general practitioner (GP) and for society. Early identification of patients with MUPS in electronic medical records (EMRs) might contribute to prevention of persistent MUPS by creating awareness among GPs and providing an opportunity to start stepped care management. However, procedures for identification of patients with MUPS in EMRs are not well established yet. In this validation study we explore the test characteristics of an EMR screening method to identify patients with MUPS. Methods The EMR screening method consists of three steps. First, all patients ?18 years were included when they had five or more contacts in the last 12 months. Second, patients with known chronic conditions were excluded. Finally, patients were included with a MUPS syndrome or when they had three or more complaints suggestive for MUPS. We compared the results of the EMR screening method with scores on the Patient Health Questionnaire-15 (PHQ-15), which we used as reference test. We calculated test characteristics for various cut-off points. Results From the 1223 patients in our dataset who completed the PHQ-15, 609 (49/8%) scored ?5 on the PHQ-15. The EMR screening method detected 131/1223 (10.7%) as patients with MUPS. Of those, 102 (77.9%) scored ?5 on the PHQ-15 and 53 (40.5%) scored ?10. When compared with the PHQ-15 cut-off point ?10, sensitivity and specificity were 0.30 and 0.93 and positive and negative predictive values were 0.40 and 0.89, respectively. Conclusions The EMR screening method to identify patients with MUPS has a high specificity. However, many potential MUPS patients will be missed. Before using this method as a screening instrument for selecting patients who might benefit from structured care, its sensitivity needs to be improved while maintaining its specificity.

2014-01-01

415

Implementing and integrating a clinically driven electronic medical record for radiation oncology in a large medical enterprise.  

PubMed

Purpose/Objective: While our department is heavily invested in computer-based treatment planning, we historically relied on paper-based charts for management of Radiation Oncology patients. In early 2009, we initiated the process of conversion to an electronic medical record (EMR) eliminating the need for paper charts. Key goals included the ability to readily access information wherever and whenever needed, without compromising safety, treatment quality, confidentiality, or productivity. Methodology: In February, 2009, we formed a multi-disciplinary team of Radiation Oncology physicians, nurses, therapists, administrators, physicists/dosimetrists, and information technology (IT) specialists, along with staff from the Duke Health System IT department. The team identified all existing processes and associated information/reports, established the framework for the EMR system and generated, tested and implemented specific EMR processes. Results: Two broad classes of information were identified: information which must be readily accessed by anyone in the health system versus that used solely within the Radiation Oncology department. Examples of the former are consultation reports, weekly treatment check notes, and treatment summaries; the latter includes treatment plans, daily therapy records, and quality assurance reports. To manage the former, we utilized the enterprise-wide system, which required an intensive effort to design and implement procedures to export information from Radiation Oncology into that system. To manage "Radiation Oncology" data, we used our existing system (ARIA, Varian Medical Systems.) The ability to access both systems simultaneously from a single workstation (WS) was essential, requiring new WS and modified software. As of January, 2010, all new treatments were managed solely with an EMR. We find that an EMR makes information more widely accessible and does not compromise patient safety, treatment quality, or confidentiality. However, compared to paper charts, time required by clinicians to access/enter patient information has substantially increased. While productivity is improving with experience, substantial growth will require better integration of the system components, decreased access times, and improved user interfaces. $127K was spent on new hardware and software; elimination of paper yields projected savings of $21K/year. One year after conversion to an EMR, more than 90% of department staff favored the EMR over the previous paper charts. Conclusion: Successful implementation of a Radiation Oncology EMR required not only the effort and commitment of all functions of the department, but support from senior health system management, corporate IT, and vendors. Realization of the full benefits of an EMR will require experience, faster/better integrated software, and continual improvement in underlying clinical processes. PMID:23616946

Kirkpatrick, John P; Light, Kim L; Walker, Robyn M; Georgas, Debra L; Antoine, Phillip A; Clough, Robert W; Cozart, Heidi B; Yin, Fang-Fang; Yoo, Sua; Willett, Christopher G

2013-01-01

416

Implementing and Integrating a Clinically Driven Electronic Medical Record for Radiation Oncology in a Large Medical Enterprise  

PubMed Central

Purpose/Objective: While our department is heavily invested in computer-based treatment planning, we historically relied on paper-based charts for management of Radiation Oncology patients. In early 2009, we initiated the process of conversion to an electronic medical record (EMR) eliminating the need for paper charts. Key goals included the ability to readily access information wherever and whenever needed, without compromising safety, treatment quality, confidentiality, or productivity. Methodology: In February, 2009, we formed a multi-disciplinary team of Radiation Oncology physicians, nurses, therapists, administrators, physicists/dosimetrists, and information technology (IT) specialists, along with staff from the Duke Health System IT department. The team identified all existing processes and associated information/reports, established the framework for the EMR system and generated, tested and implemented specific EMR processes. Results: Two broad classes of information were identified: information which must be readily accessed by anyone in the health system versus that used solely within the Radiation Oncology department. Examples of the former are consultation reports, weekly treatment check notes, and treatment summaries; the latter includes treatment plans, daily therapy records, and quality assurance reports. To manage the former, we utilized the enterprise-wide system, which required an intensive effort to design and implement procedures to export information from Radiation Oncology into that system. To manage “Radiation Oncology” data, we used our existing system (ARIA, Varian Medical Systems.) The ability to access both systems simultaneously from a single workstation (WS) was essential, requiring new WS and modified software. As of January, 2010, all new treatments were managed solely with an EMR. We find that an EMR makes information more widely accessible and does not compromise patient safety, treatment quality, or confidentiality. However, compared to paper charts, time required by clinicians to access/enter patient information has substantially increased. While productivity is improving with experience, substantial growth will require better integration of the system components, decreased access times, and improved user interfaces. $127K was spent on new hardware and software; elimination of paper yields projected savings of $21K/year. One year after conversion to an EMR, more than 90% of department staff favored the EMR over the previous paper charts. Conclusion: Successful implementation of a Radiation Oncology EMR required not only the effort and commitment of all functions of the department, but support from senior health system management, corporate IT, and vendors. Realization of the full benefits of an EMR will require experience, faster/better integrated software, and continual improvement in underlying clinical processes.

Kirkpatrick, John P.; Light, Kim L.; Walker, Robyn M.; Georgas, Debra L.; Antoine, Phillip A.; Clough, Robert W.; Cozart, Heidi B.; Yin, Fang-Fang; Yoo, Sua; Willett, Christopher G.

2013-01-01

417

Novel open-source electronic medical records system for palliative care in low-resource settings  

PubMed Central

Background The need for palliative care in sub-Saharan Africa is staggering: this region shoulders over 67% of the global burden of HIV/AIDS and cancer. However, provisions for these essential services remain limited and poorly integrated with national health systems in most nations. Moreover, the evidence base for palliative care in the region remains scarce. This study chronicles the development and evaluation of DataPall, an open-source electronic medical records system that can be used to track patients, manage data, and generate reports for palliative care providers in these settings. DataPall was developed using design criteria encompassing both functional and technical objectives articulated by hospital leaders and palliative care staff at a leading palliative care center in Malawi. The database can be used with computers that run Windows XP SP 2 or newer, and does not require an internet connection for use. Subsequent to its development and implementation in two hospitals, DataPall was tested among both trained and untrained hospital staff populations on the basis of its usability with comparison to existing paper records systems as well as on the speed at which users could perform basic database functions. Additionally, all participants evaluated this program on a standard system usability scale. Results In a study of health professionals in a Malawian hospital, DataPall enabled palliative care providers to find patients’ appointments, on average, in less than half the time required to locate the same record in current paper records. Moreover, participants generated customizable reports documenting patient records and comprehensive reports on providers’ activities with little training necessary. Participants affirmed this ease of use on the system usability scale. Conclusions DataPall is a simple, effective electronic medical records system that can assist in developing an evidence base of clinical data for palliative care in low resource settings. The system is available at no cost, is specifically designed to chronicle care in the region, and is catered to meet the technical needs and user specifications of such facilities.

2013-01-01

418

Task-oriented evaluation of electronic medical records systems: development and validation of a questionnaire for physicians  

Microsoft Academic Search

BACKGROUND: Evaluation is a challenging but necessary part of the development cycle of clinical information systems like the electronic medical records (EMR) system. It is believed that such evaluations should include multiple perspectives, be comparative and employ both qualitative and quantitative methods. Self-administered questionnaires are frequently used as a quantitative evaluation method in medical informatics, but very few validated questionnaires

Hallvard Lærum; Arild Faxvaag

2004-01-01

419

Healthcare and Guidelines: A Population-Based Survey of Recorded Medical Problems and Health Surveillance for People with Down syndrome  

ERIC Educational Resources Information Center

Background: Medical problems are described in a population of persons with Down syndrome. Health surveillance is compared to the recommendations of national guidelines. Method: Case records from the specialised and primary healthcare and disability services were analysed. Results: A wide spectrum of age-specific medical and surgical problems was…

Maatta, Tuomo; Maatta, Joonas; Tervo-Maatta, Tuula; Taanila, Anja; Kaski, Markus; Iivanainen, Matti

2011-01-01

420

Development of an electronic medical record-based algorithm to identify patients with unknown HIV status.  

PubMed

Individuals with unknown HIV status are at risk for undiagnosed HIV, but practical and reliable methods for identifying these individuals have not been described. We developed an algorithm to identify patients with unknown HIV status using data from the electronic medical record (EMR) of a large health care system. We developed EMR-based criteria to classify patients as having known status (HIV-positive or HIV-negative) or unknown status and applied these criteria to all patients seen in the affiliated health care system from 2008 to 2012. Performance characteristics of the algorithm for identifying patients with unknown HIV status were calculated by comparing a random sample of the algorithm's results to a reference standard medical record review. The algorithm classifies all patients as having either known or unknown HIV status. Its sensitivity and specificity for identifying patients with unknown status are 99.4% (95% CI: 96.5-100%) and 95.2% (95% CI: 83.8-99.4%), respectively, with positive and negative predictive values of 98.7% (95% CI: 95.5-99.8%) and 97.6% (95% CI: 87.1-99.1%), respectively. Using commonly available data from an EMR, our algorithm has high sensitivity and specificity for identifying patients with unknown HIV status. This algorithm may inform expanded HIV testing strategies aiming to test the untested. PMID:24779521

Felsen, Uriel R; Bellin, Eran Y; Cunningham, Chinazo O; Zingman, Barry S

2014-10-01

421

Veterinary Anatomy Instruction  

NSDL National Science Digital Library

With one of the most well regarded veterinary schools in the United States, the University of Minnesota continues to break new ground in the training of new veterinarians. Of course, more and more of these training materials are finding their way to the web, and this site will be quite helpful to those persons with an interest in this particular field. Created by different faculty members, the materials here are categorized by the course they are most commonly associated with, such as gross anatomy or neurobiology. In the gross anatomy section, visitors will find materials that include a glossary of terms related to veterinary anatomy and dissections, animations that illustrate the major gaits of various quadrupeds, and the nervous system pathways of canines. The neurobiology section contains instructional materials that include information about brain dissection neuroanatomy and neurohistology.

422

Veterinary Anatomy Instruction  

NSDL National Science Digital Library

With one of the most well regarded veterinary schools in the United States, the University of Minnesota continues to break new ground in the training of new veterinarians on a regular basis. Of course, more and more of these training materials are finding their way to the web, and this site will be quite helpful to those persons with an interest in this particular field. Created by different faculty members, the materials here are categorized by the course they are most commonly associated with, such as gross anatomy or neurobiology. In the gross anatomy section, visitors will find materials that include a glossary of terms related to veterinary anatomy and dissections, animations that illustrate the major gaits of various quadrupeds, and the nervous system pathways of canines. The neurobiology section contains instructional materials that include information about brain dissection neuroanatomy and neurohistology.

2006-10-30

423

Assessment of Medical Records Module of Health Information System According to ISO 9241-10  

PubMed Central

Introduction Hospital managers and personnel need to Hospital Information System (HIS) to increase the efficiency and effectiveness in their organization. Accurate, appropriate, precise, timely, valid information, and Suitable Information system for their tasks is required and the basis for decision making in various levels of the hospital management, since, this study was conducted to Assess of Selected HIS in Isfahan University of Medical Science Hospitals According to ISO 9241-10. Methods This paper obtained from an applied, descriptive cross sectional study, in which the medical records module of IUMS selected HIS in Isfahan University of Medical Science affiliated seven hospitals were assessed with ISO 9241-10 questionnaire contained 7 principles and 74 items. The obtained data were analyzed with SPSS software and descriptive statistics were used to examine measures of central tendencies. Results The analysis of data revealed the following about the software: Suitability for user tasks, self descriptiveness, controllability by user, Conformity with user expectations, error tolerance, suitability for individualization, and suitability for user learning, respectively, was 68, 67, 70, 74, 69, 53, and 68 percent. Total compliance with ISO 9241-10 was 67 percent. Conclusion Information is the basis for policy and decision making in various levels of the hospital management. Consequently, it seems that HIS developers should decrease HIS errors and increase its suitability for tasks, self descriptiveness, controllability, conformity with user expectations, error tolerance, suitability for individualization, suitability for user learning.

Ehteshami, Asghar; Sadoughi, Farahnaz; Saeedbakhsh, Saeed; Isfahani, Mahtab Kasaei

2013-01-01

424

Standardized exchange of medical data between a research database, an electronic patient record and an electronic health record using CDA/SCIPHOX.  

PubMed

The exchange of medical data from research and clinical routine across institution borders in a structured way, based on national and international standards, is essential to build an integrated and connected health platform. In this project we developed a HL7 CDA/SCIPHOX based integration platform to exchange data between a research database, an electronic health record and an electronic patient record (Soarian). PMID:16779250

Gerdsen, Frederic; Müeller, Sascha; Jablonski, Stefan; Prokosch, Hans-Ulrich

2005-01-01

425

The integration of medical images with the electronic patient record and their web-based distribution 1  

Microsoft Academic Search

Medical images are currently created digitally and stored in the radiology department’s picture archiving and communication system. Reports are usually stored in the electronic patient record of other information systems, such as the radiology information system (RIS) and the hospital information system (HIS). But high-quality services can only be provided if electronic patient record data is integrated with digital images

H. Münch; U. Engelmann; A. Schröter; H. P. Meinzer

2004-01-01

426

History of the Rochester Epidemiology Project: Half a Century of Medical Records Linkage in a US Population  

PubMed Central

The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide.

Rocca, Walter A.; Yawn, Barbara P.; St. Sauver, Jennifer L.; Grossardt, Brandon R.; Melton, L. Joseph

2012-01-01

427

An innovative approach to medical control: semiautomatic defibrillators with solid-state memory modules for recording cardiac arrest events.  

PubMed

We evaluated the use of microprocessor-based memory modules incorporated into automatic external defibrillators. These solid-state modules store information about each clinical use, including selected segments of the ECG rhythm and notations on defibrillator operation. A playback unit provides annotated printouts of the recorded information. The purpose of our evaluation was to determine whether this memory module could adequately support medical control "run-reviews" when compared with dualfunction (voice and ECG) tape recordings. A total of 41 resuscitation attempts by emergency medical technicians trained to defibrillate (EMT-Ds) were evaluated in five preselected performance areas: defibrillation skills, command and communication at the scene, patient assessment and support, safety, and speed. When performance was reviewed using the tape recordings, the average EMT-D performance score was 16.2 (maximum, 20); when reviewed using the printouts from the medical control modules, the average score, 7.2, was significantly lower (P less than .01). The lower scores with the medical control module occurred because not all five areas of skill could be evaluated adequately by the memory module approach. Assessment of the areas of communication/command at the scene, patient assessment/support, and safety required verbal tape recordings. The medical control module appeared superior to the tape recordings at providing a quick, convenient, and accurate evaluation of rhythm assessment, shock decisions, time intervals, and defibrillator performance. They make several features of medical control review easier and more convenient, and may encourage implementation of early defibrillation programs. We conclude, however, that medical control modules cannot replace on-scene tape recordings for adequate medical control of EMT-D programs. PMID:3394986

Cummins, R O; Austin, D; Graves, J R; Hambly, C

1988-08-01

428

Veterinary Medicines and the Environment  

Microsoft Academic Search

\\u000a Veterinary medicines may be emitted either directly or indirectly into the environment, following its use. As veterinary medicines\\u000a are biologically active compounds, there is a concern that their occurrence in the environment may have an adverse impact\\u000a on aquatic and terrestrial organisms. This chapter reviews the major sources by which veterinary medicines enter the environment,\\u000a the fate, behaviour and occurrence

Alistair B. A. Boxall

429

Job dynamics of veterinary professionals in an academic research institution. I. Retention and turnover of veterinary technicians.  

PubMed

The turnover of veterinary technicians within an animal resources program averaged 33% annually over 18 y, peaking at 67% in 1998 to 1999. Insufficient retention of veterinary technicians led to diversion of veterinarian effort to technical tasks and to increased allocation of administrative resources for supervising and managing an expanding team of veterinary technicians. To identify factors and trends related to poor retention, address any causes, and reduce turnover, a retrospective analysis of employment records was done. The retention of veterinary technicians was significantly greater for the 9 technicians hired from veterinary private practice rather than for any of 3 other general sources: promotions from the animal care staff, transfers from other research institutions, and miscellaneous sources. Veterinary technician turnover was reduced from a mean of 60% over 1995 to 1999 to an average of 26% during 2000 to 2004. Higher retention was associated with management practices that included renewed concentration on recruiting and interviewing strategies and emphasis on training and career development including merit raises for technician certification through the American Association for Laboratory Animal Science. Higher retention yielded correspondingly greater experience on the job as the mean tenure increased from 1.1 y in 2000 to 2.8 y in 2004. The most valued attributes related to employment by veterinary technicians as determined by survey were to do meaningful work, earn a good living, and have a committed team of coworkers. PMID:16995642

Huerkamp, Michael J

2006-09-01

430

Building national electronic medical record systems via the World Wide Web.  

PubMed Central

Electronic medical record systems (EMRSs) currently do not lend themselves easily to cross-institutional clinical care and research. Unique system designs coupled with a lack of standards have led to this difficulty. The authors have designed a preliminary EMRS architecture (W3-EMRS) that exploits the multiplatform, multiprotocol, client-server technology of the World Wide Web. The architecture abstracts the clinical information model and the visual presentation away from the underlying EMRS. As a result, computation upon data elements of the EMRS and their presentation are no longer tied to the underlying EMRS structures. The architecture is intended to enable implementation of programs that provide uniform access to multiple, heterogeneous legacy EMRSs. The authors have implemented an initial prototype of W3-EMRS that accesses the database of the Boston Children's Hospital Clinician's Workstation.

Kohane, I S; Greenspun, P; Fackler, J; Cimino, C; Szolovits, P

1996-01-01

431

Modeling Drug Exposure Data in Electronic Medical Records: an Application to Warfarin  

PubMed Central

Identification of patients’ drug exposure information is critical to drug-related research that is based on electronic medical records (EMRs). Drug information is often embedded in clinical narratives and drug regimens change frequently because of various reasons like intolerance or insurance issues, making accurate modeling challenging. Here, we developed an informatics framework to determine patient drug exposure histories from EMRs by combining natural language processing (NLP) and machine learning (ML) technologies. Our framework consists of three phases: 1) drug entity recognition - identifying drug mentions; 2) drug event detection - labeling drug mentions with a status (e.g., “on” or “stop”); and 3) drug exposure modeling - predicting if a patient is taking a drug at a given time using the status and temporal information associated with the mentions. We applied the framework to determine patient warfarin exposure at hospital admissions and achieved 87% precision, 79% recall, and an area under the receiver-operator characteristic curve of 0.93.

Liu, Mei; Jiang, Min; Kawai, Vivian K.; Stein, Charles M.; Roden, Dan M.; Denny, Joshua C.; Xu, Hua

2011-01-01

432

A New Model for the Organizational Structure of Medical Record Departments in Hospitals in Iran  

PubMed Central

The organizational structure of medical record departments in Iran is not appropriate for the efficient management of healthcare information. In addition, there is no strong information management division to provide comprehensive information management services in hospitals in Iran. Therefore, a suggested model was designed based on four main axes: 1) specifications of a Health Information Management Division, 2) specifications of a Healthcare Information Management Department, 3) the functions of the Healthcare Information Management Department, and 4) the units of the Healthcare Information Management Department. The validity of the model was determined through use of the Delphi technique. The results of the validation process show that the majority of experts agree with the model and consider it to be appropriate and applicable for hospitals in Iran. The model is therefore recommended for hospitals in Iran.

Moghaddasi, Hamid; Hosseini, Azamossadat; Sheikhtaheri, Abbas

2006-01-01

433

Patient Perception Versus Medical Record Entry of Health-Related Conditions Among Patients With Heart Failure  

PubMed Central

A shared understanding of medical conditions between patients and their health care providers may improve self-care and outcomes. In this study, the concordance between responses to a medical history self-report (MHSR) form and the corresponding provider documentation in electronic health records (EHRs) of 19 select co-morbidities and habits in 230 patients with heart failure were evaluated. Overall concordance was assessed using the ? statistic, and crude, positive, and negative agreement were determined for each condition. Concordance between MHSR and EHR varied widely for cardiovascular conditions (? = 0.37 to 0.96), noncardiovascular conditions (? = 0.06 to 1.00), and habits (? = 0.26 to 0.69). Less than 80% crude agreement was seen for history of arrhythmias (72%), dyslipidemia (74%), and hypertension (79%) among cardiovascular conditions and lung disease (70%) and peripheral arterial disease (78%) for noncardiovascular conditions. Perfect agreement was observed for only 1 of the 19 conditions (human immunodeficiency virus status). Negative agreement >80% was more frequent than >80% positive agreement for a condition (15 of 19 [79%] vs 8 of 19 [42%], respectively, p = 0.02). Only 20% of patients had concordant MSHRs and EHRs for all 7 cardiovascular conditions; in 40% of patients, concordance was observed for ?5 conditions. For noncardiovascular conditions, only 28% of MSHR-EHR pairs agreed for all 9 conditions; 37% agreed for ?7 conditions. Cumulatively, 39% of the pairs matched for ?15 of 19 conditions. In conclusion, there is significant variation in the perceptions of patients with heart failure compared to providers’ records of co-morbidities and habits. The root causes of this variation and its impact on outcomes need further study.

Malik, Adnan S.; Giamouzis, Grigorios; Georgiopoulou, Vasiliki V.; Fike, Lucy V.; Kalogeropoulos, Andreas P.; Norton, Catherine R.; Sorescu, Dan; Azim, Sidra; Laskar, Sonjoy R.; Smith, Andrew L.; Dunbar, Sandra B.; Butler, Javed

2013-01-01

434

Combining Free Text and Structured Electronic Medical Record Entries to Detect Acute Respiratory Infections  

PubMed Central

Background The electronic medical record (EMR) contains a rich source of information that could be harnessed for epidemic surveillance. We asked if structured EMR data could be coupled with computerized processing of free-text clinical entries to enhance detection of acute respiratory infections (ARI). Methodology A manual review of EMR records related to 15,377 outpatient visits uncovered 280 reference cases of ARI. We used logistic regression with backward elimination to determine which among candidate structured EMR parameters (diagnostic codes, vital signs and orders for tests, imaging and medications) contributed to the detection of those reference cases. We also developed a computerized free-text search to identify clinical notes documenting at least two non-negated ARI symptoms. We then used heuristics to build case-detection algorithms that best combined the retained structured EMR parameters with the results of the text analysis. Principal Findings An adjusted grouping of diagnostic codes identified reference ARI patients with a sensitivity of 79%, a specificity of 96% and a positive predictive value (PPV) of 32%. Of the 21 additional structured clinical parameters considered, two contributed significantly to ARI detection: new prescriptions for cough remedies and elevations in body temperature to at least 38°C. Together with the diagnostic codes, these parameters increased detection sensitivity to 87%, but specificity and PPV declined to 95% and 25%, respectively. Adding text analysis increased sensitivity to 99%, but PPV dropped further to 14%. Algorithms that required satisfying both a query of structured EMR parameters as well as text analysis disclosed PPVs of 52–68% and retained sensitivities of 69–73%. Conclusion Structured EMR parameters and free-text analyses can be combined into algorithms that can detect ARI cases with new levels of sensitivity or precision. These results highlight potential paths by which repurposed EMR information could facilitate the discovery of epidemics before they cause mass casualties.

DeLisle, Sylvain; South, Brett; Anthony, Jill A.; Kalp, Ericka; Gundlapallli, Adi; Curriero, Frank C.; Glass, Greg E.; Samore, Matthew; Perl, Trish M.

2010-01-01

435

Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial  

PubMed Central

Objective To determine the effects of a personal health record (PHR)-linked medications module on medication accuracy and safety. Design From September 2005 to March 2007, we conducted an on-treatment sub-study within a cluster-randomized trial involving 11 primary care practices that used the same PHR. Intervention practices received access to a medications module prompting patients to review their documented medications and identify discrepancies, generating ‘eJournals’ that enabled rapid updating of medication lists during subsequent clinical visits. Measurements A sample of 267 patients who submitted medications eJournals was contacted by phone 3?weeks after an eligible visit and compared with a matched sample of 274 patients in control practices that received a different PHR-linked intervention. Two blinded physician adjudicators determined unexplained discrepancies between documented and patient-reported medication regimens. The primary outcome was proportion of medications per patient with unexplained discrepancies. Results Among 121?046 patients in eligible practices, 3979 participated in the main trial and 541 participated in the sub-study. The proportion of medications per patient with unexplained discrepancies was 42% in the intervention arm and 51% in the control arm (adjusted OR 0.71, 95% CI 0.54 to 0.94, p=0.01). The number of unexplained discrepancies per patient with potential for severe harm was 0.03 in the intervention arm and 0.08 in the control arm (adjusted RR 0.31, 95% CI 0.10 to 0.92, p=0.04). Conclusions When used, concordance between documented and patient-reported medication regimens and reduction in potentially harmful medication discrepancies can be improved with a PHR medication review tool linked to the provider's medical record. Trial registration number This study was registered at ClinicalTrials.gov (NCT00251875).

Gandhi, Tejal K; Wald, Jonathan S; Grant, Richard W; Poon, Eric G; Volk, Lynn A; Businger, Alexandra; Williams, Deborah H; Siteman, Elizabeth; Buckel, Lauren; Middleton, Blackford

2012-01-01

436

Enhancing patient safety through electronic medical record documentation of vital signs.  

PubMed

As technology becomes more sophisticated in healthcare, there is increasing need to measure its impact on key quality indicators, such as error reduction, patient safety, and cost-benefit ratios. When a product is designed to decrease medical errors, the baseline error rate must be determined before implementation to accurately measure the impact. Given the opportunity to adopt a technology that would eliminate the need to manually document vital signs, a large Florida hospital decided to measure the current process and error rate of vital signs documentation. University Community Hospital in Tampa, Fla., designed a two-phase study to evaluate this process. Phase I of the study evaluated errors in the electronic medical record and traditional manual documentation. The results demonstrate that use of an EMR can reduce vital sign documentation errors by more than half compared with traditional manual documentation in paper charts. Researchers found the error rate for electronic vital signs documentation to be less than 5 percent, compared with the paper chart error rate of 10 percent. PMID:17091789

Gearing, Pauline; Olney, Christine M; Davis, Kim; Lozano, Diego; Smith, Laura B; Friedman, Bruce

2006-01-01

437

The effect of electronic medical record adoption on outcomes in US hospitals  

PubMed Central

Background The electronic medical record (EMR) is one of the most promising components of health information technology. However, the overall impact of EMR adoption on outcomes at US hospitals remains unknown. This study examined the relationship between basic EMR adoption and 30-day rehospitalization, 30-day mortality, inpatient mortality and length of stay. Methods Our overall approach was to compare outcomes for the two years before and two years after the year of EMR adoption, at 708 acute-care hospitals in the US from 2000 to 2007. We looked at the effect of EMR on outcomes using two methods. First, we compared the outcomes by quarter for the period before and after EMR adoption among hospitals that adopted EMR. Second, we compared hospitals that adopted EMR to those that did not, before and after EMR adoption, using a generalized linear model. Results Hospitals adopting EMR experienced 0.11 (95% CI: -0.218 to ?0.002) days’ shorter length of stay and 0.182 percent lower 30-day mortality, but a 0.19 (95% CI: 0.0006 to 0.0033) percent increase in 30-day rehospitalization in the two years after EMR adoption. The association of EMR adoption with outcomes also varied by type of admission (medical vs. surgical). Conclusions Previous studies using observational data from large samples of hospitals have produced conflicting results. However, using different methods, we found a small but statistically significant association of EMR adoption with outcomes of hospitalization.

2013-01-01

438

Disease risk factors identified through shared genetic architecture and electronic medical records.  

PubMed

Genome-wide association studies have identified genetic variants for thousands of diseases and traits. We evaluated the relationships between specific risk factors (for example, blood cholesterol level) and diseases on the basis of their shared genetic architecture in a comprehensive human disease-single-nucleotide polymorphism association database (VARIMED), analyzing the findings from 8962 published association studies. Similarity between traits and diseases was statistically evaluated on the basis of their association with shared gene variants. We identified 120 disease-trait pairs that were statistically similar, and of these, we tested and validated five previously unknown disease-trait associations by searching electronic medical records (EMRs) from three independent medical centers for evidence of the trait appearing in patients within 1 year of first diagnosis of the disease. We validated that the mean corpuscular volume is elevated before diagnosis of acute lymphoblastic leukemia; both have associated variants in the gene IKZF1. Platelet count is decreased before diagnosis of alcohol dependence; both are associated with variants in the gene C12orf51. Alkaline phosphatase level is elevated in patients with venous thromboembolism; both share variants in ABO. Similarly, we found that prostate-specific antigen and serum magnesium levels were altered before the diagnosis of lung cancer and gastric cancer, respectively. Disease-trait associations identify traits that could serve as future prognostics, if validated through EMR and subsequent prospective trials. PMID:24786325

Li, Li; Ruau, David J; Patel, Chirag J; Weber, Susan C; Chen, Rong; Tatonetti, Nicholas P; Dudley, Joel T; Butte, Atul J

2014-04-30

439

Anonymization of electronic medical records for validating genome-wide association studies  

PubMed Central

Genome-wide association studies (GWAS) facilitate the discovery of genotype–phenotype relations from population-based sequence databases, which is an integral facet of personalized medicine. The increasing adoption of electronic medical records allows large amounts of patients’ standardized clinical features to be combined with the genomic sequences of these patients and shared to support validation of GWAS findings and to enable novel discoveries. However, disseminating these data “as is” may lead to patient reidentification when genomic sequences are linked to resources that contain the corresponding patients’ identity information based on standardized clinical features. This work proposes an approach that provably prevents this type of data linkage and furnishes a result that helps support GWAS. Our approach automatically extracts potentially linkable clinical features and modifies them in a way that they can no longer be used to link a genomic sequence to a small number of patients, while preserving the associations between genomic sequences and specific sets of clinical features corresponding to GWAS-related diseases. Extensive experiments with real patient data derived from the Vanderbilt's University Medical Center verify that our approach generates data that eliminate the threat of individual reidentification, while supporting GWAS validation and clinical case analysis tasks.

Loukides, Grigorios; Gkoulalas-Divanis, Aris; Malin, Bradley

2010-01-01

440

[General information system through whole hospital and electronic medical record system].  

PubMed

A new system has been introduced and implemented at the Nagoya City University Hospital since January 2004 in order to improve services for patients and general operation for management of the hospital. General Information System has been consisted with Electronic Medical Record System (EMRS), which is the core of all system and divisional system such as Clinical Laboratory Tests, Images, Medical Accounting and so on. A new system has been built and operated to work with the EMRS at the Department of Central Clinical Laboratory (CCL). To cooperate with the new system, we have constructed and operated directly the EMRS such as automatic registration the latest information on infectious diseases and blood transfusions, clinical reports on laboratory test through the hospital news and/or e-mail, introducing laboratory pre test before the consultation, rapid reports of panic values to the doctor in charge of the patients directly, the new system build up a closer cooperation between division of blood transfusion division and that of immuno-chemistry in CCL through EMRS. The new system has been brought not only efficiency and strengthen of function in CCL but also strengthen the service to patients in the hospital. PMID:16548236

Goto, Takaaki

2006-02-01

441

Combining Information from Cancer Registry and Medical Records Data to Improve Analyses of Adjuvant Cancer Therapies  

PubMed Central

SUMMARY Cancer registry records contain valuable data on provision of adjuvant therapies for cancer patients. Previous studies, however, have shown that these therapies are underreported in registry systems. Hence direct use of the registry data may lead to invalid analysis results. We propose first to impute correct treatment status, borrowing information from an additional source such as medical records data collected in a validation sample, and then to analyze the multiply imputed data, as in Yucel and Zaslavsky (2005). We extend their models to multiple therapies using multivariate probit models with random effects. Our model takes into account the associations among different therapies in both administration and probability of reporting, as well as the multilevel structure (patients clustered within hospitals) of registry data. We use Gibbs sampling to estimate model parameters and impute treatment status. The proposed methodology is applied to the data from the Quality of Cancer Care project, in which stage II or III colorectal cancer patients were eligible to receive adjuvant chemotherapy and radiation therapy.

2009-01-01

442

Feasibility of incorporating genomic knowledge into electronic medical records for pharmacogenomic clinical decision support  

PubMed Central

In pursuing personalized medicine, pharmacogenomic (PGx) knowledge may help guide prescribing drugs based on a person’s genotype. Here we evaluate the feasibility of incorporating PGx knowledge, combined with clinical data, to support clinical decision-making by: 1) analyzing clinically relevant knowledge contained in PGx knowledge resources; 2) evaluating the feasibility of a rule-based framework to support formal representation of clinically relevant knowledge contained in PGx knowledge resources; and, 3) evaluating the ability of an electronic medical record/electronic health record (EMR/EHR) to provide computable forms of clinical data needed for PGx clinical decision support. Findings suggest that the PharmGKB is a good source for PGx knowledge to supplement information contained in FDA approved drug labels. Furthermore, we found that with supporting knowledge (e.g. IF age <18 THEN patient is a child), sufficient clinical data exists in University of Washington’s EMR systems to support 50% of PGx knowledge contained in drug labels that could be expressed as rules.

2010-01-01

443

Tissue Banking, Bioinformatics, and Electronic Medical Records: The Front-End Requirements for Personalized Medicine  

PubMed Central

Personalized medicine promises patient-tailored treatments that enhance patient care and decrease overall treatment costs by focusing on genetics and “-omics” data obtained from patient biospecimens and records to guide therapy choices that generate good clinical outcomes. The approach relies on diagnostic and prognostic use of novel biomarkers discovered through combinations of tissue banking, bioinformatics, and electronic medical records (EMRs). The analytical power of bioinformatic platforms combined with patient clinical data from EMRs can reveal potential biomarkers and clinical phenotypes that allow researchers to develop experimental strategies using selected patient biospecimens stored in tissue banks. For cancer, high-quality biospecimens collected at diagnosis, first relapse, and various treatment stages provide crucial resources for study designs. To enlarge biospecimen collections, patient education regarding the value of specimen donation is vital. One approach for increasing consent is to offer publically available illustrations and game-like engagements demonstrating how wider sample availability facilitates development of novel therapies. The critical value of tissue bank samples, bioinformatics, and EMR in the early stages of the biomarker discovery process for personalized medicine is often overlooked. The data obtained also require cross-disciplinary collaborations to translate experimental results into clinical practice and diagnostic and prognostic use in personalized medicine.

Suh, K. Stephen; Sarojini, Sreeja; Youssif, Maher; Nalley, Kip; Milinovikj, Natasha; Elloumi, Fathi; Russell, Steven; Pecora, Andrew; Schecter, Elyssa; Goy, Andre

2013-01-01

444

7 CFR 371.4 - Veterinary Services.  

Code of Federal Regulations, 2010 CFR

...a) General statement. Veterinary Services (VS) protects...coordinates activities pertaining to veterinary biologics. (b) Deputy...activities of the Center for Veterinary Biologics. (3) Providing...methods development, and research activities in support of...

2009-01-01

445

7 CFR 371.4 - Veterinary Services.  

Code of Federal Regulations, 2010 CFR

...a) General statement. Veterinary Services (VS) protects...coordinates activities pertaining to veterinary biologics. (b) Deputy...activities of the Center for Veterinary Biologics. (3) Providing...methods development, and research activities in support of...

2010-01-01

446

Statement on access to relevant medical and other health records and relevant legal records for forensic medical evaluations of alleged torture and other cruel, inhuman or degrading treatment or punishment.  

PubMed

In some jurisdictions attempts have been made to limit or deny access to medical records for victims of torture seeking remedy or reparations or for individuals who have been accused of crimes based on confessions allegedly extracted under torture. The following article describes the importance of full disclosure of all medical and other health records, as well as legal documents, in any case in which an individual alleges that they have been subjected to torture or other forms of cruel, inhuman or degrading treatment of punishment. A broad definition of what must be included in the terms medical and health records is put forward, and an overview of why their full disclosure is an integral part of international standards for the investigation and documentation of torture (the Istanbul Protocol). The fact that medical records may reveal the complicity or direct participation of healthcare professionals in acts of torture and other ill-treatment is discussed. A summary of international law and medical ethics surrounding the right of access to personal information, especially health information in connection with allegations of torture is also given. PMID:23472795

Alempijevic, D; Beriashvili, R; Beynon, J; Duque, M; Duterte, P; Fernando, R; Fincanci, S; Hansen, S; Hardi, L; Hougen, H; Iacopino, V; Mendonça, M; Modvig, J; Mendez, M; Özkalipci, Ö; Payne-James, J; Peel, M; Rasmussen, O; Reyes, H; Rogde, S; Sajantila, A; Treue, F; Vanezis, P; Vieira, D

2013-04-01

447

Strategies for Educational Action To Meet Veterinary Medicine's Role in Biodefense and Public Health.  

ERIC Educational Resources Information Center

Summarizes recommendations of a conference focused on how veterinary education needs to change to meet the challenges ahead related to biodefense and public health. Presents results of seven sections, each dealing with a major issue related to veterinary medical education. (SLD)

Baker, John; Blackwell, Michael; Buss, Daryl; Eyre, Peter; Held, Joe R.; Ogilvie, Tim; Pappaioanou, Marguerite; Sawyer, Leigh

2003-01-01

448

Veterinary Research and the African Rinderpest Epizootic: The Cape Colony, 1896-1898  

Microsoft Academic Search

The rinderpest epizootic produced in the Cape Colony a crisis of knowledge about animal disease and its control. The Cape government drew on the knowledge and expertise of veterinary and medical scientists to devise means of dealing with the epizootic. This article examines veterinary policy and research into rinderpest at the Cape. Policy was initially based on the British model

Daniel Gilfoyle

2003-01-01

449

Recordings  

Microsoft Academic Search

Akom: the art of possession. Village Pulse VPU?1009, 1999. 72 mins. Recordings and booklet (24pp.) by Scott Kiehl in English.Soungalo Coulibaly: Dengo. Ethnomad ARN 64544, 2001 (recorded in 1995). 51 mins. Booklet (16pp.) in French, English.Serbie: antholagie de la musique populaire serbe \\/ Serbia: an anthology of Serbian folk musk. VDE?GALLO, CP 945\\/ AIMP LX, 1999. 72.22 mins. Recordings (1975–96)

Trevor Wiggins; Jelena Jovanovi?; Razia Sultanova; Neil Sorrell; Jan Fairley

2001-01-01

450

Veterinary cancer epidemiology.  

PubMed

This paper reviews the impact of veterinary cancer epidemiology on veterinary oncology, human oncology, comparative oncology, and on the etiology and pathogenesis of cancer. The detection of clusters of diseased animals has led to the discovery of the infectious, viral-associated nature of malignant lymphoma of cats, poultry, and cattle. Although some viruses (FeLV, BLV) can, under experimental conditions, cross the species barrier, there is thus far no evidence for a zoonotic hazard for the human. The keeping of pet/birds or pigeons was found to be associated with an increased risk of lung cancer in the bird keepers. Dogs appear to be useful 'sentinels' for environmental hazards (asbestos, dyes, passive smoking, insecticides). The complex pathogenesis of cancer was dissected in an epidemiologic-experimental study in cows, which had intestinal papillomas and carcinomas. Endogenous genetic factors may also play a role in pathogenesis, as is evidenced by species, breed (Boxer!), and family related aggregates of tumour diseases. Epidemiology may provide a means to prevent tumour diseases by, for example, withdrawal of hormones (mammary cancer) or isolation of tumour-virus positive animals (malignant lymphoma). PMID:8833612