Sample records for administration electronic systems

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

    PubMed

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

    2016-06-01

    Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care facilities. The accuracy and safety of these systems has not been studied. What does this paper add? The present study identified discrepancies between general practitioners' orders and pharmacy-prepared electronic medication administration charts, back-up paper medication charts and dose-administration aids, as well as delays between ordering, charting and administering medicines. Discrepancies and delays sometimes led to medication administration errors. What are the implications for practitioners? Facilities that use hybrid systems need to implement robust systems for communicating medication changes to their pharmacy and reconciling prescribers' orders against pharmacy-generated medication charts and dose-administration aids. Fully integrated, paperless medication management systems, in which prescribers' electronic medication orders directly populate an electronic medication administration chart and are automatically communicated to the facility's pharmacy, could improve patient safety.

  2. Integrated information systems for electronic chemotherapy medication administration.

    PubMed

    Levy, Mia A; Giuse, Dario A; Eck, Carol; Holder, Gwen; Lippard, Giles; Cartwright, Julia; Rudge, Nancy K

    2011-07-01

    Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations.

  3. Integrated Information Systems for Electronic Chemotherapy Medication Administration

    PubMed Central

    Levy, Mia A.; Giuse, Dario A.; Eck, Carol; Holder, Gwen; Lippard, Giles; Cartwright, Julia; Rudge, Nancy K.

    2011-01-01

    Introduction: Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. Methods: We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. Results: We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. Conclusion: Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations. PMID:22043185

  4. Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.

    PubMed

    Cartmill, Randi S; Walker, James M; Blosky, Mary Ann; Brown, Roger L; Djurkovic, Svetolik; Dunham, Deborah B; Gardill, Debra; Haupt, Marilyn T; Parry, Dean; Wetterneck, Tosha B; Wood, Kenneth E; Carayon, Pascale

    2012-11-01

    To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients. We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated. The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration. The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. 48 CFR 504.500 - Scope of subpart.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Scope of subpart. 504.500 Section 504.500 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 504.500 Scope of subpart. This subpart provides policy and procedure for use of GSA's Electronic...

  6. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    ERIC Educational Resources Information Center

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  7. 12 CFR 609.925 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... systems. (c) Electronic business (E-business) or electronic commerce (E-commerce) means buying, selling, producing, or working in an electronic medium. (d) Electronic mail (E-mail) means: (1) To send or submit... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions...

  8. 12 CFR 609.925 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... systems. (c) Electronic business (E-business) or electronic commerce (E-commerce) means buying, selling, producing, or working in an electronic medium. (d) Electronic mail (E-mail) means: (1) To send or submit... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions...

  9. 12 CFR 609.925 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... systems. (c) Electronic business (E-business) or electronic commerce (E-commerce) means buying, selling, producing, or working in an electronic medium. (d) Electronic mail (E-mail) means: (1) To send or submit... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions...

  10. 12 CFR 609.925 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... systems. (c) Electronic business (E-business) or electronic commerce (E-commerce) means buying, selling, producing, or working in an electronic medium. (d) Electronic mail (E-mail) means: (1) To send or submit... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions...

  11. 12 CFR 609.925 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... systems. (c) Electronic business (E-business) or electronic commerce (E-commerce) means buying, selling, producing, or working in an electronic medium. (d) Electronic mail (E-mail) means: (1) To send or submit... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions...

  12. "Teaching Case": ComprehensiveCare and the Failed Implementation of an Electronic Health Records System

    ERIC Educational Resources Information Center

    Gomillion, David L.

    2017-01-01

    Administrator Jennifer Stanton attempts to adopt an Electronic Health Records system at ComprehensiveCare, a multispecialty healthcare practice. Consultants from the vendor provide guidance to the organization, but do not provide that guidance in a way that the non-technical administrator understands. The project experiences escalation of…

  13. Deconstructing Clinical Workflow: Identifying Teaching-Learning Principles for Barcode Electronic Medication Administration With Nursing Students.

    PubMed

    Booth, Richard G; Sinclair, Barbara; Strudwick, Gillian; Brennan, Laura; Morgan, Lisa; Collings, Stephanie; Johnston, Jessica; Loggie, Brittany; Tong, James; Singh, Chantal

    The purpose of this quality improvement project was to better understand how to teach medication administration underpinned by an electronic medication administration record (eMAR) system used in simulated, prelicensure nursing education. Methods included a workflow and integration analysis and a detailed process mapping of both an oral and a sublingual medication administration. Procedural and curriculum development considerations related to medication administration using eMAR technology are presented for nurse educators.

  14. Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia

    PubMed Central

    El.Mahalli, Azza; El-Khafif, Sahar H.; Yamani, Wid

    2016-01-01

    The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended. PMID:26903780

  15. Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

    PubMed

    El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

    2016-01-01

    The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

  16. The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study.

    PubMed

    Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

    2007-08-01

    To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (p<0.001; chi(2) test). MAEs occurred in 7.0% of 1473 non-intravenous doses pre-intervention and 4.3% of 1139 afterwards (p = 0.005; chi(2) test). Patient identity was not checked for 82.6% of 1344 doses pre-intervention and 18.9% of 1291 afterwards (p<0.001; chi(2) test). Medical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; chi(2) test). A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

  17. 12 CFR 609.950 - Electronic communications.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... with E-SIGN, System institutions may communicate electronically in business, consumer, or commercial transactions. E-commerce transactions require the agreement of all parties when you do business. (b....950 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General...

  18. 12 CFR 609.950 - Electronic communications.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... with E-SIGN, System institutions may communicate electronically in business, consumer, or commercial transactions. E-commerce transactions require the agreement of all parties when you do business. (b....950 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General...

  19. 12 CFR 609.950 - Electronic communications.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... with E-SIGN, System institutions may communicate electronically in business, consumer, or commercial transactions. E-commerce transactions require the agreement of all parties when you do business. (b....950 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General...

  20. 12 CFR 609.950 - Electronic communications.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... with E-SIGN, System institutions may communicate electronically in business, consumer, or commercial transactions. E-commerce transactions require the agreement of all parties when you do business. (b....950 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General...

  1. 12 CFR 609.950 - Electronic communications.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... with E-SIGN, System institutions may communicate electronically in business, consumer, or commercial transactions. E-commerce transactions require the agreement of all parties when you do business. (b....950 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General...

  2. 76 FR 72087 - Special Conditions: Diamond Aircraft Industries, Model DA-40NG; Electronic Engine Control (EEC...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-22

    ... engine design certification, and the certification requirements for engine control systems are driven by... following novel or unusual design features: Electronic engine control system. Discussion As discussed above...; Electronic Engine Control (EEC) System AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final...

  3. Implementation and testing of a Neighborhood Office Center (NOC) and integration of the NOC with an administrative correspondence management information system. [for NASA

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The application of telecommunications and telecomputing was investigated as a means of reducing NASA's consumption of natural resources and the proliferation of paper copies of correspondence. The feasibility, operational advantages, and limitations of decentralized (remote) neighborhood offices (NOC) linked through an electronic network are demonstrated. These offices are joined to a management information system for correspondence tracking, and to an administrative office center service based on the use of magnetic medium word processing typewriters which handle the daily typing load. In connection with an augmented teleconference network, a uniform means is provided for creating, storing, and retrieving administrative documents, records, and data, while simultaneously permitting users of the system to track their status. Information will be transferred without using paper - merely through digital electronic communication and display, as a step toward the establishment of an agency-wide electronic mail system.

  4. 12 CFR 609.905 - Background.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... facilitates electronic commerce (E-commerce) and allows Farm Credit System (System) institutions and their customers to use new technologies. System institutions may use E-commerce but must establish good business... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.905...

  5. 12 CFR 609.905 - Background.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... facilitates electronic commerce (E-commerce) and allows Farm Credit System (System) institutions and their customers to use new technologies. System institutions may use E-commerce but must establish good business... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.905...

  6. 12 CFR 609.905 - Background.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... facilitates electronic commerce (E-commerce) and allows Farm Credit System (System) institutions and their customers to use new technologies. System institutions may use E-commerce but must establish good business... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.905...

  7. 12 CFR 609.905 - Background.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... facilitates electronic commerce (E-commerce) and allows Farm Credit System (System) institutions and their customers to use new technologies. System institutions may use E-commerce but must establish good business... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.905...

  8. 12 CFR 609.905 - Background.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... facilitates electronic commerce (E-commerce) and allows Farm Credit System (System) institutions and their customers to use new technologies. System institutions may use E-commerce but must establish good business... Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.905...

  9. 12 CFR 205.13 - Administrative enforcement; record retention.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 2 2011-01-01 2011-01-01 false Administrative enforcement; record retention. 205.13 Section 205.13 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM ELECTRONIC FUND TRANSFERS (REGULATION E) § 205.13 Administrative enforcement; record...

  10. 12 CFR 205.13 - Administrative enforcement; record retention.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Administrative enforcement; record retention. 205.13 Section 205.13 Banks and Banking FEDERAL RESERVE SYSTEM BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM ELECTRONIC FUND TRANSFERS (REGULATION E) § 205.13 Administrative enforcement; record...

  11. Evaluating a Serious Gaming Electronic Medication Administration Record System Among Nursing Students: Protocol for a Pragmatic Randomized Controlled Trial.

    PubMed

    Booth, Richard; Sinclair, Barbara; McMurray, Josephine; Strudwick, Gillian; Watson, Gavan; Ladak, Hanif; Zwarenstein, Merrick; McBride, Susan; Chan, Ryan; Brennan, Laura

    2018-05-28

    Although electronic medication administration record systems have been implemented in settings where nurses work, nursing students commonly lack robust learning opportunities to practice the skills and workflow of digitalized medication administration during their formative education. As a result, nursing students' performance in administering medication facilitated by technology is often poor. Serious gaming has been recommended as a possible intervention to improve nursing students' performance with electronic medication administration in nursing education. The objectives of this study are to examine whether the use of a gamified electronic medication administration simulator (1) improves nursing students' attention to medication administration safety within simulated practice, (2) increases student self-efficacy and knowledge of the medication administration process, and (3) improves motivational and cognitive processing attributes related to student learning in a technology-enabled environment. This study comprised the development of a gamified electronic medication administration record simulator and its evaluation in 2 phases. Phase 1 consists of a prospective, pragmatic randomized controlled trial with second-year baccalaureate nursing students at a Canadian university. Phase 2 consists of qualitative focus group interviews with a cross-section of nursing student participants. The gamified medication administration simulator has been developed, and data collection is currently under way. If the gamified electronic medication administration simulator is found to be effective, it could be used to support other health professional simulated education and scaled more widely in nursing education programs. ClinicalTrials.gov NCT03219151; https://clinicaltrials.gov/show/NCT03219151 (Archived by WebCite at http://www.webcitation.org/6yjBROoDt). RR1-10.2196/9601. ©Richard Booth, Barbara Sinclair, Josephine McMurray, Gillian Strudwick, Gavan Watson, Hanif Ladak, Merrick Zwarenstein, Susan McBride, Ryan Chan, Laura Brennan. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.05.2018.

  12. Use of Electronic Medication Administration Records to Reduce Perceived Stress and Risk of Medication Errors in Nursing Homes.

    PubMed

    Alenius, Malin; Graf, Peter

    2016-07-01

    Concerns have been raised about the effects of current medication administration processes on the safety of many of the aspects of medication administration. Keeping electronic medication administration records could decrease many of these problems. Unfortunately, there has not been much research on this topic, especially in nursing homes. A prospective case-control survey was consequently performed at two nursing homes; the electronic record system was introduced in one, whereas the other continued to use paper records. The personnel were asked to fill in a questionnaire of their perceptions of stress and risk of medication errors at baseline (n = 66) and 20 weeks after the intervention group had started recording medication administration electronically (n = 59). There were statistically significant decreases in the perceived risk of omitting a medication, of medication errors occurring because of communication problems, and of medication errors occurring because of inaccurate medication administration records in the intervention group (all P < .01 vs the control group). The perceived overall daily stress levels were also reduced in the intervention group (P < .05). These results indicate that the utilization of electronic medication administration records will reduce many of the concerns regarding the medication administration process.

  13. 48 CFR 252.244-7001 - Contractor purchasing system administration.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....246-7007, Contractor Counterfeit Electronic Part Detection and Avoidance System, if applicable; (20... Defense to rely upon information produced by the system that is needed for management purposes. (b... Counterfeit Electronic Part Detection and Avoidance System; (2) Provide for an organizational and...

  14. 12 CFR 620.10 - Preparing the quarterly report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 620.10 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO SHAREHOLDERS... must: (1) Prepare and send, to the Farm Credit Administration, an electronic copy of its quarterly...) Publish a copy of its quarterly report on its Web site when it electronically sends the report to the Farm...

  15. Electronic surveillance and using administrative data to identify healthcare associated infections.

    PubMed

    Gastmeier, Petra; Behnke, Michael

    2016-08-01

    Traditional surveillance of healthcare associated infections (HCAI) is time consuming and error-prone. We have analysed literature of the past year to look at new developments in this field. It is divided into three parts: new algorithms for electronic surveillance, the use of administrative data for surveillance of HCAI, and the definition of new endpoints of surveillance, in accordance with an automatic surveillance approach. Most studies investigating electronic surveillance of HCAI have concentrated on bloodstream infection or surgical site infection. However, the lack of important parameters in hospital databases can lead to misleading results. The accuracy of administrative coding data was poor at identifying HCAI. New endpoints should be defined for automatic detection, with the most crucial step being to win clinicians' acceptance. Electronic surveillance with conventional endpoints is a successful method when hospital information systems implemented key changes and enhancements. One requirement is the access to systems for hospital administration and clinical databases.Although the primary source of data for HCAI surveillance is not administrative coding data, these are important components of a hospital-wide programme of automated surveillance. The implementation of new endpoints for surveillance is an approach which needs to be discussed further.

  16. The impact of a closed‐loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before‐and‐after study

    PubMed Central

    Franklin, Bryony Dean; O'Grady, Kara; Donyai, Parastou; Jacklin, Ann; Barber, Nick

    2007-01-01

    Objectives To assess the impact of a closed‐loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants Before‐and‐after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention Closed‐loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results Prescribing errors were identified in 3.8% of 2450 medication orders pre‐intervention and 2.0% of 2353 orders afterwards (p<0.001; χ2 test). MAEs occurred in 7.0% of 1473 non‐intravenous doses pre‐intervention and 4.3% of 1139 afterwards (p = 0.005; χ2 test). Patient identity was not checked for 82.6% of 1344 doses pre‐intervention and 18.9% of 1291 afterwards (p<0.001; χ2 test). Medical staff required 15 s to prescribe a regular inpatient drug pre‐intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre‐intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions A closed‐loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication‐related tasks increased. PMID:17693676

  17. 23 CFR 950.3 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION INTELLIGENT TRANSPORTATION SYSTEMS ELECTRONIC TOLL... Express Lanes Demonstration Program, and the Interstate System Construction Toll Pilot Program. Electronic toll collection means the ability for vehicle operators to pay tolls automatically without slowing down...

  18. Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.2

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

    Burford, M.J.; Burnett, R.A.; Curtis, L.M.

    The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Chemical biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS system package. System administrators, database administrators, and general users can use this guide to install, configure, and maintain the FEMIS client software package. This document provides a description of the FEMIS environment; distribution media; data, communications, and electronic mail servers; user workstations; and system management.

  19. 77 FR 39206 - Public Hearing on Proposed Rule for Heavy Vehicle Electronic Stability Control Systems

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... Control Systems AGENCY: National Highway Traffic Safety Administration (NHTSA), Department of...) systems on truck tractors and large buses. NHTSA is announcing a public hearing to provide an opportunity... No. 136, Electronic Stability Control Systems for Heavy Vehicles (77 FR 30766). The standard would...

  20. 75 FR 77569 - Special Conditions: Gulfstream Model GVI Airplane; Electronic Flight Control System Mode...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-13

    ... Unusual Design Features The GVI will have a fly-by-wire electronic flight control system. This system... the design of the flight control system has multiple modes of operation, a means must be provided to... Control System Mode Annunciation AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of...

  1. A Framework for Global Electronic Commerce: An Executive Summary.

    ERIC Educational Resources Information Center

    Office of the Press Secretary of the White House

    1997-01-01

    An abbreviated version of a longer policy document on electronic commerce released by the Clinton Administration, this article examines principles and recommendations on tariffs, taxes, electronic payment systems, uniform commercial code for electronic commerce, intellectual property protection, privacy, security, telecommunications infrastructure…

  2. Bringing Up Gopher: Access to Local & Remote Electronic Resources for University Library Users.

    ERIC Educational Resources Information Center

    Brown, Melvin Marlo; And Others

    Some of the administrative and organizational issues in creating a gopher, specifically a library gopher for university libraries, are discussed. In 1993 the Electronic Collections Task Force of the New Mexico State University library administration began to develop a library-based gopher system that would enable users to have unlimited access to…

  3. Functional Requirements Study

    DTIC Science & Technology

    2008-07-01

    Identification System, AIS, Vessel Traffic Services, VTS, Transmit, Broadcast, Functional Requirements, United States Coast Guard, USCG, Mariner, Electronic ...Chart Systems, ECS, Vessel Operators, National Oceanic Atmospheric Administration, NOAA, US Army Corp of Engineers , USACE, ECDIS 18. Distribution...and River Information Service COPT Captain of the Port DGPS Differential Global Positioning System ECDIS Electronic Chart Display Information System

  4. 76 FR 14795 - Special Conditions: Gulfstream Model GVI Airplane; Electronic Flight Control System Mode...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ...). Novel or Unusual Design Features The GVI will have a fly-by-wire electronic flight control system. This... type certification basis for Gulfstream GVI airplanes. If the design of the flight control system has... Control System Mode Annunciation. AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Final...

  5. 48 CFR 604.502 - Policy.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Policy. 604.502 Section 604.502 Federal Acquisition Regulations System DEPARTMENT OF STATE GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 604.502 Policy. (b) The Assistant Secretary of State for Administration is...

  6. 48 CFR 4.502 - Policy.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Policy. 4.502 Section 4.502 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 4.502 Policy. (a) The Federal Government shall use electronic...

  7. 76 FR 31456 - Special Conditions: Gulfstream Model GVI Airplane; Electronic Flight Control System: Control...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-01

    ... Control System: Control Surface Position Awareness AGENCY: Federal Aviation Administration (FAA), DOT... electronic flight control system. The applicable airworthiness regulations do not contain adequate or... regulatory adequacy pursuant to section 611 of Public Law 92-574, the ``Noise Control Act of 1972.'' The FAA...

  8. 5 CFR 850.106 - Electronic signatures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Electronic signatures. 850.106 Section... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION General Provisions § 850.106 Electronic signatures. (a) Subject to any provisions prescribed by the Director under § 850.104— (1) An electronic communication may be...

  9. 5 CFR 850.106 - Electronic signatures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Electronic signatures. 850.106 Section... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION General Provisions § 850.106 Electronic signatures. (a) Subject to any provisions prescribed by the Director under § 850.104— (1) An electronic communication may be...

  10. 48 CFR 204.270 - Electronic Document Access.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

  11. 48 CFR 204.270 - Electronic Document Access.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

  12. 48 CFR 204.270 - Electronic Document Access.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

  13. 5 CFR 850.106 - Electronic signatures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Electronic signatures. 850.106 Section... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION General Provisions § 850.106 Electronic signatures. (a) Subject to any provisions prescribed by the Director under § 850.104— (1) An electronic communication may be...

  14. 48 CFR 204.270 - Electronic Document Access.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

  15. 48 CFR 204.270 - Electronic Document Access.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Electronic Document Access..., DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Distribution 204.270 Electronic Document Access. Follow the procedures at PGI 204.270 relating to obtaining an account in the Electronic Document Access...

  16. 5 CFR 850.106 - Electronic signatures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Electronic signatures. 850.106 Section... (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION General Provisions § 850.106 Electronic signatures. (a) Subject to any provisions prescribed by the Director under § 850.104— (1) An electronic communication may be...

  17. Long-term changes of information environments and computer anxiety of nurse administrators in Japan.

    PubMed

    Majima, Yukie; Izumi, Takako

    2013-01-01

    In Japan, medical information systems, including electronic medical records, are being introduced increasingly at medical and nursing fields. Nurse administrators, who are involved in the introduction of medical information systems and who must make proper judgment, are particularly required to have at least minimal knowledge of computers and networks and the ability to think about easy-to-use medical information systems. However, few of the current generation of nurse administrators studied information science subjects in their basic education curriculum. It can be said that information education for nurse administrators has become a pressing issue. Consequently, in this study, we conducted a survey of participants taking the first level program of the education course for Japanese certified nurse administrators to ascertain the actual conditions, such as the information environments that nurse administrators are in, their anxiety attitude to computers. Comparisons over the seven years since 2004 revealed that although introduction of electronic medical records in hospitals was progressing, little change in attributes of participants taking the course was observed, such as computer anxiety.

  18. Exploring the Relationships between the Electronic Health Record System Components and Patient Outcomes in an Acute Hospital Setting

    ERIC Educational Resources Information Center

    Wiggley, Shirley L.

    2011-01-01

    Purpose: The purpose of this study was to examine the relationship between the electronic health record system components and patient outcomes in an acute hospital setting, given that the current presidential administration has earmarked nearly $50 billion to the implementation of the electronic health record. The relationship between the…

  19. 78 FR 37958 - Special Conditions: Cessna Aircraft Company, Model J182T; Electronic Engine Control System...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ...; Electronic Engine Control System Installation AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... feature(s) associated with the installation of an electronic engine control. The applicable airworthiness...) Engines, Inc. SR305-230E-C1 which is a four-stroke, air cooled, diesel cycle engine that uses turbine (jet...

  20. The Microcomputer in the Administrative Office.

    ERIC Educational Resources Information Center

    Huntington, Fred

    1983-01-01

    Discusses microcomputer uses for administrative computing in education at site level and central office and recommends that administrators start with a word processing program for time management, an electronic spreadsheet for financial accounting, a database management system for inventories, and self-written programs to alleviate paper…

  1. Security of Data, Stored in Information Systems of Bulgarian Municipal Administrations

    NASA Astrophysics Data System (ADS)

    Kapralyakov, Petko

    2011-12-01

    Massive influx of information technology in municipal administrations increases their efficiency in delivering public services but increased the risk of theft of confidential information electronically. The report proposed an approach for improving information security for small municipal governments in Bulgaria through enhanced intrusion detection and prevention system.

  2. Database Administrator

    ERIC Educational Resources Information Center

    Moore, Pam

    2010-01-01

    The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…

  3. Automating Veterans Administration libraries: II. Implementation at the Kansas City Medical Center Library.

    PubMed

    Smith, V K; Ting, S C

    1987-04-01

    In 1985, the Kansas City Veterans Administration Medical Center began implementation of the Decentralized Hospital Computer Program (DHCP). An integrated library system, a subset of that program, was started by the medical library for acquisitions and an outline catalog. To test the system, staff of the Neurology Service were trained to use the outline catalog and electronic mail to request interlibrary loans and literature searches. In implementing the project with the Neurology Service, the library is paving the way for many types of electronic access and interaction with the library.

  4. Electronic Approval: Another Step toward a Paperless Office.

    ERIC Educational Resources Information Center

    Blythe, Kenneth C.; Morrison, Dennis L.

    1992-01-01

    Pennsylvania State University's award-winning electronic approval system allows administrative documents to be electronically generated, approved, and updated in the university's central database. Campus business can thus be conducted faster, less expensively, more accurately, and with greater security than with traditional paper approval…

  5. 48 CFR 504.570 - Procedures for using the EPS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 504.570 Procedures for using the EPS. (a... [Identify address block in the solicitation]. (e) The Electronic Posting System Manual provides detailed... that electronic access to a solicitation will result in adequate competition, distribute the...

  6. 75 FR 33898 - Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0021] Agency Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity Under OMB Review AGENCY: Veterans Benefits... Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below...

  7. 78 FR 79058 - Proposed Information Collection Request; Notice of New Requirements and Procedures for Grant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ...The DOT invites the public and other Federal agencies to comment on a revision to a previously approved information collection concerning new requirements and procedures for grant payment request submission. DOT will submit the proposed renewal of information collection request to the Office of Management and Budget (OMB) for review, as required by the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3506 (c)(2)(A)). This notice sets forth new requirements and procedures for grantees that submit and receive payments from DOT Operating Administrations (OAs).\\1\\ DOT is updating systems that support grant payments and there will be changes to the way grantees complete and submit payment requests. Simplifying the DOT grant payment process will save both the grantee and the Federal Government time and expense that come with paper-based grant application and payment administration. Note: At this time, this requirement is not applicable to DOT grant recipients requesting payment electronically through the National Highway Traffic Safety Administration's Grant Tracking System (GTS), the Federal Highway Administration's Rapid Approval State Payment System (RASPS), or Federal Transit Administration (FTA) grant recipients requesting payment through the Electronic Clearing House Operation System (ECHO-Web). ---------------------------------------------------------------------------

  8. 78 FR 11555 - Special Conditions: Embraer S.A., Model EMB-550 Airplane; Design Roll Maneuver for Electronic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ...; Design Roll Maneuver for Electronic Flight Controls AGENCY: Federal Aviation Administration (FAA), DOT... design roll maneuver for electronic flight controls, specifically an electronic flight control system... control surfaces. The Model EMB-550 airplane is designed for 8 passengers, with a maximum of 12 passengers...

  9. "Teaching Case": ComprehensiveCare and the Re-Adoption of an Electronic Health Records System: Preparing for a Successful Adoption after a Failed Attempt

    ERIC Educational Resources Information Center

    Gomillion, David L.

    2017-01-01

    After a prior failed adoption, ComprehensiveCare plans for a second attempt in adopting Electronic Health Records. The owner-physicians on the board of directors have replaced the administrator due in part to the missteps of the prior adoption. William Shoemaker, the new administrator, must grapple with several important decisions to provide the…

  10. The Frustrated Nerds Project--Resources for Systems Administrators in Higher Education: A Resource Webliography

    ERIC Educational Resources Information Center

    Henninger, Jessamyn; Aber, Susan Ward

    2010-01-01

    Systems Architects and Information Technology administrators working in higher education help faculty, staff, and student computer users. Yet, who helps them? What resources do these professionals value? A case study was conducted using purposeful sampling and data collection through electronic interview to gather the preferred information-seeking…

  11. 12 CFR 620.4 - Preparing and providing the annual report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....4 Section 620.4 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO... institution of the Farm Credit System must: (1) Prepare and send to the Farm Credit Administration an... copy of its annual report on its Web site when it sends the report electronically to the Farm Credit...

  12. 19 CFR 360.108 - Loss of electronic licensing privileges.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Loss of electronic licensing privileges. 360.108 Section 360.108 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.108 Loss of electronic licensing privileges. Should Commerce determine...

  13. 19 CFR 360.108 - Loss of electronic licensing privileges.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Loss of electronic licensing privileges. 360.108 Section 360.108 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.108 Loss of electronic licensing privileges. Should Commerce determine...

  14. 19 CFR 360.108 - Loss of electronic licensing privileges.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Loss of electronic licensing privileges. 360.108 Section 360.108 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.108 Loss of electronic licensing privileges. Should Commerce determine...

  15. 19 CFR 360.108 - Loss of electronic licensing privileges.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Loss of electronic licensing privileges. 360.108 Section 360.108 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.108 Loss of electronic licensing privileges. Should Commerce determine...

  16. 19 CFR 360.108 - Loss of electronic licensing privileges.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Loss of electronic licensing privileges. 360.108 Section 360.108 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.108 Loss of electronic licensing privileges. Should Commerce determine...

  17. Automating Veterans Administration libraries: II. Implementation at the Kansas City Medical Center Library.

    PubMed Central

    Smith, V K; Ting, S C

    1987-01-01

    In 1985, the Kansas City Veterans Administration Medical Center began implementation of the Decentralized Hospital Computer Program (DHCP). An integrated library system, a subset of that program, was started by the medical library for acquisitions and an outline catalog. To test the system, staff of the Neurology Service were trained to use the outline catalog and electronic mail to request interlibrary loans and literature searches. In implementing the project with the Neurology Service, the library is paving the way for many types of electronic access and interaction with the library. PMID:3594023

  18. ASHP national survey of pharmacy practice in hospital settings: dispensing and administration--2011.

    PubMed

    Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

    2012-05-01

    Results of the 2011 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are presented. A stratified random sample of pharmacy directors at 1401 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 40.1%. Decentralization of the medication-use system continues, with 40% of hospitals using a decentralized system and 58% of hospitals planning to use a decentralized model in the future. Automated dispensing cabinets were used by 89% of hospitals, robots were used by 11%, carousels were used in 18%, and machine-readable coding was used in 34% of hospitals to verify doses before dispensing. Overall, 65% of hospitals had a United States Pharmacopeia chapter 797 compliant cleanroom for compounding sterile preparations. Medication administration records (MARs) have become increasingly computerized, with 67% of hospitals using electronic MARs. Bar-code-assisted medication administration was used in 50% of hospitals, and 68% of hospitals had smart infusion pumps. Health information is becoming more electronic, with 67% of hospitals having partially or completely implemented an electronic health record and 34% of hospitals having computerized prescriber order entry. The use of these technologies has substantially increased over the past year. The average number of full-time equivalent staff per 100 occupied beds averaged 17.5 for pharmacists and 15.0 for technicians. Directors of pharmacy reported declining vacancy rates for pharmacists. Pharmacists continue to improve medication use at the dispensing and administration steps of the medication-use system. The adoption of new technology is changing the philosophy of medication distribution, and health information is rapidly becoming electronic.

  19. Electronics. Criterion-Referenced Test (CRT) Item Bank.

    ERIC Educational Resources Information Center

    Davis, Diane, Ed.

    This document contains 519 criterion-referenced multiple choice and true or false test items for a course in electronics. The test item bank is designed to work with both the Vocational Instructional Management System (VIMS) and the Vocational Administrative Management System (VAMS) in Missouri. The items are grouped into 15 units covering the…

  20. SpecialNet. A National Computer-Based Communications Network.

    ERIC Educational Resources Information Center

    Morin, Alfred J.

    1986-01-01

    "SpecialNet," a computer-based communications network for educators at all administrative levels, has been established and is managed by National Systems Management, Inc. Users can send and receive electronic mail, share information on electronic bulletin boards, participate in electronic conferences, and send reports and other documents to each…

  1. Minimizing human error in radiopharmaceutical preparation and administration via a bar code-enhanced nuclear pharmacy management system.

    PubMed

    Hakala, John L; Hung, Joseph C; Mosman, Elton A

    2012-09-01

    The objective of this project was to ensure correct radiopharmaceutical administration through the use of a bar code system that links patient and drug profiles with on-site information management systems. This new combined system would minimize the amount of manual human manipulation, which has proven to be a primary source of error. The most common reason for dosing errors is improper patient identification when a dose is obtained from the nuclear pharmacy or when a dose is administered. A standardized electronic transfer of information from radiopharmaceutical preparation to injection will further reduce the risk of misadministration. Value stream maps showing the flow of the patient dose information, as well as potential points of human error, were developed. Next, a future-state map was created that included proposed corrections for the most common critical sites of error. Transitioning the current process to the future state will require solutions that address these sites. To optimize the future-state process, a bar code system that links the on-site radiology management system with the nuclear pharmacy management system was proposed. A bar-coded wristband connects the patient directly to the electronic information systems. The bar code-enhanced process linking the patient dose with the electronic information reduces the number of crucial points for human error and provides a framework to ensure that the prepared dose reaches the correct patient. Although the proposed flowchart is designed for a site with an in-house central nuclear pharmacy, much of the framework could be applied by nuclear medicine facilities using unit doses. An electronic connection between information management systems to allow the tracking of a radiopharmaceutical from preparation to administration can be a useful tool in preventing the mistakes that are an unfortunate reality for any facility.

  2. Designing and testing a tool for evaluating electronic flight bags

    DOT National Transportation Integrated Search

    2004-09-29

    The Federal Aviation Administration (FAA), system designers, and customers all recognize that Electronic Flight Bags (EFBs) are sophisticated devices whose use could affect pilot performance. As a result, human factors issues have received considerab...

  3. 49 CFR 239.303 - Electronic recordkeeping.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Electronic recordkeeping. 239.303 Section 239.303 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... limits and controls accessibility to such information retained in its database system and identifies...

  4. Designing a tool to assess the usability of electronic flight bags (EFBs)

    DOT National Transportation Integrated Search

    2004-09-01

    The Federal Aviation Administration (FAA), system designers, and customers all recognize that Electronic Flight Bags (EFBs) are sophisticated devices whose use could affect pilot performance. As a result, human factors issues have received considerab...

  5. Online Treasures: No Rest for the Weary, or, a Systems Administrator's Work is Never Done

    ERIC Educational Resources Information Center

    Balas, Janet L.

    2006-01-01

    It is easy for a library systems administrator to sometimes feel quite overwhelmed by the responsibilities of the job. Keeping a network running smoothly is a challenge in itself, but they must also be concerned with protecting the network from the many threats that exist. Constant vigilance is necessary to guard against electronic attacks…

  6. Safety and fitness electronic records system (SAFER) : user and system requirements document

    DOT National Transportation Integrated Search

    1996-10-28

    The Federal Highway Administration (FHWA) is currently testing and evaluating Intelligent : Transportation Systems (ITS) technologies to enhance the safety and efficiency of interstate and : intrastate commercial vehicle operations. The current focus...

  7. 49 CFR 239.303 - Electronic recordkeeping.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Electronic recordkeeping. 239.303 Section 239.303 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... accessibility to such information retained in its database system and identifies those individuals who have such...

  8. 49 CFR 239.303 - Electronic recordkeeping.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Electronic recordkeeping. 239.303 Section 239.303 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... accessibility to such information retained in its database system and identifies those individuals who have such...

  9. 49 CFR 239.303 - Electronic recordkeeping.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Electronic recordkeeping. 239.303 Section 239.303 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... accessibility to such information retained in its database system and identifies those individuals who have such...

  10. 49 CFR 239.303 - Electronic recordkeeping.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Electronic recordkeeping. 239.303 Section 239.303 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... accessibility to such information retained in its database system and identifies those individuals who have such...

  11. Impact of an electronic medication administration record on medication administration efficiency and errors.

    PubMed

    McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

    2014-12-01

    The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.

  12. 75 FR 22678 - Pipeline Safety: Implementation of Electronic Filing for Recently Revised Incident/Accident...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-29

    ... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... Liquid Systems AGENCY: Pipeline and Hazardous Materials Safety Administration (PHMSA), DOT. ACTION: Notice; Issuance of Advisory Bulletin. SUMMARY: This notice advises owners and operators of gas pipeline...

  13. 49 CFR 217.9 - Program of operational tests and inspections; recordkeeping.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... controls accessibility to such information retained in its electronic database system and identifies those... inspections required by this section, the Associate Administrator for Safety may, for cause stated, disapprove... disapproval decision. If the Associate Administrator for Safety disapproves the program, (1) The railroad has...

  14. 49 CFR 217.9 - Program of operational tests and inspections; recordkeeping.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... controls accessibility to such information retained in its electronic database system and identifies those... inspections required by this section, the Associate Administrator for Safety may, for cause stated, disapprove... disapproval decision. If the Associate Administrator for Safety disapproves the program, (1) The railroad has...

  15. 49 CFR 217.9 - Program of operational tests and inspections; recordkeeping.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... controls accessibility to such information retained in its electronic database system and identifies those... inspections required by this section, the Associate Administrator for Safety may, for cause stated, disapprove... disapproval decision. If the Associate Administrator for Safety disapproves the program, (1) The railroad has...

  16. 49 CFR 217.9 - Program of operational tests and inspections; recordkeeping.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... controls accessibility to such information retained in its electronic database system and identifies those... inspections required by this section, the Associate Administrator for Safety may, for cause stated, disapprove... disapproval decision. If the Associate Administrator for Safety disapproves the program, (1) The railroad has...

  17. The UNIX/XENIX Advantage: Applications in Libraries.

    ERIC Educational Resources Information Center

    Gordon, Kelly L.

    1988-01-01

    Discusses the application of the UNIX/XENIX operating system to support administrative office automation functions--word processing, spreadsheets, database management systems, electronic mail, and communications--at the Central Michigan University Libraries. Advantages and disadvantages of the XENIX operating system and system configuration are…

  18. 48 CFR 4.501 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false [Reserved] 4.501 Section 4.501 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 4.501 [Reserved] ...

  19. 12 CFR 609.945 - Records retention.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Records retention. 609.945 Section 609.945 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.945 Records retention. Records stored electronically must be accurate, accessible...

  20. 36 CFR § 1222.26 - What are the general recordkeeping requirements for agency programs?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF... be created and maintained to document program policies, procedures, functions, activities, and... electronic records; (c) Related records series and systems; (d) The relationship between paper and electronic...

  1. 12 CFR 609.945 - Records retention.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Records retention. 609.945 Section 609.945 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.945 Records retention. Records stored electronically must be accurate, accessible...

  2. 21 CFR 10.205 - Electronic media coverage of public administrative proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Electronic media coverage of public administrative... SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media Coverage of Public Administrative Proceedings; Guideline on Policy and Procedures § 10.205 Electronic media coverage of public administrative...

  3. 21 CFR 10.205 - Electronic media coverage of public administrative proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Electronic media coverage of public administrative... SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media Coverage of Public Administrative Proceedings; Guideline on Policy and Procedures § 10.205 Electronic media coverage of public administrative...

  4. 21 CFR 10.205 - Electronic media coverage of public administrative proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Electronic media coverage of public administrative... SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media Coverage of Public Administrative Proceedings; Guideline on Policy and Procedures § 10.205 Electronic media coverage of public administrative...

  5. 21 CFR 10.205 - Electronic media coverage of public administrative proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Electronic media coverage of public administrative... SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media Coverage of Public Administrative Proceedings; Guideline on Policy and Procedures § 10.205 Electronic media coverage of public administrative...

  6. 21 CFR 10.205 - Electronic media coverage of public administrative proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Electronic media coverage of public administrative... SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media Coverage of Public Administrative Proceedings; Guideline on Policy and Procedures § 10.205 Electronic media coverage of public administrative...

  7. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

    PubMed Central

    Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-01-01

    Background The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. Objective We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. Methods We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. Results This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Conclusions Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. PMID:29669709

  8. Server-Based and Server-Less Byod Solutions to Support Electronic Learning

    DTIC Science & Technology

    2016-06-01

    Knowledge Online NSD National Security Directive OS operating system OWA Outlook Web Access PC personal computer PED personal electronic device PDA...mobile devices, institute mobile device policies and standards, and promote the development and use of DOD mobile and web -enabled applications” (DOD...with an isolated BYOD web server, properly educated system administrators must carry out and execute the necessary, pre-defined network security

  9. Future Directions in Navy Electronic System Reliability and Survivability.

    DTIC Science & Technology

    1981-06-01

    CENTERSAN DIEGO, CA 92152 AN ACTIVITY OF THE NAVAL MATERIAL COMMAND SL GUILLE, CAPT, USN HLBLOOD Commander Technical Director ADMINISTRATIVE INFORMATION...maintenancepoiys proposed as one remedy to these problems. To implement this policy, electronic systems which are very reliable and which include health ...distribute vital data, data-processing capability, and communication capability through the use of intraship and intership networks. The capability to

  10. 12 CFR 620.10 - Preparing the quarterly report.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Preparing the quarterly report. 620.10 Section 620.10 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM DISCLOSURE TO SHAREHOLDERS... must: (1) Prepare and send, to the Farm Credit Administration, an electronic copy of its quarterly...

  11. 14 CFR 1215.102 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION TRACKING AND DATA RELAY SATELLITE SYSTEM.... The Tracking and Data Relay Satellite System including Tracking and Data Relay Satellites (TDRS), the... user ground system/TDRSS interface. (c) Bit stream. The digital electronic signals acquired by TDRSS...

  12. 78 FR 29204 - Notice of Request for Revisions of an Information Collection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... public transportation systems. In two subsequent years, The Transportation, Housing and Urban Development... DEPARTMENT OF TRANSPORTATION Federal Transit Administration [FTA Docket No. FTA-2013-0025] Notice... electronic docket site. (Note: The U.S. Department of Transportation's (DOT's) electronic docket is no longer...

  13. 77 FR 65913 - Privacy Act of 1974: Systems of Records.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... performing clerical, stenographic, or data analysis functions, or by reproduction of records by electronic or... performing clerical, stenographic, or data analysis functions, or by reproduction of records by electronic or... Services (OGIS) National Archives and Records Administration, in connection with mediation of FOIA requests...

  14. 78 FR 73993 - Special Conditions: Cessna Model 680 Series Airplanes; Aircraft Electronic System Security...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-10

    ... design feature associated with the architecture and connectivity capabilities of the airplanes' computer... vulnerabilities to the airplanes' systems. The proposed network architecture includes the following connectivity.... Operator business and administrative support systems, and 3. Passenger entertainment systems, and access by...

  15. I Was Attacked Online!

    ERIC Educational Resources Information Center

    Hensel, Jan

    1996-01-01

    Considers some of the problems posed by electronic mail systems when the identity of the user is protected by the server. Suggests that high school instructors and administrators have good reason to circulate electronic messages through a central site, as students need to be protected from exploitative users and prohibited from sending abusive…

  16. Internet Database Review: The FDA BBS.

    ERIC Educational Resources Information Center

    Tomaiuolo, Nicholas G.

    1993-01-01

    Describes the electronic bulletin board system (BBS) of the Food and Drug Administration (FDA) that is accessible through the Internet. Highlights include how to gain access; the menu-driven software; other electronic sources of FDA information; and adding value. Examples of the FDA BBS menu and the help screen are included. (LRW)

  17. 48 CFR 204.604 - Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Section 204.604 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Reporting 204.604 Responsibilities. (1) The... in the associated Government contract file instead of including a paper copy of the electronically...

  18. 48 CFR 204.604 - Responsibilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Section 204.604 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Reporting 204.604 Responsibilities. (1) The... in the associated Government contract file instead of including a paper copy of the electronically...

  19. 48 CFR 204.604 - Responsibilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Section 204.604 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Reporting 204.604 Responsibilities. (1) The... in the associated Government contract file instead of including a paper copy of the electronically...

  20. 48 CFR 204.604 - Responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Section 204.604 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Reporting 204.604 Responsibilities. (1) The... in the associated Government contract file instead of including a paper copy of the electronically...

  1. 48 CFR 204.604 - Responsibilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Section 204.604 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE GENERAL ADMINISTRATIVE MATTERS Contract Reporting 204.604 Responsibilities. (1) The... in the associated Government contract file instead of including a paper copy of the electronically...

  2. 76 FR 70209 - Proposed Information Collection Request; Notice of New Requirements and Procedures for Grant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... Procedures for Grant Payment Request Submission. OMB Control Number: XXXX-XXXX. Type of Request: New... Administrations (OAs).\\1\\ DOT is updating systems that support grant payments and there will be changes to the way... requesting payment electronically through the National Highway Traffic Safety Administration's Grant Tracking...

  3. 75 FR 1446 - Future Systems Technology Advisory Panel Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-11

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2010-0001] Future Systems Technology Advisory Panel... systems technology and electronic services at the agency five to ten years into the future. The Panel will recommend a road map to aid SSA in determining what future systems technologies may be developed to assist...

  4. [Views of health system administrators, professionals, and users concerning the electronic health record and facilitators and obstacles to its implementation].

    PubMed

    Costa, Jose Felipe Riani; Portela, Margareth Crisóstomo

    2018-02-05

    The design and deployment of complex technologies like the electronic health record (EHR) involve technical, personal, social, and organizational issues. The Brazilian public and private scenario includes different local and regional initiatives for implementation of the electronic health record. The Brazilian Ministry of Health also has a proposal to develop a national EHR. The current study aimed to provide a comprehensive view of perceptions by health system administrators, professionals, and users concerning their experiences with the electronic health record and their opinions of the possibility of developing a national EHR. This qualitative study involved 28 semi-structured interviews. The results revealed both the diversity of factors that can influence the implementation of an electronic health record and the existence of convergences and aspects that tend to be valued differently according to the different points of view. Key aspects include discussions on the electronic health record's attributes and it impact on healthcare, especially in the case of local electronic health records, concerns over costs and confidentiality and privacy pertaining to electronic health records in general, and the possible implications of centralized versus decentralized data storage in the case of a national EHR. The interviews clearly showed the need to establish more effective communication among the various stakeholders, and that the different perspectives should be considered when drafting and deploying an EHR at the local, regional, and national levels.

  5. International Conference on Harmonisation; Electronic Transmission of Postmarket Individual Case Safety Reports for Drugs and Biologics, Excluding Vaccines; Availability of Food and Drug Administration Regional Implementation Specifications for ICH E2B(R3) Reporting to the Food and Drug Administration Adverse Event Reporting System. Notice of Availability.

    PubMed

    2016-06-23

    The Food and Drug Administration (FDA) is announcing the availability of its FDA Adverse Event Reporting System (FAERS) Regional Implementation Specifications for the International Conference on Harmonisation (ICH) E2B(R3) Specification. FDA is making this technical specifications document available to assist interested parties in electronically submitting individual case safety reports (ICSRs) (and ICSR attachments) to the Center for Drug Evaluation and Research (CDER) and the Center for Biologics Evaluation and Research (CBER). This document, entitled "FDA Regional Implementation Specifications for ICH E2B(R3) Implementation: Postmarket Submission of Individual Case Safety Reports (ICSRs) for Drugs and Biologics, Excluding Vaccines" supplements the "E2B(R3) Electronic Transmission of Individual Case Safety Reports (ICSRs) Implementation Guide--Data Elements and Message Specification" final guidance for industry and describes FDA's technical approach for receiving ICSRs, for incorporating regionally controlled terminology, and for adding region-specific data elements when reporting to FAERS.

  6. Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

    PubMed

    Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris

    2018-04-18

    The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa. ©Naomi Muinga, Steve Magare, Jonathan Monda, Onesmus Kamau, Stuart Houston, Hamish Fraser, John Powell, Mike English, Chris Paton. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.

  7. 49 CFR 232.105 - General requirements for locomotives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRAKE SYSTEM SAFETY STANDARDS FOR FREIGHT AND OTHER NON-PASSENGER... reservoir on locomotives and related piping shall be zero, unless the system is capable of maintaining the... equalizing-reservoir leakage can be corrected. On locomotives equipped with electronic brakes, if the system...

  8. 76 FR 36861 - Special Conditions: Gulfstream Model GVI Airplane; Electronic Systems Security Isolation or...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... incorporate the following novel or unusual design features: Digital systems architecture composed of several connected networks. The proposed architecture and network configuration may be used for, or interfaced with... navigation systems (aircraft control domain), 2. Airline business and administrative support (airline...

  9. Feedback mechanisms including real-time electronic alerts to achieve near 100% timely prophylactic antibiotic administration in surgical cases.

    PubMed

    Nair, Bala G; Newman, Shu-Fang; Peterson, Gene N; Wu, Wei-Ying; Schwid, Howard A

    2010-11-01

    Administration of prophylactic antibiotics during surgery is generally performed by the anesthesia providers. Timely antibiotic administration within the optimal time window before incision is critical for prevention of surgical site infections. However, this often becomes a difficult task for the anesthesia team during the busy part of a case when the patient is being anesthetized. Starting with the implementation of an anesthesia information management system (AIMS), we designed and implemented several feedback mechanisms to improve compliance of proper antibiotic delivery and documentation. This included generating e-mail feedback of missed documentation, distributing monthly summary reports, and generating real-time electronic alerts with a decision support system. In 20,974 surgical cases for the period, June 2008 to January 2010, the interventions of AIMS install, e-mail feedback, summary reports, and real-time alerts changed antibiotic compliance by -1.5%, 2.3%, 4.9%, and 9.3%, respectively, when compared with the baseline value of 90.0% ± 2.9% when paper anesthesia records were used. Highest antibiotic compliance was achieved when using real-time alerts. With real-time alerts, monthly compliance was >99% for every month between June 2009 and January 2010. Installation of AIMS itself did not improve antibiotic compliance over that achieved with paper anesthesia records. However, real-time guidance and reminders through electronic messages generated by a computerized decision support system (Smart Anesthesia Messenger, or SAM) significantly improved compliance. With such a system a consistent compliance of >99% was achieved.

  10. 48 CFR 2804.506 - Exemptions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Exemptions. 2804.506 Section 2804.506 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE General ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 2804.506 Exemptions. Pursuant to FAR 4.506(b), all...

  11. 75 FR 51115 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-18

    ... Labor--Occupational Safety and Health Administration (OSHA), Office of Management and Budget, Room 10235... information technology, e.g., permitting electronic submission of responses. Agency: Occupational Safety and...-system design and installation, and employee training; annual recertification of safety systems...

  12. Enabling Systemic Change: Creating an ePortfolio Implementation Framework through Design and Development Research for Use by Higher Education Professionals

    ERIC Educational Resources Information Center

    Blevins, Samantha; Brill, Jennifer

    2017-01-01

    Drawing from a design and development research approach, specifically model research, this study investigated the perspectives of higher education faculty and administrators regarding their experiences with a university-wide electronic portfolio implementation initiative. Participants in the study were fifty-two faculty and administrators at a…

  13. Evaluation of a BCMA’s Electronic Medication Administration Record

    PubMed Central

    Staggers, Nancy; Iribarren, Sarah; Guo, Jia-Wen; Weir, Charlene

    2015-01-01

    Barcode medication administration (BCMA) systems can reduce medication errors, but sociotechnical issues are quite common. Although crucial to nurses’ work, few usability evaluations are available for electronic medication administration record screens (eMARs). The purpose of this research was to identify current usability problems in the VA’s eMAR/BCMA system and explore how these might impact nurses’ situation awareness. Three expert evaluators used 10 tasks/elements, heuristic evaluation techniques and explored potential impacts using a situation awareness perspective. The results yielded 99 usability problems categorized into 440 heuristic violations with the largest volume in the category of Match with the Real World. Fifteen usability issues were rated as catastrophic with the Administer/Chart medications task having the most. Situational awareness was impacted at all levels, especially at Level 2, Comprehension. Usability problems point to important areas for improvement because these issues have the potential to impact nurses’ situation awareness, “at a glance” information, nurse productivity and patient safety. PMID:25601936

  14. 12 CFR 609.940 - Internal systems and controls.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... business plan objectives and policies and procedures requirements regarding E-commerce; and (b) Prevent and... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Internal systems and controls. 609.940 Section 609.940 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards...

  15. 12 CFR 609.940 - Internal systems and controls.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... business plan objectives and policies and procedures requirements regarding E-commerce; and (b) Prevent and... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Internal systems and controls. 609.940 Section 609.940 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards...

  16. 12 CFR 609.940 - Internal systems and controls.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... business plan objectives and policies and procedures requirements regarding E-commerce; and (b) Prevent and... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Internal systems and controls. 609.940 Section 609.940 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards...

  17. 12 CFR 609.940 - Internal systems and controls.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... business plan objectives and policies and procedures requirements regarding E-commerce; and (b) Prevent and... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Internal systems and controls. 609.940 Section 609.940 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards...

  18. 12 CFR 609.940 - Internal systems and controls.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... business plan objectives and policies and procedures requirements regarding E-commerce; and (b) Prevent and... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Internal systems and controls. 609.940 Section 609.940 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards...

  19. 75 FR 67804 - Future Systems Technology Advisory Panel Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2010-0071] Future Systems Technology Advisory Panel... recommendations on the future of systems technology and electronic services at the agency five to ten years into... technologies may be developed to assist in carrying out its statutory mission. Advice and recommendations can...

  20. 48 CFR 4.302 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Policy. 4.302 Section 4.302 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Paper Documents 4.302 Policy. When electronic commerce methods (see 4.502) are not being used, a...

  1. A Correlational Analysis: Electronic Health Records (EHR) and Quality of Care in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Khan, Arshia A.

    2012-01-01

    Driven by the compulsion to improve the evident paucity in quality of care, especially in critical access hospitals in the United States, policy makers, healthcare providers, and administrators have taken the advise of researchers suggesting the integration of technology in healthcare. The Electronic Health Record (EHR) System composed of multiple…

  2. NASA Tech Briefs Index, 1976. [bibliography

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Abstracts of new technology derived from the research and development activities of the National Aeronautics and Space Administration are presented. Emphasis is placed on information considered likely to be transferrable across industrial, regional, or disciplinary lines. Subject matter covered includes: electronic components and circuits; electronic systems; physical sciences; materials; life sciences; mechanics; machinery; fabrication technology; and mathematics and information sciences.

  3. Combining patient administration and laboratory computer systems - a proposal to measure and improve the quality of care.

    PubMed

    Wolff, Anthony H; Kellett, John

    2011-12-01

    Several approaches to measuring the quality of hospital care have been suggested. We propose the simple and objective approach of using the health related data of the patient administration systems and the laboratory results that have been collected and stored electronically in hospitals for years. Imaginative manipulation of this data can give new insights into the quality of patient care. Copyright © 2011 European Federation of Internal Medicine. All rights reserved.

  4. Nursing self-efficacy of an integrated clinical and administrative information system.

    PubMed

    Dillon, Thomas W; Lending, Diane; Crews, Thaddeus R; Blankenship, Ray

    2003-01-01

    Self-efficacy is a user's confidence that he or she has the ability to use an information system. A survey gathered demographics, self-assessed computer skills, attitude and self-efficacy before installation of an integrated clinical and administrative information system. Results showed that higher levels of nursing education, home computer use, and average levels of self-assessed e-mail, Internet search, word processing, and general computer expertise predicted self-efficacy of the system. In addition, previous use of home and office electronics equipment, such as an answering machine, predicted self-efficacy. Implications for training and future adoption of clinical information systems are presented.

  5. Using High-Technology Simulators to Prepare Anesthesia Providers Before Implementation of a New Electronic Health Record Module: A Technical Report.

    PubMed

    Weintraub, Ari Y; Deutsch, Ellen S; Hales, Roberta L; Buchanan, Newton A; Rock, Whitney L; Rehman, Mohamed A

    2017-06-01

    Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Training was feasible and valued by participants but required a combination of electronic and manual components. Further exploration may reveal simulated patient care training that provides the greatest benefit to participants as well as feedback to inform electronic health record improvements.

  6. The development and application of electronic information system for safety administration of newborns in the rooming-in care.

    PubMed

    Wang, Fang; Dong, Jian-Cheng; Chen, Jian-Rong; Wu, Hui-Qun; Liu, Man-Hua; Xue, Li-Ly; Zhu, Xiang-Hua; Wang, Jian

    2015-01-01

    To independently research and develop an electronic information system for safety administration of newborns in the rooming-in care, and to investigate the effects of its clinical application. By VS 2010 SQL SERVER 2005 database and adopting Microsoft visual programming tool, an interactive mobile information system was established, with integrating data, information and knowledge with using information structures, information processes and information technology. From July 2011 to July 2012, totally 210 newborns from the rooming-in care of the Obstetrics Department of the Second Affiliated Hospital of Nantong University were chosen and randomly divided into two groups: the information system monitoring group (110 cases) and the regular monitoring group (100 cases). Incidence of abnormal events and degree of satisfaction were recorded and calculated. ① The wireless electronic information system has four main functions including risk scaling display, identity recognition display, nursing round notes board and health education board; ② statistically significant differences were found between the two groups both on the active or passive discovery rate of abnormal events occurred in the newborns (P<0.05) and the satisfaction degree of the mothers and their families (P<0.05); ③ the system was sensitive and reliable, and the wireless transmission of information was correct and safety. The system is with high practicability in the clinic and can ensure the safety for the newborns with improved satisfactions.

  7. 28 CFR 115.18 - Upgrades to facilities and technologies.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... 115.18 Section 115.18 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Prevention Planning § 115.18 Upgrades... abuse. (b) When installing or updating a video monitoring system, electronic surveillance system, or...

  8. 28 CFR 115.18 - Upgrades to facilities and technologies.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... 115.18 Section 115.18 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Prevention Planning § 115.18 Upgrades... abuse. (b) When installing or updating a video monitoring system, electronic surveillance system, or...

  9. 28 CFR 115.18 - Upgrades to facilities and technologies.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... 115.18 Section 115.18 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Prevention Planning § 115.18 Upgrades... abuse. (b) When installing or updating a video monitoring system, electronic surveillance system, or...

  10. Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach.

    PubMed

    Fragidis, Leonidas L; Chatzoglou, Prodromos D; Aggelidis, Vassilios P

    2016-11-14

    The integration of heterogeneous electronic health records systems by building an interoperable nationwide electronic health record system provides undisputable benefits in health care, like superior health information quality, medical errors prevention and cost saving. This paper proposes a semi-distributed system architecture approach for an integrated national electronic health record system incorporating the advantages of the two dominant approaches, the centralized architecture and the distributed architecture. The high level design of the main elements for the proposed architecture is provided along with diagrams of execution and operation and data synchronization architecture for the proposed solution. The proposed approach effectively handles issues related to redundancy, consistency, security, privacy, availability, load balancing, maintainability, complexity and interoperability of citizen's health data. The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the characteristics of the Greek national healthcare system along with the national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.

  11. 21 CFR 10.206 - Procedures for electronic media coverage of agency public administrative proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Procedures for electronic media coverage of agency..., DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media... electronic media coverage of agency public administrative proceedings. (a) To facilitate the agency's...

  12. 21 CFR 10.206 - Procedures for electronic media coverage of agency public administrative proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Procedures for electronic media coverage of agency..., DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media... electronic media coverage of agency public administrative proceedings. (a) To facilitate the agency's...

  13. 21 CFR 10.206 - Procedures for electronic media coverage of agency public administrative proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Procedures for electronic media coverage of agency..., DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media... electronic media coverage of agency public administrative proceedings. (a) To facilitate the agency's...

  14. 21 CFR 10.206 - Procedures for electronic media coverage of agency public administrative proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Procedures for electronic media coverage of agency..., DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media... electronic media coverage of agency public administrative proceedings. (a) To facilitate the agency's...

  15. 21 CFR 10.206 - Procedures for electronic media coverage of agency public administrative proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Procedures for electronic media coverage of agency..., DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media... electronic media coverage of agency public administrative proceedings. (a) To facilitate the agency's...

  16. 78 FR 979 - Petition for Positive Train Control Safety Plan Approval and System Certification of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-07

    ...] Petition for Positive Train Control Safety Plan Approval and System Certification of the Electronic Train... the Federal Railroad Administration (FRA) for Positive Train Control (PTC) Safety Plan (PTCSP...-based train control system safety overlay designed to protect against the consequences of train-to-train...

  17. Improving Student Learning: A Strategic Planning Framework for an Integrated Student Information System in Charlotte-Mecklenburg Schools

    ERIC Educational Resources Information Center

    Ngoma, Sylvester

    2010-01-01

    There is growing recognition that an electronic Student Information System (SIS) affects student learning. Given the strategic importance of SIS in supporting school administration and enhancing student performance, school districts are increasingly interested in acquiring the most effective and efficient Student Information Systems for their…

  18. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements

    PubMed Central

    Citty, Sandra W.; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct type, amount and frequency of nutritional products (p=0.0001). ENAR represented an effective strategy to improve administration and documentation of nutritional supplements for hospitalized patients. PMID:28243439

  19. Optimizing the electronic health record to standardize administration and documentation of nutritional supplements.

    PubMed

    Citty, Sandra W; Kamel, Amir; Garvan, Cynthia; Marlowe, Lee; Westhoff, Lynn

    2017-01-01

    Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased hospital costs. Methods to improve the administration and documentation of nutritional supplements for hospitalized patients are needed to improve patient care, outcomes and resource utilization. Staff at a medium-sized academic health science center hospital in the southeastern United States noted that nutritional supplements ordered for patients at high risk for malnutrition were not offered or administered to patients in a standardized manner and/or not documented clearly in the electronic health record as per prescription. This paper reports on a process improvement project that redesigned the ordering, administration and documentation process of oral nutritional supplements in the electronic health record. By adding nutritional products to the medication order sets and adding an electronic nutrition administration record (ENAR) tab, the multidisciplinary team sought to standardize nutritional supplement ordering, documentation and administration at prescribed intervals. This process improvement project used a triangulated approach to evaluating pre- and post-process change including: medical record reviews, patient interviews, and nutrition formula room log reports. Staff education and training was carried out prior to initiation of the system changes. This process change resulted in an average decrease in the return of unused nutritional formula from 76% returned at baseline to 54% post-process change. The process change resulted in 100% of nutritional supplement orders having documentation about nutritional medication administration and/or reason for non-administration. Documentation in the ENAR showed that 41% of ONS orders were given and 59% were not given. Significantly more patients reported being offered the ONS product (p=0.0001) after process redesign and more patients (5% before ENAR and 86% after ENAR reported being offered the correct type, amount and frequency of nutritional products (p=0.0001). ENAR represented an effective strategy to improve administration and documentation of nutritional supplements for hospitalized patients.

  20. Applications of hypermedia systems

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

    Lennon, J.; Maurer, H.

    1995-05-01

    In this paper, we consider several new aspects of modern hypermedia systems. The applications discussed include: (1) General Information and Communication Systems: Distributed information systems for businesses, schools and universities, museums, libraries, health systems, etc. (2) Electronic orientation and information displays: Electronic guided tours, public information kiosks, and publicity dissemination with archive facilities. (3) Lecturing: A system going beyond the traditional to empower both teachers and learners. (4) Libraries: A further step towards fully electronic library systems. (5) Directories of all kinds: Staff, telephone, and all sorts of generic directories. (6) Administration: A fully integrated system such as the onemore » proposed will mean efficient data processing and valuable statistical data. (7) Research: Material can now be accessed from databases all around the world. The effects of networking and computer-supported collaborative work are discussed, and examples of new scientific visualization programs are quoted. The paper concludes with a section entitled {open_quotes}Future Directions{close_quotes}.« less

  1. Lack of agreement in pediatric emergency department discharge diagnoses from clinical and administrative data sources.

    PubMed

    Gorelick, Marc H; Knight, Stacey; Alessandrini, Evaline A; Stanley, Rachel M; Chamberlain, James M; Kuppermann, Nathan; Alpern, Elizabeth R

    2007-07-01

    Diagnosis information from existing data sources is used commonly for epidemiologic, administrative, and research purposes. The quality of such data for emergency department (ED) visits is unknown. To determine the agreement on final diagnoses between two sources, electronic administrative sources and manually abstracted medical records, for pediatric ED visits, in a multicenter network. This was a cross sectional study at 19 EDs nationwide. The authors obtained data from two sources at each ED during a three-month period in 2003: administrative sources for all visits and abstracted records for randomly selected visits during ten days over the study period. Records were matched using unique identifiers and probabilistic linkage. The authors recorded up to three diagnoses from each abstracted medical record and up to ten for the administrative data source. Diagnoses were grouped into 104 groups using a modification of the Clinical Classification System. A total of 8,860 abstracted records had at least one valid diagnosis code (with a total of 12,895 diagnoses) and were successfully matched to records in the administrative source. Overall, 67% (95% confidence interval = 66% to 68%) of diagnoses from the administrative and abstracted sources were within the same diagnosis group. Agreement varied by site, ranging from 54% to 77%. Agreement varied substantially by diagnosis group; there was no difference by method of linkage. Clustering clinically similar diagnosis groups improved agreement between administrative and abstracted data sources. ED diagnoses retrieved from electronic administrative sources and manual chart review frequently disagree, even if similar diagnosis codes are grouped. Agreement varies by institution and by diagnosis. Further work is needed to improve the accuracy of diagnosis coding; development of a grouping system specific to pediatric emergency care may be beneficial.

  2. Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data.

    PubMed

    Widdifield, Jessica; Bernatsky, Sasha; Thorne, J Carter; Bombardier, Claire; Jaakkimainen, R Liisa; Wing, Laura; Paterson, J Michael; Ivers, Noah; Butt, Debra; Lyddiatt, Anne; Hofstetter, Catherine; Ahluwalia, Vandana; Tu, Karen

    2016-01-01

    The Wait Time Alliance recently established wait time benchmarks for rheumatology consultations in Canada. Our aim was to quantify wait times to primary and rheumatology care for patients with rheumatic diseases. We identified patients from primary care practices in the Electronic Medical Record Administrative data Linked Database who had referrals to Ontario rheumatologists over the period 2000-2013. To assess the full care pathway, we identified dates of symptom onset, presentation in primary care and referral from electronic medical records. Dates of rheumatologist consultations were obtained by linking with physician service claims. We determined the duration of each phase of the care pathway (symptom onset to primary care encounter, primary care encounter to referral, and referral to rheumatologist consultation) and compared them with established benchmarks. Among 2430 referrals from 168 family physicians, 2015 patients (82.9%) were seen by 146 rheumatologists within 1 year of referral. Of the 2430 referrals, 2417 (99.5%) occurred between 2005 and 2013. The main reasons for referral were osteoarthritis (32.4%) and systemic inflammatory rheumatic diseases (30.6%). Wait times varied by diagnosis and geographic region. Overall, the median wait time from referral to rheumatologist consultation was 74 (interquartile range 27-101) days; it was 66 (interquartile range 18-84) days for systemic inflammatory rheumatic diseases. Wait time benchmarks were not achieved, even for the most urgent types of referral. For systemic inflammatory rheumatic diseases, most of the delays occurred before referral. Rheumatology wait times exceeded established benchmarks. Targeted efforts are needed to promote more timely access to both primary and rheumatology care. Routine linkage of electronic medical records with administrative data may help fill important gaps in knowledge about waits to primary and specialty care.

  3. 75 FR 81280 - Office of Head Start; Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... Head Start). OHS develops legislative and budgetary proposals; identifies areas for research... systems, and electronic mail requests; (c) providing management and administrative services and advice, by... support through: (a) The oversight of information resources management (IRM) systems, including the Early...

  4. NASA Tech Briefs Index, 1978. [bibliography

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Approximately 601 announcements of new technology derived from the research and development activities of the National Aeronautics and Space Administration are presented. Emphasis is placed on information considered likely to be transferrable across industrial, regional, or disciplinary lines. Subject matter covered includes: electronic components and circuits; electron systems; physical sciences; materials; life sciences; mechanics; machinery; fabrication technology; and mathematics and information sciences.

  5. Injuries Associated With Hazards Involving Motor Vehicle Power Windows

    DOT National Transportation Integrated Search

    1997-05-01

    National Highway Traffic Safety Administration's (NHTSA) National Center for : Statistics and Analysis (NCSA) recently completed a study of data from the : Consumer Product Safety Commission's (CPSC) National Electronic Injury : Surveillance System (...

  6. Evaluation of immunization data completeness within a large community health care system exchanging data with a state immunization information system.

    PubMed

    Hendrickson, Bryan K; Panchanathan, Sarada S; Petitti, Diana

    2015-01-01

    Information systems are used by most states to maintain registries of immunization data both for monitoring population-level adherence and for use in clinical practice and research. Direct data exchange between such systems and electronic health record systems presents an opportunity to improve the completeness and quality of information available. Our goals were to describe and compare the completeness of the Arizona State Immunization System, the electronic health record at a large community health provider in Arizona exchanging electronic data with the Arizona system, and personal immunization records in an effort to contribute to the discussion on the completeness of state-run immunization registries and data exchange with these registries. Immunization histories from these sources were collected and reviewed sequentially. Unique dates of vaccination administrations were counted for each patient and tagged on the basis of comparisons across sources. We quantified completeness by combining information from all 3 sources and comparing each source with the complete set. We determined that the state registry was 71.8% complete, the hospital electronic health record was 81.9% complete, and personal records were 87.8% complete. Of the 2017 unique vaccination administrations, 65% were present in all 3 sources, 24.6% in 2 of the 3 sources, and 10.4% in only 1 source. Only 11% of patients had records in complete agreement across the 3 sources. This study highlights issues related to data completeness, exchange, and reporting of immunization information to state registries and suggests that there is some degree of deficiency in completeness of immunization registries and other sources. This study indicates that there is a need to strengthen links between electronic data sources with immunization information and describes potential improvements in completeness that such efforts could provide, enabling providers to better rely on state immunization registries and to improve research utilization of immunization information systems.

  7. Critical issues in an electronic documentation system.

    PubMed

    Weir, Charlene R; Nebeker, Jonathan R

    2007-10-11

    The Veterans Health Administration (VHA), of the U.S. Department of Veteran Affairs has instituted a medical record (EMR) that includes electronic documentation of all narrative components of the medical record. To support clinicians using the system, multiple efforts have been instituted to ease the creation of narrative reports. Although electronic documentation is easier to read and improves access to information, it also may create new and additional hazards for users. This study is the first step in a series of studies to evaluate the issues surrounding the creation and use of electronic documentation. Eighty-eight providers across multiple clinical roles were interviewed in 10 primary care sites in the VA system. Interviews were tape-recorded, transcribed and qualitatively analyzed for themes. In addition, specific questions were asked about perceived harm due to electronic documentation practices. Five themes relating to difficulties with electronic documentation were identified: 1) information overload; 2) hidden information; 3) lack of trust; 4) communication; 5) decision-making. Three providers reported that they knew of an incident where current documentation practices had caused patient harm and over 75% of respondents reported significant mis-trust of the system.

  8. 76 FR 18549 - Casmalia Disposal Site; Notice of Proposed CERCLA Administrative De Minimis Settlement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-04

    ... Inc. as successor in interest to the claims asserted against Western Electric Company, Inc. and AT&T Technologies, Inc; Avery Dennison Corporation; B/E Aerospace; BAE Systems Information and Electronic Systems... Kenworth, Inc.; Ken Dale; L-3 Communication Corporation; Life Technologies Corporation; Macy's Inc...

  9. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Image-intensified fluoroscopic x-ray system. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... through electronic amplification. This generic type of device may include signal analysis and display...

  10. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Image-intensified fluoroscopic x-ray system. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... through electronic amplification. This generic type of device may include signal analysis and display...

  11. 21 CFR 892.1650 - Image-intensified fluoroscopic x-ray system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Image-intensified fluoroscopic x-ray system. 892.1650 Section 892.1650 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... through electronic amplification. This generic type of device may include signal analysis and display...

  12. The Role of the Systems Librarian/Administrator: A Report of the Survey.

    ERIC Educational Resources Information Center

    Hatcher, Karen A.

    1995-01-01

    A 1991 survey asked how the position of systems librarian has changed. Data from three categories of academic and research libraries was analyzed by size of library, and changes involving increasing implementation of electronic media were identified. It was found that the role of systems librarian is difficult to define while technology changes…

  13. Chief Information Officer's Role in Adopting an Interoperable Electronic Health Record System for Medical Data Exchange

    ERIC Educational Resources Information Center

    Akpabio, Akpabio Enebong Ema

    2013-01-01

    Despite huge growth in hospital technology systems, there remains a dearth of literature examining health care administrator's perceptions of the efficacy of interoperable EHR systems. A qualitative research methodology was used in this multiple-case study to investigate the application of diffusion of innovations theory and the technology…

  14. 75 FR 63208 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National Archives and Records Administration. ACTION: Notice of meeting. SUMMARY: In... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic...

  15. 76 FR 65218 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National Archives and Records Administration. ACTION: Notice of meeting. SUMMARY: In... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic...

  16. Implementing a bar-coded bedside medication administration system.

    PubMed

    Yates, Cindy

    2007-01-01

    Hospitals across the nation are struggling with implementing electronic medication administration and reporting (eMAR) systems as part of patient safety programs. St Luke's Hospital in Chesterfield, Mo, initiated their eMAR initiative in June 2003, initiating program start-up in September 2004. This case study documents how the project was approached, its overall success, and what was learned along the way. Also included is a recent update highlighting the expansion of St Luke's patient safety initiative, adapting eMAR to two specialty units: dialysis and laboratory processes.

  17. Wheelchair User Injuries and Deaths Associated with Motor Vehicle Related Incidents

    DOT National Transportation Integrated Search

    1997-09-01

    National Highway Traffic Safety Administration's National Center for Statistics : and Analysis (NCSA) recently completed a study of data from the Consumer Product : Safety Commission's (CPSC) National Electronic Injury Surveillance System : (NEISS) o...

  18. Evaluating acceptance of an electronic data management system at a tertiary care institution.

    PubMed

    Young, Wendy; Klima, George; Isaac, Winston

    2011-01-01

    This research reports on satisfaction with the introduction of an electronic document management system in a tertiary hospital environment. A buffet of training and familiarization options were offered: one-on-one training, open house, drop-in, e-learning, classroom training, and self-study. It was found that professions differ in their pattern of satisfaction with training and they also differ in their satisfaction with both the usefulness and the ease of use of the system. Satisfaction among administrators was highest and that among nurses lowest. There was an association between attendance at the open house event and satisfaction with the system.

  19. 41 CFR 102-118.550 - How does a TSP file an administrative claim using EDI or other electronic means?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... administrative claim using EDI or other electronic means? 102-118.550 Section 102-118.550 Public Contracts and... EDI or other electronic means? The medium and precise format of data for an administrative claim filed electronically must be approved in advance by the GSA Audit Division. GSA will use an authenticating EDI...

  20. 76 FR 15349 - Advisory Committee on the Electronic Records Archives (ACERA); Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA); Meeting AGENCY: National Archives and Records Administration. ACTION: Notice of Meeting. SUMMARY... Archives and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic...

  1. 36 CFR § 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO THE... Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi Road... and Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi...

  2. 36 CFR 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF REC- ORDS TO THE... Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi Road... and Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi...

  3. Closing the loop of the medication use process using electronic medication administration registration.

    PubMed

    Lenderink, Bertil W; Egberts, Toine C G

    2004-08-01

    Recent reports and studies of errors in the medication process have raised the awareness of the threat to public health. An essential step in this multi-stage process is the actual administration of a medicine to the patient. The closed loop system is thought to be a way of preventing medication errors. Current information technology can facilitate this process. This article describes the way barcode technology is being used to facilitate medication administration registration on several wards in our hospital and nursing home.

  4. 5 CFR 1315.3 - Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... standardized information and electronic data exchange to the central management agency. Systems shall provide complete, timely, reliable, useful and consistent financial management information. Payment capabilities... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.3 Responsibilities...

  5. Federal Highway Administration health in transportation working group : 2013 annual report

    DOT National Transportation Integrated Search

    2000-04-24

    Intelligent Transportation Systems (ITS) are the application of advanced computer, electronics, and communications technologies to increase the safety and efficiency of surface transportation. ITS depend on the ability to integrate many advanced tech...

  6. 12 CFR 614.4940 - Required use of standard flood hazard determination form.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Required use of standard flood hazard determination form. 614.4940 Section 614.4940 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM... used in a printed, computerized, or electronic manner. A System institution may obtain the standard...

  7. 78 FR 43234 - Agency Information Collection Activities; Submission to OMB for Reinstatement, With Change, of a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-19

    ...) administrator, the Financial Crimes Enforcement Network (FinCEN) transitioned from a system originally designed... forms. FinCEN's objective is to have one electronically-filed dynamic and interactive BSA-SAR that will... and oversight of supervised institutions. \\2\\ The Board of Governors of the Federal Reserve System...

  8. Automated information systems provide health information management support to veterans' healthcare.

    PubMed

    Lloyd, S S

    1992-06-01

    The Veterans Health Administration has implemented a comprehsnsive DHCP which supports the VA healthcare system at both local and national levels. Numerous clinical and management modules have been developed; an overview was given of selected applications impacting health information managers. Continuing development includes an automated clinical record and expanded electronic data exchange.

  9. Nurses' perceptions of the impact of electronic health records on work and patient outcomes.

    PubMed

    Kossman, Susan P; Scheidenhelm, Sandra L

    2008-01-01

    This study addresses community hospital nurses' use of electronic health records and views of the impact of such records on job performance and patient outcomes. Questionnaire, interview, and observation data from 46 nurses in medical-surgical and intensive care units at two community hospitals were analyzed. Nurses preferred electronic health records to paper charts and were comfortable with technology. They reported use of electronic health records enhanced nursing work through increased information access, improved organization and efficiency, and helpful alert screens. They thought use of the records hindered nursing work through impaired critical thinking, decreased interdisciplinary communication, and a high demand on work time (73% reported spending at least half their shift using the records). They thought use of electronic health records enabled them to provide safer care but decreased the quality of care. Administrative implications include involving bedside nurses in system choice, streamlining processes, developing guidelines for consistent documentation quality and location, increasing system speed, choosing hardware that encourages bedside use, and improving system information technology support.

  10. New paradigms for measuring clinical performance using electronic health records.

    PubMed

    Weiner, Jonathan P; Fowles, Jinnet B; Chan, Kitty S

    2012-06-01

    Measures of provider success are the centerpiece of quality improvement and pay-for-performance programs around the globe. In most nations, these measures are derived from administrative records, paper charts and consumer surveys; increasingly, electronic patient record systems are also being used. We use the term 'e-QMs' to describe quality measures that are based on data found within electronic health records and other related health information technology (HIT). We offer a framework or typology for e-QMs and describe opportunities and impediments associated with the transition from old to new If public and private systems of care are to effectively use HIT to support and evaluate health-care system quality and safety, the quality measurement field must embrace new paradigms and strategically address a series of technical, conceptual and practical challenges.

  11. The new Electronic Grants Management System of the Space Telescope Science Institute

    NASA Astrophysics Data System (ADS)

    Beaser, R.; Wagner, E.

    1999-12-01

    The Space Telescope Science Institute has developed a new web-based Grants Management System which will be implemented at grantee institutions in the Spring of 2000. The system will feature on-line preparation and submission of budgets for all programs as well as e-mail notifications to Principal Investigators (PIs) and Authorizing Officials (AOs) of all Awards and Amendments. PDF versions of the documents will be available on the ST ScI web site. In addition, all financial and performance reports will be submitted via the web and grantees will be notified electronically of due and overdue reports. All administrative requests such as budget revisions, requests to extend the grant period, etc., will be submitted electronically to ST ScI. Detailed grant status information will be on-line and a variety of proposal and grant reports will be available to PIs and AOs. The system will also permit electronic routing of budgets and financial reports through the grantee institution.

  12. 49 CFR 585.86 - Reporting requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PHASE-IN REPORTING REQUIREMENTS Electronic Stability Control System Phase-In Reporting Requirements § 585.86 Reporting requirements. (a) General reporting..., or, at the manufacturer's option, for the current production year. A new manufacturer that has not...

  13. 49 CFR 585.86 - Reporting requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PHASE-IN REPORTING REQUIREMENTS Electronic Stability Control System Phase-In Reporting Requirements § 585.86 Reporting requirements. (a) General reporting..., or, at the manufacturer's option, for the current production year. A new manufacturer that has not...

  14. 15 CFR 772.1 - Definitions of terms as used in the Export Administration Regulations (EAR).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... instructions include replacement of fixed storage devices, but not a physical change in wiring or... digital electronic control system for a gas turbine engine that is able to autonomously control the engine...

  15. 36 CFR 1222.28 - What are the series level recordkeeping requirements?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping... systems adequately document agency policies, transactions, and activities, each program must develop... phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

  16. 36 CFR 1222.28 - What are the series level recordkeeping requirements?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping... systems adequately document agency policies, transactions, and activities, each program must develop... phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

  17. 36 CFR 1222.28 - What are the series level recordkeeping requirements?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency Recordkeeping... systems adequately document agency policies, transactions, and activities, each program must develop... phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

  18. 5 CFR 850.401 - Electronic notice of coverage determination.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... determination. 850.401 Section 850.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Submission of Law Enforcement... notice of law enforcement officer, firefighter, or nuclear materials retirement coverage, required by...

  19. 5 CFR 850.401 - Electronic notice of coverage determination.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... determination. 850.401 Section 850.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Submission of Law Enforcement... notice of law enforcement officer, firefighter, or nuclear materials retirement coverage, required by...

  20. 5 CFR 850.401 - Electronic notice of coverage determination.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... determination. 850.401 Section 850.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Submission of Law Enforcement... notice of law enforcement officer, firefighter, or nuclear materials retirement coverage, required by...

  1. 5 CFR 850.401 - Electronic notice of coverage determination.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... determination. 850.401 Section 850.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT SYSTEMS MODERNIZATION Submission of Law Enforcement... notice of law enforcement officer, firefighter, or nuclear materials retirement coverage, required by...

  2. Espace

    ERIC Educational Resources Information Center

    De Volder, Maurice; Slootmaker, Aad; Kurvers, Hub; Rutjens, Marjo; van der Baaren, John; Bitter, Marlies; Kappe, Rutger; Roossink, Henk; de Goeijen, Jan; Reitzema, Hans

    2007-01-01

    This article describes Espace (Electronic System for Peer Assessment and Coaching Efficiency), a student peer-feedback tool that enhances the educational quality of assignments without overburdening faculty or adding administrative costs. Developed and tested by four universities in the Netherlands, Espace focuses on qualitative feedback and…

  3. Improving efficiency and reducing administrative burden through electronic communication.

    PubMed

    Cook, Katlyn E; Ludens, Gail M; Ghosh, Amit K; Mundell, William C; Fleming, Kevin C; Majka, Andrew J

    2013-01-01

    The InBox messaging system is an internal, electronic program used at Mayo Clinic, Rochester, MN, to facilitate the sending, receiving, and answering of patient-specific messages and alerts. A standardized InBox was implemented in the Division of General Internal Medicine to decrease the time physicians, physician assistants, and nurse practitioners (clinicians) spend on administrative tasks and to increase efficiency. Clinicians completed surveys and a preintervention InBox pilot test to determine inefficiencies related to administrative burdens and defects (message entry errors). Results were analyzed using Pareto diagrams, value stream mapping, and root cause analysis to prioritize administrative-burden inefficiencies to develop a new, standardized InBox. Clinicians and allied health staff were the target of this intervention and received standardized InBox training followed by a postintervention pilot test for clinicians. Sixteen of 28 individuals (57%) completed the preintervention survey. Twenty-eight clinicians participated in 2 separate 8-day pilot tests (before and after intervention) for the standardized InBox. The number of InBox defects was substantially reduced from 37 (Pilot 1) to 7 (Pilot 2). Frequent InBox defects decreased from 25% to 10%. More than half of clinicians believed the standardized InBox positively affected their work, and 100% of clinicians reported no negative affect on their work. This project demonstrated the successful implementation of the standardized InBox messaging system. Initial assessments show substantial reduction of InBox entry defects and administrative tasks completed by clinicians. The findings of this project suggest increased clinician and allied health staff efficiency, satisfaction, improved clinician work-life balance, and decreased clinician burden caused by administrative tasks.

  4. 76 FR 52991 - Renewal of Advisory Committee on Electronic Records Archives

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Renewal of Advisory Committee on Electronic Records... Records Administration's (NARA) Advisory Committee on Electronic Records Archives. In accordance with... Committee on Electronic Records Archives in NARA's ceiling of discretionary advisory committees. FOR FURTHER...

  5. 76 FR 39263 - Antidumping and Countervailing Duty Proceedings: Electronic Filing Procedures; Administrative...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... resulting from the Department's implementation of an electronic filing and documents management program... regulations that is entitled ``IA ACCESS Handbook On Electronic Filing Procedures'' (``IA ACCESS Handbook... management program named Import Administration Antidumping and Countervailing Duty Centralized Electronic...

  6. Develop security architecture for both in-house healthcare information systems and electronic patient record

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Chen, Xiaomeng; Zhuang, Jun; Jiang, Jianrong; Zhang, Xiaoyan; Wu, Dongqing; Huang, H. K.

    2003-05-01

    In this paper, we presented a new security approach to provide security measures and features in both healthcare information systems (PACS, RIS/HIS), and electronic patient record (EPR). We introduced two security components, certificate authoring (CA) system and patient record digital signature management (DSPR) system, as well as electronic envelope technology, into the current hospital healthcare information infrastructure to provide security measures and functions such as confidential or privacy, authenticity, integrity, reliability, non-repudiation, and authentication for in-house healthcare information systems daily operating, and EPR exchanging among the hospitals or healthcare administration levels, and the DSPR component manages the all the digital signatures of patient medical records signed through using an-symmetry key encryption technologies. The electronic envelopes used for EPR exchanging are created based on the information of signers, digital signatures, and identifications of patient records stored in CAS and DSMS, as well as the destinations and the remote users. The CAS and DSMS were developed and integrated into a RIS-integrated PACS, and the integration of these new security components is seamless and painless. The electronic envelopes designed for EPR were used successfully in multimedia data transmission.

  7. 15 CFR 2301.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) technologies. Closing date means the date and time which the Administrator sets as the deadline for the receipt.... Nonbroadcast means the distribution of electronic signals by a means other than broadcast technologies. Examples of nonbroadcast technologies are Instructional Television Fixed Service (ITFS), satellite systems...

  8. 5 CFR 1204.21 - Submission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES AVAILABILITY OF OFFICIAL INFORMATION Appeals § 1204.21 Submission. (a) A person may appeal the following actions, or failure to act by... technically not possible to reproduce electronically maintained information in the requester's preferred...

  9. 5 CFR 1204.21 - Submission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES AVAILABILITY OF OFFICIAL INFORMATION Appeals § 1204.21 Submission. (a) A person may appeal the following actions, or failure to act by... technically not possible to reproduce electronically maintained information in the requester's preferred...

  10. 5 CFR 1204.21 - Submission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES AVAILABILITY OF OFFICIAL INFORMATION Appeals § 1204.21 Submission. (a) A person may appeal the following actions, or failure to act by... technically not possible to reproduce electronically maintained information in the requester's preferred...

  11. 5 CFR 1204.21 - Submission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES AVAILABILITY OF OFFICIAL INFORMATION Appeals § 1204.21 Submission. (a) A person may appeal the following actions, or failure to act by... technically not possible to reproduce electronically maintained information in the requester's preferred...

  12. 5 CFR 1204.21 - Submission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION AND PROCEDURES AVAILABILITY OF OFFICIAL INFORMATION Appeals § 1204.21 Submission. (a) A person may appeal the following actions, or failure to act by... technically not possible to reproduce electronically maintained information in the requester's preferred...

  13. 15 CFR 772.1 - Definitions of terms as used in the Export Administration Regulations (EAR).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., but not a physical change in wiring or interconnections. Digital transfer rate. (Cat 5)—The total bit...) means an electronic control system for gas turbine or combined cycle engines utilizing a digital...

  14. An Integrated Approach to Student Services.

    ERIC Educational Resources Information Center

    Kelly, Rob

    2001-01-01

    Describes the comprehensive, coordinated approach to student support services at the University of Wisconsin Learning Innovations, an electronic learning consultation utility that develops online programs for distance learning. Topics include the Learner Relationship Management System, advising opportunities, help desk, administrative Web site,…

  15. 23 CFR 950.9 - Enforcement.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Enforcement. 950.9 Section 950.9 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION INTELLIGENT TRANSPORTATION SYSTEMS ELECTRONIC TOLL COLLECTION § 950.9 Enforcement. (a) The tolling authority of any facility operating pursuant to authority...

  16. 32 CFR 2001.50 - Telecommunications automated information systems and network security.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and network security. 2001.50 Section 2001.50 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED... network security. Each agency head shall ensure that classified information electronically accessed...

  17. 32 CFR 2001.50 - Telecommunications automated information systems and network security.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and network security. 2001.50 Section 2001.50 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED... network security. Each agency head shall ensure that classified information electronically accessed...

  18. 32 CFR 2001.50 - Telecommunications automated information systems and network security.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and network security. 2001.50 Section 2001.50 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED... network security. Each agency head shall ensure that classified information electronically accessed...

  19. 78 FR 31879 - General Services Administration Acquisition Regulation (GSAR); Electronic Contracting Initiative...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ...); Electronic Contracting Initiative (ECI) AGENCY: Office of Acquisition Policy, General Services Administration..., Electronic Contracting Initiative, by any of the following methods: Regulations.gov : http://www.regulations... the rewrite of GSAR Part 538, Electronic Contracting Initiative (Modifications). On December 17, 2012...

  20. 76 FR 64428 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... for discussion of electronic tax administration issues in support of the overriding goal that...

  1. 77 FR 70879 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998, the Internal Revenue Service established the Electronic Tax... for discussion of electronic tax administration issues in support of the overriding goal that...

  2. 77 FR 31441 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-25

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... for discussion of electronic tax administration issues in support of the overriding goal that...

  3. 78 FR 22345 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic... United States, on technical, mission, and service issues related to the Electronic Records Archives (ERA...

  4. 77 FR 21812 - Advisory Committee on the Electronic Records Archives (ACERA).

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic... United States, on technical, mission, and service issues related to the Electronic Records Archives (ERA...

  5. The use of electronic health records in Spanish hospitals.

    PubMed

    Marca, Guillem; Perez, Angel; Blanco-Garcia, Martin German; Miravalles, Elena; Soley, Pere; Ortiga, Berta

    The aims of this study were to describe the level of adoption of electronic health records in Spanish hospitals and to identify potential barriers and facilitators to this process. We used an observational cross-sectional design. The survey was conducted between September and December 2011, using an electronic questionnaire distributed through email. We obtained a 30% response rate from the 214 hospitals contacted, all belonging to the Spanish National Health Service. The level of adoption of electronic health records in Spanish hospitals was found to be high: 39.1% of hospitals surveyed had a comprehensive EHR system while a basic system was functioning in 32.8% of the cases. However, in 2011 one third of the hospitals did not have a basic electronic health record system, although some have since implemented electronic functionalities, particularly those related to clinical documentation and patient administration. Respondents cited the acquisition and implementation costs as the main barriers to implementation. Facilitators for EHR implementation were: the possibility to hire technical support, both during and post implementation; security certification warranty; and objective third-party evaluations of EHR products. In conclusion, the number of hospitals that have electronic health records is in general high, being relatively higher in medium-sized hospitals.

  6. Model citizens. Outsourcing helps start-up Medicare HMO.

    PubMed

    Slavic, B; Adami, S

    1999-04-01

    Health Plans of Pennsylvania (HPP), the managed care arm of Crozer-Keystone Health System, in Media, Pa. Selecting the information systems and building the infrastructure to support the start-up of a new Medicare HMO product. HPP chose to outsource the information systems needed to integrate all the components of managed care administration into a cost-effective and cohesive program. Because of its aggressive programming and start-up of the MedCarePlus product offering, HPP became the first plan in the country to submit Medicare claims data electronically for encounter reporting to the Health Care Financing Administration (HCFA). "Through an integrated team approach, an organization truly can benefit from the economies of scale gained through outsourcing."

  7. 75 FR 71188 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... organized public forum for discussion of electronic tax administration issues in support of the overriding...

  8. 78 FR 32306 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... notice. SUMMARY: An open meeting of the Electronic Tax Administration Advisory Committee (ETAAC) will be conducted via telephone conference call. The ETAAC will discuss recommendations for electronic tax...

  9. 76 FR 12793 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-08

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... open meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... organized public forum for discussion of electronic tax administration issues in support of the overriding...

  10. 75 FR 30109 - Open Meeting for the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Meeting for the Electronic Tax... Open Meeting. SUMMARY: In 1998 the Internal Revenue Service established the Electronic Tax... organized public forum for discussion of electronic tax administration issues in support of the overriding...

  11. The impact of closed-loop electronic medication management on time to first dose: a comparative study between paper and digital hospital environments.

    PubMed

    Austin, Jodie A; Smith, Ian R; Tariq, Amina

    2018-01-22

    Closed-loop electronic medication management systems (EMMS) are recognised as an effective intervention to improve medication safety, yet evidence of their effectiveness in hospitals is limited. Few studies have compared medication turnaround time for a closed-loop electronic versus paper-based medication management environment. To compare medication turnaround times in a paper-based hospital environment with a digital hospital equipped with a closed-loop EMMS, consisting of computerised physician order entry, profiled automated dispensing cabinets packaged with unit dose medications and barcode medication administration. Data were collected during 2 weeks at three private hospital sites (one with closed-loop EMMS) within the same organisation network in Queensland, Australia. Time between scheduled and actual administration times was analysed for first dose of time-critical and non-critical medications located on the ward or sourced via pharmacy. Medication turnaround times at the EMMS site were less compared to the paper-based sites (median, IQR: 35 min, 8-57 min versus 120 min, 30-180 min, P < 0.001). For time-critical medications, 77% were administered within 60 min of scheduled time at the EMMS site versus 38% for the paper-based sites. Similar difference was observed for non-critical medications, 80% were administered within 60 min of their scheduled time at the EMMS site versus 41% at the paper-based facilities. The study indicates medication turnaround times utilising a closed-loop EMMS are less compared to paper-based systems. This improvement may be attributable to increased accessibility of medications using automated dispensing cabinets and electronic medication administration records flagging tasks to nurses in real time. © 2018 Royal Pharmaceutical Society.

  12. Implementing for Sustainability: Promoting Use of a Measurement Feedback System for Innovation and Quality Improvement.

    PubMed

    Douglas, Susan; Button, Suzanne; Casey, Susan E

    2016-05-01

    Measurement feedback systems (MFSs) are increasingly recognized as evidence-based treatments for improving mental health outcomes, in addition to being a useful administrative tool for service planning and reporting. Promising research findings have driven practice administrators and policymakers to emphasize the incorporation of outcomes monitoring into electronic health systems. To promote MFS integrity and protect against potentially negative outcomes, it is vital that adoption and implementation be guided by scientifically rigorous yet practical principles. In this point of view, the authors discuss and provide examples of three user-centered and theory-based principles: emphasizing integration with clinical values and workflow, promoting administrative leadership with the 'golden thread' of data-informed decision-making, and facilitating sustainability by encouraging innovation. In our experience, enacting these principles serves to promote sustainable implementation of MFSs in the community while also allowing innovation to occur, which can inform improvements to guide future MFS research.

  13. Comparison of methodologies for calculating quality measures based on administrative data versus clinical data from an electronic health record system: implications for performance measures.

    PubMed

    Tang, Paul C; Ralston, Mary; Arrigotti, Michelle Fernandez; Qureshi, Lubna; Graham, Justin

    2007-01-01

    New reimbursement policies and pay-for-performance programs to reward providers for producing better outcomes are proliferating. Although electronic health record (EHR) systems could provide essential clinical data upon which to base quality measures, most metrics in use were derived from administrative claims data. We compared commonly used quality measures calculated from administrative data to those derived from clinical data in an EHR based on a random sample of 125 charts of Medicare patients with diabetes. Using standard definitions based on administrative data (which require two visits with an encounter diagnosis of diabetes during the measurement period), only 75% of diabetics determined by manually reviewing the EHR (the gold standard) were identified. In contrast, 97% of diabetics were identified using coded information in the EHR. The discrepancies in identified patients resulted in statistically significant differences in the quality measures for frequency of HbA1c testing, control of blood pressure, frequency of testing for urine protein, and frequency of eye exams for diabetic patients. New development of standardized quality measures should shift from claims-based measures to clinically based measures that can be derived from coded information in an EHR. Using data from EHRs will also leverage their clinical content without adding burden to the care process.

  14. 75 FR 12573 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National Archives and Records Administration. ACTION: Notice of meeting. SUMMARY: In... and Records Administration (NARA) announces a [[Page 12574

  15. Gymnastics Safety and The Law.

    ERIC Educational Resources Information Center

    Dailey, Bob

    Data collected from the National Electronic Injury Surveillance System (NEISS) and 26 tort liability cases are examined as a basis for recommendations for gymnastics instructors, supervisors, and administrators. Tables supply supportive statistics for a discussion of gymnastics injuries classified by sex, body part injured, severity, and…

  16. 45 CFR 205.36 - State plan requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., of an automated statewide management information system designed effectively and efficiently, to assist management in the administration of an approved AFDC State plan. The submission process to amend... aid or services is changed. (c) To electronically refer and exchange information with programs under...

  17. 36 CFR 1008.6 - Assuring integrity of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... subject to the Privacy Act be maintained with appropriate administrative, technical and physical...) Records security. Whether maintained in physical or electronic form, records subject to the Privacy Act... the system of records. The Privacy Act Officer will periodically review these security measures to...

  18. 36 CFR § 1222.28 - What are the series level recordkeeping requirements?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... AND RECORDS ADMINISTRATION RECORDS MANAGEMENT CREATION AND MAINTENANCE OF FEDERAL RECORDS Agency... series and systems adequately document agency policies, transactions, and activities, each program must... documentation of phone calls, meetings, instant messages, and electronic mail exchanges that include substantive...

  19. 23 CFR 950.1 - Purpose.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Purpose. 950.1 Section 950.1 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION INTELLIGENT TRANSPORTATION SYSTEMS ELECTRONIC TOLL COLLECTION § 950.1 Purpose. The purpose of this part is to establish interoperability requirements for toll...

  20. 45 CFR 160.516 - Discovery.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... stored in an electronic data storage system must be produced in a form accessible to the requesting party... DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS GENERAL..., reports, answers, records, accounts, papers and other data and documentary evidence. Nothing contained in...

  1. 45 CFR 160.516 - Discovery.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... stored in an electronic data storage system must be produced in a form accessible to the requesting party... DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS GENERAL..., reports, answers, records, accounts, papers and other data and documentary evidence. Nothing contained in...

  2. 45 CFR 160.516 - Discovery.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... stored in an electronic data storage system must be produced in a form accessible to the requesting party... Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS GENERAL..., reports, answers, records, accounts, papers and other data and documentary evidence. Nothing contained in...

  3. 45 CFR 160.516 - Discovery.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... stored in an electronic data storage system must be produced in a form accessible to the requesting party... DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS GENERAL..., reports, answers, records, accounts, papers and other data and documentary evidence. Nothing contained in...

  4. Whole Foods Market Group, Inc. Nationwide RCRA Administrative Settlement

    EPA Pesticide Factsheets

    The U.S. Environmental Protection Agency (EPA) today announced an agreement with the grocery chain Whole Foods Market Group, Inc., to implement a state-of-the-art electronic system at its stores throughout the U.S. for identifying and classifying consumer

  5. 12 CFR 609.920 - Interpretations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... E-commerce as long as the safeguards of E-SIGN are met and its exceptions recognized. Generally, an... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions § 609.920 Interpretations. (a) E-SIGN preempts most statutes and regulations, including the Act...

  6. 12 CFR 609.920 - Interpretations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... E-commerce as long as the safeguards of E-SIGN are met and its exceptions recognized. Generally, an... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions § 609.920 Interpretations. (a) E-SIGN preempts most statutes and regulations, including the Act...

  7. 12 CFR 609.920 - Interpretations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... E-commerce as long as the safeguards of E-SIGN are met and its exceptions recognized. Generally, an... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions § 609.920 Interpretations. (a) E-SIGN preempts most statutes and regulations, including the Act...

  8. 12 CFR 609.920 - Interpretations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... E-commerce as long as the safeguards of E-SIGN are met and its exceptions recognized. Generally, an... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions § 609.920 Interpretations. (a) E-SIGN preempts most statutes and regulations, including the Act...

  9. 12 CFR 609.920 - Interpretations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... E-commerce as long as the safeguards of E-SIGN are met and its exceptions recognized. Generally, an... and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Interpretations and Definitions § 609.920 Interpretations. (a) E-SIGN preempts most statutes and regulations, including the Act...

  10. Individualization through standardization: electronic orders for subcutaneous insulin in the hospital.

    PubMed

    Kennihan, Mary; Zohra, Tatheer; Devi, Radha; Srinivasan, Chitra; Diaz, Josefina; Howard, Bradley S; Braithwaite, Susan S

    2012-01-01

    The objective was to design electronic order sets that would promote safe, effective, and individualized order entry for subcutaneous insulin in the hospital, based on a review of best practices. Saint Francis Hospital in Evanston, Illinois, a community teaching hospital, was selected as the pilot site for 6 hospitals in the Health Care System to introduce an electronic medical record. Articles dealing with management of hospital hyperglycemia, medical order entry systems, and patient safety were reviewed selectively. In the published literature on institutional glycemic management programs and insulin order sets, features were identified that improve safety and effectiveness of subcutaneous insulin therapy. Subcutaneous electronic insulin order sets were created, designated in short: "patients eating", "patients not eating", and "patients receiving overnight enteral feedings." Together with an option for free text entry, menus of administration instructions were designed within each order set that were applicable to specific insulin orders and expressed in standardized language, such as "hold if tube feeds stop" or "do not withhold." Two design features are advocated for electronic order sets for subcutaneous insulin that will both standardize care and protect individualization. First, within the order sets, the glycemic management plan should be matched to the carbohydrate exposure of the patients, with juxtaposition of appropriate orders for both glucose monitoring and insulin. Second, in order to convey precautions of insulin use to pharmacy and nursing staff, the prescriber must be able to attach administration instructions to specific insulin orders.

  11. Measuring interoperable EHR adoption and maturity: a Canadian example.

    PubMed

    Gheorghiu, Bobby; Hagens, Simon

    2016-01-25

    An interoperable electronic health record is a secure consolidated record of an individual's health history and care, designed to facilitate authorized information sharing across the care continuum.  Each Canadian province and territory has implemented such a system and for all, measuring adoption is essential to understanding progress and optimizing use in order to realize intended benefits. About 250,000 health professionals-approximately half of Canada's anticipated potential physician, nurse, pharmacist, and administrative users-indicated that they electronically access data, such as those found in provincial/territorial lab or drug information systems, in 2015.  Trends suggest further growth as maturity of use increases. There is strong interest in health information exchange through the iEHR in Canada, and continued growth in adoption is expected. Central to managing the evolution of digital health is access to robust data about who is using solutions, how they are used, where and when.  Stakeholders such as government, program leads, and health system administrators must critically assess progress and achievement of benefits, to inform future strategic and operational decisions.

  12. Five key recommendations for the implementation of Hospital Electronic Prescribing and Medicines Administration systems in Scotland.

    PubMed

    Cresswell, Kathrin; Slee, Ann; Sheikh, Aziz

    2017-01-24

    NHS Scotland is about to embark on the implementation of Hospital Electronic Prescribing and Medicines Administration (HEPMA) systems. There are a number of risks associated with such ventures, thus drawing on existing experiences from other settings is crucial in informing deployment.Drawing on our previous and ongoing work in English settings as well as the international literature, we reflect on key lessons that NHS Scotland may wish to consider in going forward. These deliberations include recommendations surrounding key aspects of deployment strategy surrounding: 1) the way central coordination should be conceptualised, 2) how flexibility in can be ensured, 3) paying attention to optimising systems from the outset, 4) how expertise should be developed and centrally shared, and 5) ways in which learning from experience can be maximised.Our five recommendations will, we hope, provide a starting point for the strategic deliberations of policy makers. Throughout this journey, it is important to view the deployment of HEPMA as part of a wider strategic goal of creating integrated digital infrastructures across Scotland.

  13. 21 CFR 10.200 - Scope.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...'s policy on the presence and operation of electronic recording equipment at such proceedings and to... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATIVE PRACTICES AND PROCEDURES Electronic Media Coverage of Public Administrative Proceedings; Guideline on Policy and Procedures...

  14. The Idea to Promote the Development of E-Government in the Civil Aviation System

    NASA Astrophysics Data System (ADS)

    Renliang, Jiang

    E-government has a significant impact on the organizational structure, working mechanism, operating methods and behavior patterns of the civil aviation administration department.The purpose of this research is to find some countermeasures propelling the electronization, network and office automation of the civil aviation system.The method used in the study was field and literature research.The studies showed that government departments in the civil aviation system could promote the development of e-government further by promoting open administration and implementing democratic and scientific decision-making, strengthening the popularization of information technology and information technology training on civil servants, paying attention to the integration and sharing of information resources, formulating a standard e-government system for the civil aviation system, developing the legal security system for the e-government and strengthening the network security.

  15. Advanced medical imaging protocol workflow-a flexible electronic solution to optimize process efficiency, care quality and patient safety in the National VA Enterprise.

    PubMed

    Medverd, Jonathan R; Cross, Nathan M; Font, Frank; Casertano, Andrew

    2013-08-01

    Radiologists routinely make decisions with only limited information when assigning protocol instructions for the performance of advanced medical imaging examinations. Opportunity exists to simultaneously improve the safety, quality and efficiency of this workflow through the application of an electronic solution leveraging health system resources to provide concise, tailored information and decision support in real-time. Such a system has been developed using an open source, open standards design for use within the Veterans Health Administration. The Radiology Protocol Tool Recorder (RAPTOR) project identified key process attributes as well as inherent weaknesses of paper processes and electronic emulators of paper processes to guide the development of its optimized electronic solution. The design provides a kernel that can be expanded to create an integrated radiology environment. RAPTOR has implications relevant to the greater health care community, and serves as a case model for modernization of legacy government health information systems.

  16. NOAO observing proposal processing system

    NASA Astrophysics Data System (ADS)

    Bell, David J.; Gasson, David; Hartman, Mia

    2002-12-01

    Since going electronic in 1994, NOAO has continued to refine and enhance its observing proposal handling system. Virtually all related processes are now handled electronically. Members of the astronomical community can submit proposals through email, web form or via Gemini's downloadable Phase-I Tool. NOAO staff can use online interfaces for administrative tasks, technical reviews, telescope scheduling, and compilation of various statistics. In addition, all information relevant to the TAC process is made available online. The system, now known as ANDES, is designed as a thin-client architecture (web pages are now used for almost all database functions) built using open source tools (FreeBSD, Apache, MySQL, Perl, PHP) to process descriptively-marked (LaTeX, XML) proposal documents.

  17. Near field communications technology and the potential to reduce medication errors through multidisciplinary application

    PubMed Central

    Pegler, Joe; Lehane, Elaine; Livingstone, Vicki; McCarthy, Nora; Sahm, Laura J.; Tabirca, Sabin; O’Driscoll, Aoife; Corrigan, Mark

    2016-01-01

    Background Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems. Methods An NFC-based system was designed to facilitate prescribing, administration and review of medications commonly used on surgical wards. Final year medical, nursing, and pharmacy students were recruited to test the electronic system in a cross-over observational setting on a simulated ward. Medication errors were compared against errors recorded using a paper-based system. Results A significant difference in the commission of medication errors was seen when NFC and paper-based medication systems were compared. Paper use resulted in a mean of 4.09 errors per prescribing round while NFC prescribing resulted in a mean of 0.22 errors per simulated prescribing round (P=0.000). Likewise, medication administration errors were reduced from a mean of 2.30 per drug round with a Paper system to a mean of 0.80 errors per round using NFC (P<0.015). A mean satisfaction score of 2.30 was reported by users, (rated on seven-point scale with 1 denoting total satisfaction with system use and 7 denoting total dissatisfaction). Conclusions An NFC based medication system may be used to effectively reduce medication errors in a simulated ward environment. PMID:28293602

  18. Near field communications technology and the potential to reduce medication errors through multidisciplinary application.

    PubMed

    O'Connell, Emer; Pegler, Joe; Lehane, Elaine; Livingstone, Vicki; McCarthy, Nora; Sahm, Laura J; Tabirca, Sabin; O'Driscoll, Aoife; Corrigan, Mark

    2016-01-01

    Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems. An NFC-based system was designed to facilitate prescribing, administration and review of medications commonly used on surgical wards. Final year medical, nursing, and pharmacy students were recruited to test the electronic system in a cross-over observational setting on a simulated ward. Medication errors were compared against errors recorded using a paper-based system. A significant difference in the commission of medication errors was seen when NFC and paper-based medication systems were compared. Paper use resulted in a mean of 4.09 errors per prescribing round while NFC prescribing resulted in a mean of 0.22 errors per simulated prescribing round (P=0.000). Likewise, medication administration errors were reduced from a mean of 2.30 per drug round with a Paper system to a mean of 0.80 errors per round using NFC (P<0.015). A mean satisfaction score of 2.30 was reported by users, (rated on seven-point scale with 1 denoting total satisfaction with system use and 7 denoting total dissatisfaction). An NFC based medication system may be used to effectively reduce medication errors in a simulated ward environment.

  19. Safety and Quality Training Simulator

    NASA Technical Reports Server (NTRS)

    Scobby, Pete T.

    2009-01-01

    A portable system of electromechanical and electronic hardware and documentation has been developed as an automated means of instructing technicians in matters of safety and quality. The system enables elimination of most of the administrative tasks associated with traditional training. Customized, performance-based, hands-on training with integral testing is substituted for the traditional instructional approach of passive attendance in class followed by written examination.

  20. Time trend of injection drug errors before and after implementation of bar-code verification system.

    PubMed

    Sakushima, Ken; Umeki, Reona; Endoh, Akira; Ito, Yoichi M; Nasuhara, Yasuyuki

    2015-01-01

    Bar-code technology, used for verification of patients and their medication, could prevent medication errors in clinical practice. Retrospective analysis of electronically stored medical error reports was conducted in a university hospital. The number of reported medication errors of injected drugs, including wrong drug administration and administration to the wrong patient, was compared before and after implementation of the bar-code verification system for inpatient care. A total of 2867 error reports associated with injection drugs were extracted. Wrong patient errors decreased significantly after implementation of the bar-code verification system (17.4/year vs. 4.5/year, p< 0.05), although wrong drug errors did not decrease sufficiently (24.2/year vs. 20.3/year). The source of medication errors due to wrong drugs was drug preparation in hospital wards. Bar-code medication administration is effective for prevention of wrong patient errors. However, ordinary bar-code verification systems are limited in their ability to prevent incorrect drug preparation in hospital wards.

  1. Clinical Computer Systems Survey (CLICS): learning about health information technology (HIT) in its context of use.

    PubMed

    Lichtner, Valentina; Cornford, Tony; Klecun, Ela

    2013-01-01

    Successful health information technology (HIT) implementations need to be informed on the context of use and on users' attitudes. To this end, we developed the CLinical Computer Systems Survey (CLICS) instrument. CLICS reflects a socio-technical view of HIT adoption, and is designed to encompass all members of the clinical team. We used the survey in a large English hospital as part of its internal evaluation of the implementation of an electronic patient record system (EPR). The survey revealed extent and type of use of the EPR; how it related to and integrated with other existing systems; and people's views on its use, usability and emergent safety issues. Significantly, participants really appreciated 'being asked'. They also reminded us of the wider range of administrative roles engaged with EPR. This observation reveals pertinent questions as to our understanding of the boundaries between administrative tasks and clinical medicine - what we propose as the field of 'administrative medicine'.

  2. Establishing data-intensive healthcare: the case of Hospital Electronic Prescribing and Medicines Administration systems in Scotland.

    PubMed

    Cresswell, Kathrin; Smith, Pam; Swainson, Charles; Timoney, Angela; Sheikh, Aziz

    2016-10-04

    Creating learning health systems, characterised by the use and repeated reuse of demographic, process and clinical data to improve the safety, quality and efficiency of care, is a key aim in realising the potential benefits and efficiency savings associated with the implementation of health information technology. We sought to investigate stakeholder perspectives on and experiences of the implementation of hospital electronic prescribing and medicines administration (HEPMA) systems in Scotland and use these to inform political decisions on approaches to promoting the use and reuse of digitised prescribing and medication administration data in order to improve care processes and outcomes.Methods We identified and recruited key national stakeholders involved in implementing and/or using HEPMA data from generic and specialty systems. These included representatives from healthcare settings (i.e. doctors, pharmacists and nurses), managers of existing national databases, policy makers, healthcare analytics companies, system suppliers and patient representatives. We conducted multi-disciplinary focus group discussions, audio-recorded these, transcribed data verbatim and thematically analysed the transcripts with the help of NVivo10. In analysing the data, we drew on theoretical and previous empirical work on information infrastructures. We identified the following key themes: 1) micro-factors - usability of systems and motivating users to input data; 2) meso-factors - developing technical and organisational infrastructures to facilitate the aggregation of data; and 3) macro-factors - facilitating interoperability and data reuse at larger scales to ensure that data are effectively generated and used. This work is relevant not only to countries in the early stages of data strategy development but also to countries aiming to aggregate data at national levels. An overall shared vision of a learning health system at individual, organisational and national levels can help to catalyse such data-intensive transformational efforts.

  3. Materials for High-Density Electronic Packaging and Interconnection

    DTIC Science & Technology

    1990-04-10

    play a prominent role in the future. Glass and Porcelain The earliest use of electronic ceramics was as insulators for carrying telegraph lines...Administration 61L & CORES , (Ot. stem. SAI WCJm 76. LOISS (C". SUMt *oW WVCf B’%2101 Constitution Avenue. N W Washington, D.C. 20418 Washington. D.C. 20301 G...Density Packaging 84 Tape Automated Bonding 87 Diamond 88 Superconductors 88 Composites 89 Materials for Very-High-Frequency Digital Systems 91

  4. Electronic intermodal supply chain manifest field operational test evaluation draft final report

    DOT National Transportation Integrated Search

    2002-12-01

    This report presents the results of a 2.5 year freight ITS evaluation of an air cargo security and logistics system which was deployed at OHare and JFK international airports. In September 1999, the Federal Highway Administration (FHWA) and the Fe...

  5. 76 FR 6619 - Proposed Information Collection Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-07

    ... Children's Health). Project LAUNCH is intended to promote the healthy development and wellness of children... electronic reports on State/Tribal and local systems development and on services that children and families... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed...

  6. Student Financial Aid Handbook, 2000-2001. Volume 1: Student Eligibility.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC. Student Financial Assistance.

    This handbook helps financial aid administrators determine students' eligibility for aid from the U.S. Department of Education's Student Financial Assistance (SFA) programs. An introduction describes information sources, conflicting information, fraud case referral, status change, electronic requirements, the application system, and recent…

  7. 20 CFR 401.95 - Fees.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...' Benefits SOCIAL SECURITY ADMINISTRATION PRIVACY AND DISCLOSURE OF OFFICIAL RECORDS AND INFORMATION The Privacy Act § 401.95 Fees. (a) Policy. Where applicable, we will charge fees for copying records in... system of records, whether the search is manual, mechanical, or electronic. Where we must copy the record...

  8. 12 CFR 609.935 - Business planning.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.935 Business planning. When engaging in E-commerce, the business plan required under part 618 of this chapter, subpart J, must describe the E-commerce initiative, including intended...

  9. 12 CFR 609.935 - Business planning.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.935 Business planning. When engaging in E-commerce, the business plan required under part 618 of this chapter, subpart J, must describe the E-commerce initiative, including intended...

  10. 12 CFR 609.935 - Business planning.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.935 Business planning. When engaging in E-commerce, the business plan required under part 618 of this chapter, subpart J, must describe the E-commerce initiative, including intended...

  11. 12 CFR 609.935 - Business planning.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.935 Business planning. When engaging in E-commerce, the business plan required under part 618 of this chapter, subpart J, must describe the E-commerce initiative, including intended...

  12. 12 CFR 609.935 - Business planning.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE Standards for Boards and Management § 609.935 Business planning. When engaging in E-commerce, the business plan required under part 618 of this chapter, subpart J, must describe the E-commerce initiative, including intended...

  13. Custom electronic subsystems for the laboratory telerobotic manipulator

    NASA Technical Reports Server (NTRS)

    Glassell, R. L.; Butler, P. L.; Rowe, J. C.; Zimmermann, S. D.

    1990-01-01

    The National Aeronautics and Space Administration (NASA) Space Station Program presents new opportunities for the application of telerobotic and robotic systems. The Laboratory Telerobotic Manipulator (LTM) is a highly advanced 7 degrees-of-freedom (DOF) telerobotic/robotic manipulator. It was developed and built for the Automation Technology Branch at NASA's Langley Research Center (LaRC) for work in research and to demonstrate ground-based telerobotic manipulator system hardware and software systems for future NASA applications in the hazardous environment of space. The LTM manipulator uses an embedded wiring design with all electronics, motor power, and control and communication cables passing through the pitch-yaw differential joints. This design requires the number of cables passing through the pitch/yaw joint to be kept to a minimum. To eliminate the cables needed to carry each pitch-yaw joint's sensor data to the VME control computers, a custom-embedded electronics package for each manipulator joint was developed. The electronics package collects and sends the joint's sensor data to the VME control computers over a fiber optic cable. The electronics package consist of five individual subsystems: the VME Link Processor, the Joint Processor and the Joint Processor power supply in the joint module, the fiber optics communications system, and the electronics and motor power cabling.

  14. 78 FR 75453 - Special Conditions: Cessna Model 750 Series Airplanes; Aircraft Electronic System Security...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-12

    ... the comment for an association, business, labor union, etc.). DOT's complete Privacy Act Statement can...; facsimile 425-227-1149. SUPPLEMENTARY INFORMATION: The network architecture is composed of several connected... business and administrative support, and 3. Passenger entertainment. The applicable airworthiness...

  15. CKD screening and management in the Veterans Health Administration: the impact of system organization and an innovative electronic record.

    PubMed

    Patel, Thakor G; Pogach, Leonard M; Barth, Robert H

    2009-03-01

    At the beginning of this decade, Healthy People 2010 issued a series of objectives to "reduce the incidence, morbidity, mortality and health care costs of chronic kidney disease." A necessary feature of any program to reduce the burden of kidney disease in the US population must include mechanisms to screen populations at risk and institute early the aspects of management, such as control of blood pressure, management of diabetes, and, in patients with advanced chronic kidney disease (CKD), preparation for dialysis therapy and proper vascular access management, that can retard CKD progression and improve long-term outcome. The Department of Veterans Affairs and the Veterans Health Administration is a broad-based national health care system that is almost uniquely situated to address these issues and has developed a number of effective approaches using evidence-based clinical practice guidelines, performance measures, innovative use of a robust electronic medical record system, and system oversight during the past decade. In this report, we describe the application of this systems approach to the prevention of CKD in veterans through the treatment of risk factors, identification of CKD in veterans, and oversight of predialysis and dialysis care. The lessons learned and applicability to the private sector are discussed.

  16. Radiology Reporting System Data Exchange With the Electronic Health Record System: A Case Study in Iran.

    PubMed

    Ahmadi, Maryam; Ghazisaeidi, Marjan; Bashiri, Azadeh

    2015-03-18

    In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. This study provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with the electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. This is a cross-sectional study that was conducted in 2013. The study population was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also Visual Paradigm software was used to design a conceptual model. Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, with providing the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

  17. A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

    PubMed

    Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

    2010-01-01

    We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

  18. Introduction of an all-electronic administrative process for a major international pediatric surgical meeting.

    PubMed

    Applebaum, Harry; Boles, Kay; Atkinson, James B

    2003-12-01

    The administrative process for annual meetings is time consuming and increasingly costly when accomplished by traditional postal, fax, and telephone methods. The Pacific Association of Pediatric Surgeons introduced an all-electronic communication format for its 2002 annual meeting. Attendee acceptance and administrative and financial impact were evaluated. Interested physicians were directed to a Website containing detailed information and electronic forms. E-mail was used for the abstract selection and manuscript submission processes. Attendees were surveyed to evaluate the new format. Administrative costs for the new format were compared with estimated costs for a comparable traditionally managed meeting. Attendance was similar to that at previous US meetings. Eighty-two percent of respondents approved of the all-electronic format, although 48% believed a choice should remain. None suggested a complete return to the traditional format. Abstract and manuscript processing time was reduced substantially as were administrative costs (79.43 dollars savings per physician registrant). Adoption of an all-electronic annual meeting administrative process was associated with substantial cost reduction, increased efficiency, and excellent attendee satisfaction. This technology can help avoid increased registration fees while easing the burden on physician volunteers.

  19. Use of electronic information systems in nursing management.

    PubMed

    Lammintakanen, Johanna; Saranto, Kaija; Kivinen, Tuula

    2010-05-01

    The purpose of this study is to describe nurse managers' perceptions of the use of electronic information systems in their daily work. Several kinds of software are used for administrative and information management purposes in health care organizations, but the issue has been studied less from nurse managers' perspective. The material for this qualitative study was acquired according to the principles of focus group interview. Altogether eight focus groups were held with 48 nurse managers from both primary and specialized health care organizations. The nurse managers were asked in focus groups to describe the use of information systems in their daily work in addition to some other themes. The material was analyzed by inductive content analysis using ATLAS.ti computer program. The main category "pros and cons of using information systems in nursing management" summarized the nurse managers' perceptions of using electronic information systems. The main category consisted of three sub-categories: (1) nurse managers' perceptions of the use of information technology; (2) usability of management information systems; (3) development of personnel competencies and work processes. The nurse managers made several comments on the implementation of immature electronic information systems which caused inefficiencies in working processes. However, they considered electronic information systems to be essential elements of their daily work. Furthermore, the nurse managers' descriptions of the pros and cons of using information systems reflected partly the shortcomings of strategic management and lack of coordination in health care organizations. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  20. 20 CFR 411.315 - What are the minimum qualifications necessary to be an EN?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... to be an EN? 411.315 Section 411.315 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO... capability of making documents and literature available in alternate media including Braille, recorded formats, enlarged print, and electronic media; and insuring that data systems available to clients are...

  1. 20 CFR 411.315 - What are the minimum qualifications necessary to be an EN?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... to be an EN? 411.315 Section 411.315 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO... capability of making documents and literature available in alternate media including Braille, recorded formats, enlarged print, and electronic media; and insuring that data systems available to clients are...

  2. 20 CFR 411.315 - What are the minimum qualifications necessary to be an EN?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... to be an EN? 411.315 Section 411.315 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO... capability of making documents and literature available in alternate media including Braille, recorded formats, enlarged print, and electronic media; and insuring that data systems available to clients are...

  3. 20 CFR 411.315 - What are the minimum qualifications necessary to be an EN?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... to be an EN? 411.315 Section 411.315 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO... capability of making documents and literature available in alternate media including Braille, recorded formats, enlarged print, and electronic media; and insuring that data systems available to clients are...

  4. 78 FR 14311 - Statement of Organization, Functions and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Federal Assistance Management (RJ). Specifically, this notice: (1) Moves the grant officer and loan officer function from the Office of the Associate Administrator (RJ) to the Division of Grants Management Operations (RJ3); and (2) moves the electronic grant management system function from the Division of Grants...

  5. 20 CFR 411.315 - What are the minimum qualifications necessary to be an EN?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... to be an EN? 411.315 Section 411.315 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO... capability of making documents and literature available in alternate media including Braille, recorded formats, enlarged print, and electronic media; and insuring that data systems available to clients are...

  6. NATIONAL HEALTH & ENVIRONMENTAL EFFECTS RESEARCH LABORATORY BEGINS IMPLEMENTATION OF AN ELECTRONIC SCIENTIFIC DATA MANAGEMENT SYSTEM

    EPA Science Inventory

    Data and records management have changed greatly as a result of progress in computer technology, but many organizations, including the US EPA's National Records Management Program (NRMP) and the U.S. National Archives and Records Administration (NARA), still struggle to escape th...

  7. Best Manufacturing Practices: Report of Survey Conducted at Texas Instruments Defense Systems and Electronics Group, Dallas, Texas

    DTIC Science & Technology

    1988-06-01

    Washington, DC Richard Celin Naval Air Engineering Center (201) 323-2173 Lakehurst, NJ Alice Giampapa TRIAD Engineering Co., Inc. Administrative (609) 939...7 3.1 DESIGN DESIGN PROCESS Producibility Engineering ........................................................ 7 Producibility Advisor... Engineers in Manufacturing Processes ........................... 21 Method Improvement Report Program

  8. Improving oversight of the graduate medical education enterprise: one institution's strategies and tools.

    PubMed

    Afrin, Lawrence B; Arana, George W; Medio, Franklin J; Ybarra, Angela F N; Clarke, Harry S

    2006-05-01

    Accreditation organizations, financial stakeholders, legal systems, and regulatory agencies have increased the need for accountability in educational processes and curricular outcomes of graduate medical education. This demand for greater programmatic monitoring has placed pressure on institutions with graduate medical education (GME) programs to develop greater oversight of these programs. Meeting these challenges requires development of new GME management strategies and tools for institutional GME administrators to scrutinize programs, while still allowing these programs the autonomy to develop and implement educational methods to meet their unique training needs. At the Medical University of South Carolina (MUSC), senior administrators in the college of medicine felt electronic information management was a critical strategy for success and thus proceeded to carefully select an electronic residency management system (ERMS) to provide functionality for both individual programs and the GME enterprise as a whole. Initial plans in 2002 for a phased deployment had to be changed to a much more rapid deployment due to regulatory issues. Extensive communication and cooperation among MUSC's GME leaders resulted in a successful deployment in 2003. Evaluation completion rates have substantially improved, duty hours are carefully monitored, patient safety has improved through more careful oversight of residents' procedural privileges, regulators have been pleased, and central GME administrative visibility of program performance has dramatically improved. The system is now being expanded to MUSC's medical school and other health professions colleges. The authors discuss lessons learned and opportunities and challenges ahead, which include improving tracking of development of procedural competency, establishing and monitoring program performance standards, and integrating the ERMS with GME reimbursement systems.

  9. Formulation of microspheres containing Crataegus monogyna Jacq. extract with free radical scavenging activity.

    PubMed

    Lucconi, Giulia; Chlapanidas, Theodora; Martino, Emanuela; Gaggeri, Raffaella; Perteghella, Sara; Rossi, Daniela; Faragò, Silvio; Vigo, Daniele; Faustini, Massimo; Collina, Simona; Torre, Maria Luisa

    2014-02-01

    Extracts of Crataegus monogyna Jacq. (hawthorn) show an interesting free radical scavenging (FRS) effect, related to their flavonoids content. Unfortunately, their oral administration is affected by their low bioavailability. The aim of this work is to obtain a multiparticulate drug delivery system for hawthorn extracts for oral administration. The extracts from flowering tops (FL) or fruits (FR) of hawthorn were obtained with maceration, using ethanol as an extraction solvent, and their antioxidant activity was evaluated. FL extract showed the highest FRS activity (EC50 3.72 ± 1.21 µg/ml), so it was selected to prepare microparticulate systems by a spray-drying technique, which were characterized by granulometric analysis, scanning electron microscopy-energy dispersive X-ray spectroscopy, confocal fluorescence microscopy and hyperoside content. Antioxidant activity was evaluated before and after gastrointestinal transit in vitro simulation. Results indicate that the microparticulate systems maintained the antioxidant activity of hawthorn also after gastrointestinal transit in vitro simulation, exhibiting properties suitable for oral administration.

  10. Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

    PubMed

    Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

    2016-01-01

    Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

  11. Reengineering a database for clinical trials management: lessons for system architects.

    PubMed

    Brandt, C A; Nadkarni, P; Marenco, L; Karras, B T; Lu, C; Schacter, L; Fisk, J M; Miller, P L

    2000-10-01

    This paper describes the process of enhancing Trial/DB, a database system for clinical studies management. The system's enhancements have been driven by the need to maximize the effectiveness of developer personnel in supporting numerous and diverse users, of study designers in setting up new studies, and of administrators in managing ongoing studies. Trial/DB was originally designed to work over a local area network within a single institution, and basic architectural changes were necessary to make it work over the Internet efficiently as well as securely. Further, as its use spread to diverse communities of users, changes were made to let the processes of study design and project management adapt to the working styles of the principal investigators and administrators for each study. The lessons learned in the process should prove instructive for system architects as well as managers of electronic patient record systems.

  12. Electron beam processed transdermal delivery system for administration of an anti-anginal agent

    NASA Astrophysics Data System (ADS)

    Kotiyan, P. N.; Vavia, P. R.; Bharadwaj, Y. K.; Sabarwal, S.; Majali, A. B.

    2002-12-01

    Electron beam irradiation was used to synthesize a matrix type transdermal system of isosorbide dinitrate, an effective anti-anginal agent. The drug was dissolved in two monomeric systems, 2-ethylhexyl acrylate (EHA) and 2-ethylhexyl acrylate : methyl methacrylate (9 : 1). The solutions were then directly irradiated on a backing membrane (Scotchpak ®1006) at different doses to get transdermal patches. The developed systems were evaluated for residual monomer content, equilibrium weight swelling ratio, weight uniformity, thickness uniformity, drug content, peel strength, in vitro release and skin permeation kinetics. They possessed excellent tack and adhesive properties. In the case of isosorbide dinitrate-EHA systems, an increase in the peel strength values with respect to the skin was observed with increasing radiation doses. The systems exhibited promising skin permeation kinetics favorable for transdermal drug delivery. The radiation stability of the drug in the pure solid state form was also assessed.

  13. Implementation of an Anesthesia Information Management System (AIMS)

    PubMed Central

    Douglas, James R.; Ritter, Melody J.

    2011-01-01

    During the administration of anesthesia, the anesthesia provider has historically created a paper record, charted manually, that included extensive patient care–related data (vital signs, other parameters, etc) and commentaries. DocuSys, a proprietary anesthesia information management system (AIMS), creates an electronic version of the anesthesia record and provides additional information. It electronically captures data from clinical monitors and other sources, including scheduling applications and laboratory computers. The AIMS facilitates chart entries such as drug doses and case narratives. Benefits of an AIMS include improved legibility of the anesthesia record and greater efficiency in documentation efforts. Use of the AIMS assists the practitioner with decision support logic, such as the timing of antibiotic administration and the inclusion of legally required documentation. Upon case completion, the AIMS data are immediately available to other information systems, such as billing and medical records. Data can be made available from a single case or, more important, from thousands of cases to analyze variables such as efficiency of services, adherence to best practices, patient outcomes, and clinical research. The AIMS was deployed at the main campus of the Ochsner Health System on March 26, 2009. In this article, we discuss the issues involved in the AIMS implementation process: the successes, surprises, and continued challenges. PMID:21734847

  14. Implementation of an Anesthesia Information Management System (AIMS).

    PubMed

    Douglas, James R; Ritter, Melody J

    2011-01-01

    During the administration of anesthesia, the anesthesia provider has historically created a paper record, charted manually, that included extensive patient care-related data (vital signs, other parameters, etc) and commentaries. DocuSys, a proprietary anesthesia information management system (AIMS), creates an electronic version of the anesthesia record and provides additional information. It electronically captures data from clinical monitors and other sources, including scheduling applications and laboratory computers. The AIMS facilitates chart entries such as drug doses and case narratives. Benefits of an AIMS include improved legibility of the anesthesia record and greater efficiency in documentation efforts. Use of the AIMS assists the practitioner with decision support logic, such as the timing of antibiotic administration and the inclusion of legally required documentation. Upon case completion, the AIMS data are immediately available to other information systems, such as billing and medical records. Data can be made available from a single case or, more important, from thousands of cases to analyze variables such as efficiency of services, adherence to best practices, patient outcomes, and clinical research. The AIMS was deployed at the main campus of the Ochsner Health System on March 26, 2009. In this article, we discuss the issues involved in the AIMS implementation process: the successes, surprises, and continued challenges.

  15. The use of a tablet computer to complete the DASH questionnaire.

    PubMed

    Dy, Christopher J; Schmicker, Thomas; Tran, Quynh; Chadwick, Brian; Daluiski, Aaron

    2012-12-01

    To determine whether electronic self-administration of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire using a tablet computer increased completion rate compared with paper self-administration. We gave the DASH in self-administered paper form to 222 new patients in a single hand surgeon's practice. After a washout period of 5 weeks, we gave the DASH in self-administered tablet computer form to 264 new patients. A maximum of 3 questions could be omitted before the questionnaire was considered unscorable. We reviewed the submitted surveys to determine the number of scorable questionnaires and the number of omitted questions in each survey. We completed univariate analysis and regression modeling to determine the influence of survey administration type on respondent error while controlling for patient age and sex. Of the 486 total surveys, 60 (12%) were not scorable. A significantly higher proportion of the paper surveys (24%) were unscorable compared with electronic surveys (2%), with significantly more questions omitted in each paper survey (2.6 ± 4.4 questions) than in each electronic survey (0.1 ± 0.8 questions). Logistic regression analysis revealed survey administration mode to be significantly associated with DASH scorability while controlling for age and sex, with electronic survey administration being 14 times more likely than paper administration to yield a scorable DASH. In our retrospective series, electronic self-administration of the DASH decreased the number of omitted questions and yielded a higher number of scorable questionnaires. Prospective, randomized evaluation is needed to better delineate the effect of survey administration on respondent error. Administration of the DASH with a tablet computer may be beneficial for both clinical and research endeavors to increase completion rate and to gain other benefits from electronic data capture. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  16. Federating Clinical Data from Six Pediatric Hospitals: Process and Initial Results from the PHIS+ Consortium

    PubMed Central

    Narus, Scott P.; Srivastava, Rajendu; Gouripeddi, Ramkiran; Livne, Oren E.; Mo, Peter; Bickel, Jonathan P.; de Regt, David; Hales, Joseph W.; Kirkendall, Eric; Stepanek, Richard L.; Toth, Jamie; Keren, Ron

    2011-01-01

    Integrating clinical data with administrative data across disparate electronic medical record systems will help improve the internal and external validity of comparative effectiveness research. The Pediatric Health Information System (PHIS) currently collects administrative information from 43 pediatric hospital members of the Child Health Corporation of America (CHCA). Members of the Pediatric Research in Inpatient Settings (PRIS) network have partnered with CHCA and the University of Utah Biomedical Informatics Core to create an enhanced version of PHIS that includes clinical data. A specialized version of a data federation architecture from the University of Utah (“FURTHeR”) is being developed to integrate the clinical data from the member hospitals into a common repository (“PHIS+”) that is joined with the existing administrative data. We report here on our process for the first phase of federating lab data, and present initial results. PMID:22195159

  17. The paperless labeling initiative: a proof-of-concept study.

    PubMed

    Ruchalski, Charles

    2004-01-01

    Traditional paper professional package inserts (PPIs) are used on a daily basis by a variety of healthcare providers to locate and disseminate drug information. Unfortunately, paper PPIs are sometimes not accessible to the healthcare provider, appear unreadable due to varied font sizes, and are often considered not to be user-friendly. In December 2000, the Food and Drug Administration proposed regulations that would revise the format of PPIs. To determine whether electronic delivery of PPI information is achievable in community pharmacy practice settings. Electronic PPIs are an alternative means of delivering this information. This 12-week proof-of-concept study evaluated the Health Information Designs/Thomson Healthcare and Etreby Computer Company for electronic delivery of PPIs in 6 chain and 4 independent community pharmacies, with 5 pharmacies evaluating each system. Participating pharmacists were asked 9 questions designed to determine the feasibility of implementing electronic PPI delivery, as well as pharmacist satisfaction with each system. Pharmacists deemed both systems to be accessible and user-friendly. Pharmacists from both groups felt that the electronic PPIs were challenging to read and that printing took too long. Future studies in a more diverse selection of dispensing sites, including pharmacies (community and hospital based), clinics, and physician practices, need to be performed to maximize the use of electronic PPIs.

  18. Facilitating quality control for spectra assignments of small organic molecules: nmrshiftdb2--a free in-house NMR database with integrated LIMS for academic service laboratories.

    PubMed

    Kuhn, Stefan; Schlörer, Nils E

    2015-08-01

    nmrshiftdb2 supports with its laboratory information management system the integration of an electronic lab administration and management into academic NMR facilities. Also, it offers the setup of a local database, while full access to nmrshiftdb2's World Wide Web database is granted. This freely available system allows on the one hand the submission of orders for measurement, transfers recorded data automatically or manually, and enables download of spectra via web interface, as well as the integrated access to prediction, search, and assignment tools of the NMR database for lab users. On the other hand, for the staff and lab administration, flow of all orders can be supervised; administrative tools also include user and hardware management, a statistic functionality for accounting purposes, and a 'QuickCheck' function for assignment control, to facilitate quality control of assignments submitted to the (local) database. Laboratory information management system and database are based on a web interface as front end and are therefore independent of the operating system in use. Copyright © 2015 John Wiley & Sons, Ltd.

  19. A comprehensive infectious disease management system.

    PubMed

    Marcu, Alex; Farley, John D

    2009-01-01

    An efficient electronic management system is now an essential tool for the successful management and monitoring of those affected by communicable infectious diseases (Human Immunodeficiency Virus - HIV, hepatitis C - HEP C) during the course of the treatment. The current methods which depend heavily on manual collecting, compiling and disseminating treatment information are labor-intensive and time consuming. Clinics specialized in the treatment of infectious diseases use a mix of electronic systems that fail to interact with each other, result in data duplication, and do not support treatment of the patient as a whole. The purpose of the Infectious Disease Management System is to reduce the administrative overhead associated with data collection and analysis while providing correlation abilities and decision support in accordance with defined treatment guidelines. This Infectious Disease Management System was developed to: Ensure cost effectiveness by means of low software licensing costs, Introduce a centralized mechanism of collecting and monitoring all infectious disease management data, Automate electronic retrieval of laboratory findings, Introduce a decision support mechanism as per treatment guidelines, Seamlessly integrate of application modules, Provide comprehensive reporting capabilities, Maintain a high level of user friendliness.

  20. Analgesic efficacy of preoperative dexketoprofen trometamol: A systematic review and meta-analysis.

    PubMed

    Esparza-Villalpando, Vicente; Pozos-Guillén, Amaury; Masuoka-Ito, David; Gaitán-Fonseca, César; Chavarría-Bolaños, Daniel

    2018-03-01

    Post-Market Research Clinical evidence supports the use of dexketoprofen trometamol (DEX) to manage acute postoperative pain. However, controversies surround the impact of the use of this drug in preoperative analgesic protocols. The aim of the present meta-analysis was to evaluate the effectiveness of the preoperative administration of DEX under postoperative pain conditions. Electronic and manual searches were conducted through diverse electronic databases. A systematic review and meta-analysis to evaluate the analgesic efficacy of the preoperative administration of DEX was performed including Randomized Clinical Trials (RCTs) published between 2002 and 2017. Suitable individual studies were evaluated through a quality system, and the data were extracted and analyzed. Fourteen RTCs were included (12 parallel trials and 2 cross-over trials), published in the English and Turkish languages. Follow-up periods ranged from 4, 6, 8, 24, and 48 hr. All trials measured the outcome result as Acute Pain Level (APL) (VAS, NRS, VRS), time to requiring a second dose of DEX or analgesic emergency and consumption of opioids via patient-controlled analgesia. When the comparators were other drugs - paracetamol, Lornoxicam or placebo during the preoperative time, preoperative administration of DEX was superior. When the comparison comprised preoperative and postoperative DEX, both alternatives exhibited comparable analgesic effects. The analgesic efficacy of the preoperative administration of DEX when compared to placebo, lornoxicam, and paracetamol on postoperative pain was evident. Preoperative administration of DEX compared to its immediate postoperative administration showed a similar analgesic effect. © 2017 Wiley Periodicals, Inc.

  1. Instant availability of patient records, but diminished availability of patient information: A multi-method study of GP's use of electronic patient records

    PubMed Central

    Christensen, Tom; Grimsmo, Anders

    2008-01-01

    Background In spite of succesful adoption of electronic patient records (EPR) by Norwegian GPs, what constitutes the actual benefits and effects of the use of EPRs in the perspective of the GPs and patients has not been fully characterized. We wanted to study primary care physicians' use of electronic patient record (EPR) systems in terms of use of different EPR functions and the time spent on using the records, as well as the potential effects of EPR systems on the clinician-patient relationship. Methods A combined qualitative and quantitative study that uses data collected from focus groups, observations of primary care encounters and a questionnaire survey of a random sample of general practitioners to describe their use of EPR in primary care. Results The overall availability of individual patient records had improved, but the availability of the information within each EPR was not satisfactory. GPs' use of EPRs were efficient and comprehensive, but have resulted in transfer of administrative work from secretaries to physicians. We found no indications of disturbance of the clinician-patient relationship by use of computers in this study. Conclusion Although GPs are generally satisfied with their EPRs systems, there are still unmet needs and functionality to be covered. It is urgent to find methods that can make a better representation of information in large patient records as well as prevent EPRs from contributing to increased administrative workload of physicians. PMID:18373858

  2. 75 FR 67781 - Records Schedules; Availability and Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-03

    ... electronic information system used to administrate registration for educational and training sessions. 10.... Department of Justice, Tax Division (N1-60-09-1, 1 item, 1 temporary item). Memoranda documenting settlements in tax cases from the 1950s and 1960s. 16. Department of Justice, Justice Management Division (N1-60...

  3. 41 CFR 102-194.40 - For what Standard or Optional forms should an electronic version not be made available?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false For what Standard or... Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION ADMINISTRATIVE PROGRAMS 194-STANDARD AND OPTIONAL FORMS MANAGEMENT PROGRAM § 102-194.40...

  4. 40 CFR 86.509-90 - Exhaust gas sampling system.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... (insulation may remain in place and/or heating may occur during testing provided maximum temperature is not... equivalent results, and if approved in advance by the Administrator (e.g., a heat exchanger with the CFV-CVS or an electronic flow integrator without a heat exchanger, with the PDP-CVS). (b) Component...

  5. 40 CFR 86.509-90 - Exhaust gas sampling system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... (insulation may remain in place and/or heating may occur during testing provided maximum temperature is not... equivalent results, and if approved in advance by the Administrator (e.g., a heat exchanger with the CFV-CVS or an electronic flow integrator without a heat exchanger, with the PDP-CVS). (b) Component...

  6. 40 CFR 86.509-90 - Exhaust gas sampling system.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... (insulation may remain in place and/or heating may occur during testing provided maximum temperature is not... equivalent results, and if approved in advance by the Administrator (e.g., a heat exchanger with the CFV-CVS or an electronic flow integrator without a heat exchanger, with the PDP-CVS). (b) Component...

  7. 12 CFR 611.1246 - Filing of termination application and its contents.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Filing of termination application and its contents. 611.1246 Section 611.1246 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM... application in electronic form, you must send us at least one hard copy with original signatures. (b) Contents...

  8. 12 CFR 611.1246 - Filing of termination application and its contents.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Filing of termination application and its contents. 611.1246 Section 611.1246 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM... application in electronic form, you must send us at least one hard copy with original signatures. (b) Contents...

  9. Safeguarding Your Technology: Practical Guidelines for Electronic Education Information Security.

    ERIC Educational Resources Information Center

    Szuba, Tom

    This guide was developed specifically for educational administrators at the building, campus, district, system, and state levels, and is meant to serve as a framework to help them better understand why and how to effectively secure their organization's information, software, and computer and networking equipment. This document is organized into 10…

  10. Computers and Mental Health Care Delivery. A Resource Guide to Federal Information.

    ERIC Educational Resources Information Center

    Levy, Louise

    Prepared for the mental health professional or administrator who is involved in the planning, developing, or implementation of an automated information system in a mental health environment, this guide is limited to the electronic processing and storage of information for management and clinical functions. Management application areas include…

  11. Automated Transformation of CDISC ODM to OpenClinica.

    PubMed

    Gessner, Sophia; Storck, Michael; Hegselmann, Stefan; Dugas, Martin; Soto-Rey, Iñaki

    2017-01-01

    Due to the increasing use of electronic data capture systems for clinical research, the interest in saving resources by automatically generating and reusing case report forms in clinical studies is growing. OpenClinica, an open-source electronic data capture system enables the reuse of metadata in its own Excel import template, hampering the reuse of metadata defined in other standard formats. One of these standard formats is the Operational Data Model for metadata, administrative and clinical data in clinical studies. This work suggests a mapping from Operational Data Model to OpenClinica and describes the implementation of a converter to automatically generate OpenClinica conform case report forms based upon metadata in the Operational Data Model.

  12. How we developed eForms: an electronic form and data capture tool to support assessment in mobile medical education.

    PubMed

    Mooney, Jane S; Cappelli, Tim; Byrne-Davis, Lucie; Lumsden, Colin J

    2014-12-01

    Mobile learning technologies are being introduced and adopted by an increasing number of medical schools. Following the implementation of these devices, institutions are tasked with the challenge of their integration into curriculum delivery and presented with the opportunity to facilitate data collection from large student cohorts. Since 2011, Manchester Medical School (MMS) has undertaken the largest deployment of iPads within UK Higher Education. Working towards the more efficient collation of students' compulsory workplace-based assessment data led us to evaluate how existing information management software could replace previously paper-based systems. Following an evaluation of six, and a trial of one, commercially available packages, the existing software solutions were found to be inflexible and unfit for purpose. This resulted in the development of a new digital solution that addressed the limitations of the previous system. "University of Manchester (UoM) eForms" consists of an app and a web-based administration system that respectively permit high volume data collection and management. UoM eForms has now replaced the preceding paper-based and electronic systems within MMS for workplace-based assessment administration, due to the improved usability and dynamicity built into its interface and infrastructure. This new system has found many further useful applications, including research data collection, feedback, placement evaluations, quality assurance and interview marking.

  13. Development and evaluation of a system to assess antimicrobial drug use in farm animals: results of an Austrian study.

    PubMed

    Ferner, C; Obritzhauser, W; Fuchs, K; Schmerold, I

    2014-11-01

    The objective of this study was to develop and evaluate a feasible system for the collection of antimicrobial consumption data in farm animals in Austria. An electronic registry of all antibacterial pharmaceuticals approved in Austria for use in farm animals was created, listing product name, marketing authorisation number, active ingredient, package unit, strength, target species (cattle, swine, poultry), route of administration and indication, and allocating the corresponding code of the World Health Organization (WHO) Anatomical Therapeutic Chemical classification system for veterinary medicines to each substance (ATCvet-code). Different units (absolute quantities, animal daily dose, assumed daily product dose) enabled computation of the amounts of antimicrobials as pure substance, the constituents of a veterinary medicinal product, or the number of administrations. Two data collection systems were evaluated: (1) data transfer from the management software of veterinary practices or the Austrian Poultry Health Service; and (2) on-site data collection by manual data input from prescription records into an electronic registry. A total of 14,267 data sets provided by 18 practices were documented during the period January 2008 to March 2010. The total weight of active substances reported amounted to more than 5.4 tonnes for all species studied. The systems proved suitable for routine data acquisition and were considered in a recent national regulation on the surveillance of sale and consumption of veterinary antimicrobial substances. British Veterinary Association.

  14. A Study on Technology Architecture and Serving Approaches of Electronic Government System

    NASA Astrophysics Data System (ADS)

    Liu, Chunnian; Huang, Yiyun; Pan, Qin

    As E-government becomes a very active research area, a lot of solutions to solve citizens' needs are being deployed. This paper provides technology architecture of E-government system and approaches of service in Public Administrations. The proposed electronic system addresses the basic E-government requirements of user friendliness, security, interoperability, transparency and effectiveness in the communication between small and medium sized public organizations and their citizens, businesses and other public organizations. The paper has provided several serving approaches of E-government, which includes SOA, web service, mobile E-government, public library and every has its own characteristics and application scenes. Still, there are a number of E-government issues for further research on organization structure change, including research methodology, data collection analysis, etc.

  15. Vaccination coverage among children under two years of age based on electronic immunization registry in Southern Brazil.

    PubMed

    Luhm, Karin Regina; Cardoso, Maria Regina Alves; Waldman, Eliseu Alves

    2011-02-01

    To evaluate the immunization program for 12 and 24-month-old children based on electronic immunization registry. A descriptive study of a random sample of 2,637 children born in 2002 living in the city of Curitiba, Southern Brazil was performed. Data was collected from local electronic immunization registers and the National Live Birth Information System, as well as from a household survey for cases with incomplete records. Coverage at 12 and 24 months was estimated and analyzed according to the socioeconomic characteristics of each administrative district and the child's enrollment status in the health care service. The coverage, completeness, and record duplication in the registry were analyzed. Coverage of immunization was 95.3% at 12 months, with no disparities among administrative districts, and 90.3% at 24 months, with higher coverage in a district with lower socioeconomic conditions (p < 0.01). The proportion of vaccines, according to type, given before and after the recommended age reached 0.9% and 32.2%, respectively. In the surveyed sample, electronic immunization registry coverage was 98%, underreporting of vaccine doses was 11%, and record duplication was 20.6%. Groups with highest coverage included children with permanent records, children with three or more appointments through the National Unified Health Care System, and children seen within Primary Health Care Facilities fully adopting the Family Health Strategy. Vaccination coverage in Curitiba was high and homogeneous among districts, and health service enrollment status was an important factor in these results. The electronic immunization registry was a useful tool for monitoring vaccine coverage; however, it will be important to determine cost-effectiveness prior to wide-scale adoption by the National Immunization Program.

  16. Knowledge Transfer and Dissemination of Advanced Practice Nursing Information and Research to Acute-Care Administrators.

    PubMed

    Carter, Nancy; Dobbins, Maureen; Peachey, Gladys; Hoxby, Heather; Ireland, Sandra; Akhtar-Danesh, Noori; DiCenso, Alba

    2014-03-01

    The objective of this study was to ascertain the information needs and knowledge-dissemination preferences of acute-care administrators with respect to advanced practice nursing (APN). Supportive leadership is imperative for the success of APN roles and administrators need up-to-date research evidence and information, but it is unclear what the information needs of administrators are and how they prefer to receive the information. A survey tool was developed from the literature and from the findings of a qualitative study with acute-care leaders. Of 107 surveys distributed to nursing administrators in 2 teaching hospitals, 79 (73.8%) were returned. Just over half of respondents reported wanting APN information related to model of care and patient and systems outcomes of APN care; the majority expressed a preference for electronic transmission of the information. Researchers need multiple strategies for distributing context-specific APN evidence and information to nursing administrators. Copyright© by Ingram School of Nursing, McGill University.

  17. Administrative Costs Associated With Physician Billing and Insurance-Related Activities at an Academic Health Care System.

    PubMed

    Tseng, Phillip; Kaplan, Robert S; Richman, Barak D; Shah, Mahek A; Schulman, Kevin A

    2018-02-20

    Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. This study used time-driven activity-based costing. Interviews were conducted with 27 health system administrators and 34 physicians in 2016 and 2017 to construct a process map charting the path of an insurance claim through the revenue cycle management process. These data were used to calculate the cost for each major billing and insurance-related activity and were aggregated to estimate the health system's total cost of processing an insurance claim. Estimated time required to perform billing and insurance-related activities, based on interviews with management personnel and physicians. Estimated billing and insurance-related costs for 5 types of patient encounters: primary care visits, discharged emergency department visits, general medicine inpatient stays, ambulatory surgical procedures, and inpatient surgical procedures. Estimated processing time and total costs for billing and insurance-related activities were 13 minutes and $20.49 for a primary care visit, 32 minutes and $61.54 for a discharged emergency department visit, 73 minutes and $124.26 for a general inpatient stay, 75 minutes and $170.40 for an ambulatory surgical procedure, and 100 minutes and $215.10 for an inpatient surgical procedure. Of these totals, time and costs for activities carried out by physicians were estimated at a median of 3 minutes or $6.36 for a primary care visit, 3 minutes or $10.97 for an emergency department visit, 5 minutes or $13.29 for a general inpatient stay, 15 minutes or $51.20 for an ambulatory surgical procedure, and 15 minutes or $51.20 for an inpatient surgical procedure. Of professional revenue, professional billing costs were estimated to represent 14.5% for primary care visits, 25.2% for emergency department visits, 8.0% for general medicine inpatient stays, 13.4% for ambulatory surgical procedures, and 3.1% for inpatient surgical procedures. In a time-driven activity-based costing study in a large academic health care system with a certified electronic health record system, the estimated costs of billing and insurance-related activities ranged from $20 for a primary care visit to $215 for an inpatient surgical procedure. Knowledge of how specific billing and insurance-related activities contribute to administrative costs may help inform policy solutions to reduce these expenses.

  18. 49 CFR 237.155 - Documents and records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... inspection and reproduction by the Federal Railroad Administration. (a) Electronic recordkeeping; general... the information required by this part; (3) The track owner monitors its electronic records database...

  19. 49 CFR 237.155 - Documents and records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... inspection and reproduction by the Federal Railroad Administration. (a) Electronic recordkeeping; general... the information required by this part; (3) The track owner monitors its electronic records database...

  20. 49 CFR 237.155 - Documents and records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... inspection and reproduction by the Federal Railroad Administration. (a) Electronic recordkeeping; general... the information required by this part; (3) The track owner monitors its electronic records database...

  1. Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.

    PubMed

    Rangachari, Pavani

    2014-12-01

    Despite the federal policy momentum towards "meaningful use" of Electronic Health Records, the healthcare organizational literature remains replete with reports of unintended adverse consequences of implementing Electronic Health Records, including: increased work for clinicians, unfavorable workflow changes, and unexpected changes in communication patterns & practices. In addition to being costly and unsafe, these unintended adverse consequences may pose a formidable barrier to "meaningful use" of Electronic Health Records. Correspondingly, it is essential for hospital administrators to understand and detect the causes of unintended adverse consequences, to ensure successful implementation of Electronic Health Records. The longstanding Technology-in-Practice framework emphasizes the role of human agency in enacting structures of technology use or "technologies-in-practice." Given a set of unintended adverse consequences from health information technology implementation, this framework could help trace them back to specific actions (types of technology-in-practice) and institutional conditions (social structures). On the other hand, the more recent Knowledge-in-Practice framework helps understand how information and communication technologies ( e.g. , social knowledge networking systems) could be implemented alongside existing technology systems, to create new social structures, generate new knowledge-in-practice, and transform technology-in-practice. Therefore, integrating the two literature streams could serve the dual purpose of understanding and overcoming unintended adverse consequences of Electronic Health Record implementation. This paper seeks to: (1) review the theoretical literatures on technology use & implementation, and identify a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outline a broad project proposal to test the applicability of the framework in enabling "meaningful use" of Electronic Health Records in a healthcare context; and (3) identify strategies for successful implementation of Electronic Health Records in hospitals & health systems, based on the literature review and application.

  2. Integration of structural health monitoring solutions onto commercial aircraft via the Federal Aviation Administration structural health monitoring research program

    NASA Astrophysics Data System (ADS)

    Swindell, Paul; Doyle, Jon; Roach, Dennis

    2017-02-01

    The Federal Aviation Administration (FAA) started a research program in structural health monitoring (SHM) in 2011. The program's goal was to understand the technical gaps of implementing SHM on commercial aircraft and the potential effects on FAA regulations and guidance. The program evolved into a demonstration program consisting of a team from Sandia National Labs Airworthiness Assurance NDI Center (AANC), the Boeing Corporation, Delta Air Lines, Structural Monitoring Systems (SMS), Anodyne Electronics Manufacturing Corp (AEM) and the FAA. This paper will discuss the program from the selection of the inspection problem, the SHM system (Comparative Vacuum Monitoring-CVM) that was selected as the inspection solution and the testing completed to provide sufficient data to gain the first approved use of an SHM system for routine maintenance on commercial US aircraft.

  3. 76 FR 71438 - Proposed Collection; Comment Request for Forms 13768

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... 13768, Electronic Tax Administration Advisory Committee (ETACC) Membership Application. DATES: Written...: Direct all written comments to Yvette B. Lawrence, Internal Revenue Service, room 6129, 1111 Constitution... Internet at [email protected] . SUPPLEMENTARY INFORMATION: Title: Electronic Tax Administration...

  4. A novel Web-based graduate medical education management system including ACGME compliance algorithms.

    PubMed

    Gauger, Paul G; Davis, Janice W; Orr, Peter J

    2002-09-01

    Administration of graduate medical education programs has become more difficult as compliance with ACGME work guidelines has assumed increased importance. These guidelines have caused many changes in the resident work environment, including the emergence of complicated cross-cover arrangements. Many participating residents (each with his or her own individual scheduling requirements) usually generate these schedules. Accordingly, schedules are often not submitted in a timely fashion and they may not be in compliance with the ACGME guidelines for maximum on-call assignments and mandatory days off. Our objective was the establishment of a Web-based system that guides residents in creating on-call schedules that follow ACGME guidelines while still allowing maximum flexibility -- thus allowing each resident to maintain an internal locus of control. A versatile and scalable system with password-protected user (resident) and administrator interfaces was created. An entire academic year is included, and past months and years are automatically archived. The residents log on within the first 15 days of the preceding month and choose their positions in a schedule template. They then make adjustments while receiving immediate summary feedback on compliance with ACGME guidelines. The schedule is electronically submitted to the educational administrator for final approval. If a cross-cover system is required, the program automatically generates an optimal schedule using both of the approved participating service schedules. The residents then have an additional five-day period to make adjustments in the cross-cover schedule while still receiving compliance feedback. The administrator again provides final approval electronically. The communication interface automatically pages or e-mails the residents when schedules are updated or approved. Since the information exists in a relational database, simple reporting tools are included to extract the information necessary to generate records for institutional GME management. Implementation of this program has been met with great enthusiasm from the institutional stakeholders. Specifically, residents have embraced the ability to directly control their schedules and have gained appreciation for the regulatory matrix in which they function. Institutional administrators have praised the improvement in compliance and the ease of documentation. We anticipate that the system will also meet with approval from reviewing regulatory bodies, as it generates and stores accurate information about the resident work environment. This program is robust and versatile enough to be modified for any GME training program in the country.

  5. Design challenges for electronic medication administration record systems in residential aged care facilities: a formative evaluation.

    PubMed

    Tariq, A; Lehnbom, E; Oliver, K; Georgiou, A; Rowe, C; Osmond, T; Westbrook, J

    2014-01-01

    Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues. We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use.

  6. Design Challenges for Electronic Medication Administration Record Systems in Residential Aged Care Facilities

    PubMed Central

    Lehnbom, E.; Oliver, K.; Georgiou, A.; Rowe, C.; Osmond, T.; Westbrook, J.

    2014-01-01

    Summary Introduction Electronic medication administration record (eMAR) systems are promoted as a potential intervention to enhance medication safety in residential aged care facilities (RACFs). The purpose of this study was to conduct an in-practice evaluation of an eMAR being piloted in one Australian RACF before its roll out, and to provide recommendations for system improvements. Methods A multidisciplinary team conducted direct observations of workflow (n=34 hours) in the RACF site and the community pharmacy. Semi-structured interviews (n=5) with RACF staff and the community pharmacist were conducted to investigate their views of the eMAR system. Data were analysed using a grounded theory approach to identify challenges associated with the design of the eMAR system. Results The current eMAR system does not offer an end-to-end solution for medication management. Many steps, including prescribing by doctors and communication with the community pharmacist, are still performed manually using paper charts and fax machines. Five major challenges associated with the design of eMAR system were identified: limited interactivity; inadequate flexibility; problems related to information layout and semantics; the lack of relevant decision support; and system maintenance issues. We suggest recommendations to improve the design of the eMAR system and to optimize existing workflows. Discussion Immediate value can be achieved by improving the system interactivity, reducing inconsistencies in data entry design and offering dedicated organisational support to minimise connectivity issues. Longer-term benefits can be achieved by adding decision support features and establishing system interoperability requirements with stakeholder groups (e.g. community pharmacies) prior to system roll out. In-practice evaluations of technologies like eMAR system have great value in identifying design weaknesses which inhibit optimal system use. PMID:25589911

  7. Implementation of the Agitated Behavior Scale in the Electronic Health Record.

    PubMed

    Wilson, Helen John; Dasgupta, Kritis; Michael, Kathleen

    The purpose of the study was to implement an Agitated Behavior Scale through an electronic health record and to evaluate the usability of the scale in a brain injury unit at a rehabilitation hospital. A quality improvement project was conducted in the brain injury unit at a large rehabilitation hospital with registered nurses as participants using convenience sampling. The project consisted of three phases and included education, implementation of the scale in the electronic health record, and administration of the survey questionnaire, which utilized the system usability scale. The Agitated Behavior Scale was found to be usable, and there was 92.2% compliance with the use of the electronic Electronic Agitated Behavior Scale. The Agitated Behavior Scale was effectively implemented in the electronic health record and was found to be usable in the assessment of agitation. Utilization of the scale through the electronic health record on a daily basis will allow for an early identification of agitation in patients with traumatic brain injury and enable prompt interventions to manage agitation.

  8. 12 CFR 609.915 - Compliance with Federal Reserve Board Regulations B, M, and Z.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Regulations B, M, and Z. 609.915 Section 609.915 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.915 Compliance with Federal Reserve Board Regulations B, M... (Equal Credit Opportunity), M (Consumer Leasing), and Z (Truth in Lending) (12 CFR parts 202, 213, and...

  9. 12 CFR 609.915 - Compliance with Federal Reserve Board Regulations B, M, and Z.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Regulations B, M, and Z. 609.915 Section 609.915 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM ELECTRONIC COMMERCE General Rules § 609.915 Compliance with Federal Reserve Board Regulations B, M... (Equal Credit Opportunity), M (Consumer Leasing), and Z (Truth in Lending) (12 CFR parts 202, 213, and...

  10. 76 FR 24865 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ... Electronic Archive (AEA). Transfer a snap shot of the DCIPS Master File to AEA annually at the end of the fiscal year. The AEA will transfer a snap shot of DCIPS to the National Archives and Records Administration (NARA) one year after the signature by the Archivist of the United States. Thereafter, the AEA...

  11. Safeguarding the process of drug administration with an emphasis on electronic support tools

    PubMed Central

    Seidling, Hanna M; Lampert, Anette; Lohmann, Kristina; Schiele, Julia T; Send, Alexander J F; Witticke, Diana; Haefeli, Walter E

    2013-01-01

    Aims The aim of this work is to understand the process of drug administration and identify points in the workflow that resulted in interventions by clinical information systems in order to improve patient safety. Methods To identify a generic way to structure the drug administration process we performed peer-group discussions and supplemented these discussions with a literature search for studies reporting errors in drug administration and strategies for their prevention. Results We concluded that the drug administration process might consist of up to 11 sub-steps, which can be grouped into the four sub-processes of preparation, personalization, application and follow-up. Errors in drug handling and administration are diverse and frequent and in many cases not caused by the patient him/herself, but by family members or nurses. Accordingly, different prevention strategies have been set in place with relatively few approaches involving e-health technology. Conclusions A generic structuring of the administration process and particular error-prone sub-steps may facilitate the allocation of prevention strategies and help to identify research gaps. PMID:24007450

  12. Ruxolitinib-conjugated gold nanoparticles for topical administration: An alternative for treating alopecia?

    PubMed

    Boca, Sanda; Berce, Cristian; Jurj, Ancuta; Petrushev, Bobe; Pop, Laura; Gafencu, Grigore-Aristide; Selicean, Sonia; Moisoiu, Vlad; Temian, Daiana; Micu, Wilhelm-Thomas; Astilean, Simion; Braicu, Cornelia; Tomuleasa, Ciprian; Berindan-Neagoe, Ioana

    2017-11-01

    Alopecia is a dermatological condition for which Janus kinase (JAK) inhibitors have recently emerged as potential therapy options, but with limited practical use because of the systemic side effects. The topical use of Ruxolitinib in alopecia universalis has been demonstrated, but little is known about the pharmacodynamics and pharmacokinetics of this way of administration. Nanomedicine provides improved therapeutics. In the current paper we present preliminary data regarding the potential use of Ruxolitinib-conjugated gold nanoparticles (GNPs) in dermatological conditions, as GNPs have been proven to have a reduced absorption rate into the systemic blood flow for cutaneous administration. Internalization of the newly formed bioconjugate was assessed by electron microscopy and the functional effects of the drug were investigated by cell counting, flow cytometry and western blotting. Our data show that gold nanoparticles conjugated with Ruxolitinib inhibit the proliferation of fibroblasts by inhibiting JAK2 protein. Ruxolitinib carried by gold nanoparticles alters the proliferation of human fibroblasts, which is of great clinical importance as it can be readily administered on the skin with minimal risk of systemic side effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. [Evaluation of electronic health programs in Peru: multidisciplinary approach and current perspectives].

    PubMed

    Henríquez-Suarez, Milagro; Becerra-Vera, Charito E; Laos-Fernández, Elena L; Espinoza-Portilla, Elizabeth

    2017-01-01

    Electronic health (eHealth) requires a multidisciplinary approach and involves different areas of knowledge, including medicine, computer science, engineering, sociology, anthropology, social work, administration, law, and communication sciences. The assessment of eHealth should consider that information and communication technologies (ICTs) are only part of the information system of an organization. Understanding the human factors involved in health systems, the environment, and the contexts in which ICTs are used in health is essential. The objectives of this study were to describe the status of the assessment of eHealth in Peru and to discuss the strategies for multidisciplinary evaluation that should be considered to achieve the success and sustainability of these initiatives based on national and international experience.

  14. Strategic Defense Initiative Demonstration/Validation Program Environmental Assessment. Battle Management/Command and Control, and Communications (BM/C3),

    DTIC Science & Technology

    1987-08-01

    POR A ENVIOMNE. STRATEGIC DEFENSE INITRIEDNU T IATI V EI 1 0193 O RTEI ONE..()SRTGC DEFENSE INITIATV E S RATION V EO ORORNIZATION WASINZGTON DC...facilities where Demonstration/Validation activities are planned.- e Ten areas of environmental consideration are addressed: (1) air quality; (2) . water...air quality, rater quality, and hazardous vaste (63). 2.2 ELCTRONIC SYSTEMS DIVISION The Electronic Systems Division administrative offices are located

  15. Technology utilization to prevent medication errors.

    PubMed

    Forni, Allison; Chu, Hanh T; Fanikos, John

    2010-01-01

    Medication errors have been increasingly recognized as a major cause of iatrogenic illness and system-wide improvements have been the focus of prevention efforts. Critically ill patients are particularly vulnerable to injury resulting from medication errors because of the severity of illness, need for high risk medications with a narrow therapeutic index and frequent use of intravenous infusions. Health information technology has been identified as method to reduce medication errors as well as improve the efficiency and quality of care; however, few studies regarding the impact of health information technology have focused on patients in the intensive care unit. Computerized physician order entry and clinical decision support systems can play a crucial role in decreasing errors in the ordering stage of the medication use process through improving the completeness and legibility of orders, alerting physicians to medication allergies and drug interactions and providing a means for standardization of practice. Electronic surveillance, reminders and alerts identify patients susceptible to an adverse event, communicate critical changes in a patient's condition, and facilitate timely and appropriate treatment. Bar code technology, intravenous infusion safety systems, and electronic medication administration records can target prevention of errors in medication dispensing and administration where other technologies would not be able to intercept a preventable adverse event. Systems integration and compliance are vital components in the implementation of health information technology and achievement of a safe medication use process.

  16. 75 FR 48366 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ...: OMB Desk Officer for the Department of Labor--Mine Safety and Health Administration (MSHA), Office of..., electronic, mechanical, or other technological collection techniques or other forms of information technology, e.g., permitting electronic submission of responses. Agency: Mine Safety and Health Administration...

  17. Using Human Factors Methods to Design a New Interface for an Electronic Medical Record

    PubMed Central

    Saleem, Jason J.; Patterson, Emily S.; Militello, Laura; Asch, Steven M.; Doebbeling, Bradley N.; Render, Marta L.

    2007-01-01

    The Veterans Health Administration (VHA) is a leader in development and use of electronic patient records and clinical decision support. The VHA is currently reengineering a somewhat dated platform for its Computerized Patient Record System (CPRS). This process affords a unique opportunity to implement major changes to the current design and function of the system. We report on two human factors studies designed to provide input and guidance during this reengineering process. One study involved a card sort to better understand how providers tend to cognitively organize clinical data, and how that understanding can help guide interface design. The other involved a simulation to assess the impact of redesign modifications on computerized clinical reminders, a form of clinical decision support in the CPRS, on the learnability of the system for first-time users. PMID:18693914

  18. Adoption of electronic health records and barriers

    PubMed Central

    Palabindala, Venkataraman; Pamarthy, Amaleswari; Jonnalagadda, Nageshwar Reddy

    2016-01-01

    Electronic health records (EHR) are not a new idea in the U.S. medical system, but surprisingly there has been very slow adoption of fully integrated EHR systems in practice in both primary care settings and within hospitals. For those who have invested in EHR, physicians report high levels of satisfaction and confidence in the reliability of their system. There is also consensus that EHR can improve patient care, promote safe practice, and enhance communication between patients and multiple providers, reducing the risk of error. As EHR implementation continues in hospitals, administrative and physician leadership must actively investigate all of the potential risks for medical error, system failure, and legal responsibility before moving forward. Ensuring that physicians are aware of their responsibilities in relation to their charting practices and the depth of information available within an EHR system is crucial for minimizing the risk of malpractice and lawsuit. Hospitals must commit to regular system upgrading and corresponding training for all users to reduce the risk of error and adverse events. PMID:27802857

  19. 78 FR 70244 - Electronic Interim Assistance Reimbursement Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-25

    ... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 416 [Docket No. SSA-2011-0104] RIN 0960-AH45 Electronic Interim Assistance Reimbursement Program AGENCY: Social Security Administration. ACTION: Notice of.... We strongly urge you not to include in your comments any personal information, such as Social...

  20. 76 FR 6186 - Applications for Membership on the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Applications for Membership on the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Request for Applications. SUMMARY: The Internal Revenue Service (IRS) requests applications of individuals...

  1. 77 FR 13968 - Requiring Electronic Filing of Select Appeals by Certain Claimant Representatives

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-08

    ... SOCIAL SECURITY ADMINISTRATION 20 CFR Parts 404 and 416 [Docket No. SSA-2011-0094] Requiring Electronic Filing of Select Appeals by Certain Claimant Representatives AGENCY: Social Security Administration. ACTION: Revised notification of implementation of requirement. SUMMARY: We are revising the...

  2. 77 FR 4653 - Requiring Electronic Filing of Select Appeals by Certain Claimant Representatives

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... SOCIAL SECURITY ADMINISTRATION 20 CFR Parts 404 and 416 [Docket No. SSA-2011-0094] Requiring Electronic Filing of Select Appeals by Certain Claimant Representatives AGENCY: Social Security Administration. ACTION: Notification of implementation of requirement. SUMMARY: We are announcing the requirement...

  3. Validation study of an electronic method of condensed outcomes tools reporting in orthopaedics.

    PubMed

    Farr, Jack; Verma, Nikhil; Cole, Brian J

    2013-12-01

    Patient-reported outcomes (PRO) instruments are a vital source of data for evaluating the efficacy of medical treatments. Historically, outcomes instruments have been designed, validated, and implemented as paper-based questionnaires. The collection of paper-based outcomes information may result in patients becoming fatigued as they respond to redundant questions. This problem is exacerbated when multiple PRO measures are provided to a single patient. In addition, the management and analysis of data collected in paper format involves labor-intensive processes to score and render the data analyzable. Computer-based outcomes systems have the potential to mitigate these problems by reformatting multiple outcomes tools into a single, user-friendly tool.The study aimed to determine whether the electronic outcomes system presented produces results comparable with the test-retest correlations reported for the corresponding orthopedic paper-based outcomes instruments.The study is designed as a crossover study based on consecutive orthopaedic patients arriving at one of two designated orthopedic knee clinics.Patients were assigned to complete either a paper or a computer-administered questionnaire based on a similar set of questions (Knee injury and Osteoarthritis Outcome Score, International Knee Documentation Committee form, 36-Item Short Form survey, version 1, Lysholm Knee Scoring Scale). Each patient completed the same surveys using the other instrument, so that all patients had completed both paper and electronic versions. Correlations between the results from the two modes were studied and compared with test-retest data from the original validation studies.The original validation studies established test-retest reliability by computing correlation coefficients for two administrations of the paper instrument. Those correlation coefficients were all in the range of 0.7 to 0.9, which was deemed satisfactory. The present study computed correlation coefficients between the paper and electronic modes of administration. These correlation coefficients demonstrated similar results with an overall value of 0.86.On the basis of the correlation coefficients, the electronic application of commonly used knee outcome scores compare variably to the traditional paper variants with a high rate of test-retest correlation. This equivalence supports the use of the condensed electronic outcomes system and validates comparison of scores between electronic and paper modes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Development and implementation of an integrated EHR for Homecare Service: a South American experience.

    PubMed

    Aguilera Díaz, Jerónimo; Arias, Antonio Eduardo; Budalich, Cintia Mabel; Benítez, Sonia Elizabeth; López, Gastón; Borbolla, Damián; Plazzotta, Fernando; Luna, Daniel; de Quirós, Fernán González Bernaldo

    2010-01-01

    This paper describes the development and implementation of a web based electronic health record for the Homecare Service program in the Hospital Italiano de Buenos Aires. It reviews the process of the integration of the new electronic health record to the hospital information system, allowing physicians to access the clinical data repository from their Pc's at home and with the capability of consulting past and present history of the patient health care, order, tests, and referrals with others professionals trough the new Electronic Health Record. We also discuss how workflow processes were changed and improved for the physicians, nurses, and administrative personnel of the Homecare Services and the educational methods used to improve acceptance and adoption of these new technologies. We also briefly describe the validation of physicians and their field work with electronic signatures.

  5. Pharmacological Modulation of the Mitochondrial Electron Transport Chain in Paclitaxel-Induced Painful Peripheral Neuropathy.

    PubMed

    Griffiths, Lisa A; Flatters, Sarah J L

    2015-10-01

    Paclitaxel is an effective first-line chemotherapeutic with the major dose-limiting side effect of painful neuropathy. Mitochondrial dysfunction and oxidative stress have been implicated in paclitaxel-induced painful neuropathy. Here we show the effects of pharmacological modulation of mitochondrial sites that produce reactive oxygen species using systemic rotenone (complex I inhibitor) or antimycin A (complex III inhibitor) on the maintenance and development of paclitaxel-induced mechanical hypersensitivity in adult male Sprague Dawley rats. The maximally tolerated dose (5 mg/kg) of rotenone inhibited established paclitaxel-induced mechanical hypersensitivity. However, some of these inhibitory effects coincided with decreased motor coordination; 3 mg/kg rotenone also significantly attenuated established paclitaxel-induced mechanical hypersensitivity without any motor impairment. The maximally tolerated dose (.6 mg/kg) of antimycin A reversed established paclitaxel-induced mechanical hypersensitivity without any motor impairment. Seven daily doses of systemic rotenone or antimycin A were given either after paclitaxel administration or before and during paclitaxel administration. Rotenone had no significant effect on the development of paclitaxel-induced mechanical hypersensitivity. However, antimycin A significantly inhibited the development of paclitaxel-induced mechanical hypersensitivity when given before and during paclitaxel administration but had no effect when given after paclitaxel administration. These studies provide further evidence of paclitaxel-evoked mitochondrial dysfunction in vivo, suggesting that complex III activity is instrumental in paclitaxel-induced pain. This study provides further in vivo evidence that mitochondrial dysfunction is a key contributor to the development and maintenance of chemotherapy-induced painful neuropathy. This work also indicates that selective modulation of the electron transport chain can induce antinociceptive effects in a preclinical model of paclitaxel-induced pain. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. A Legislative Reform for the Food Safety System of China: A Regulatory Paradigm Shift and Collaborative Governance.

    PubMed

    Han, Yonghong

    2015-01-01

    After describing the historical development of China's food safety system from the perspectives of legislation and administration, this article discusses progress in its food law (The Draft Amendments to Food Safety Law). As a further legislative reform for China's food safety system, the Draft Amendments to the Food Safety Law contain innovative institutional designs and manifest a regulatory paradigm shift from government-centered governance to collaborative governance. However, the Draft Amendments face challenges in their implementation. This article argues that developing collaborative governance for food safety in China can be a solution to these challenges. Based on theoretical and empirical studies of collaborative governance, this article proposes that the institutional design of collaborative governance should focus on providing obligations for administrative agencies in the process of food safety rule-making and standard-setting, increasing the independence of nongovernmental organizations, and building two-way electronic platforms for public participation.

  7. The Student Storm Survey©: College Students' Thoughts on Their University's Response to a Natural Disaster

    ERIC Educational Resources Information Center

    Rosenthal, Gary T.; Boudreaux, Monique; Boudreaux, Dwight L.; Soignier, R. D.; Folse, Earl; Frias, Tracey; Soper, Barlow

    2014-01-01

    Hurricanes Gustav and Ike devastated the region that our University serves. Near the start of the semester, only one of the ten scheduled class days could be completed and administrators asked students and faculty to "continue the learning process" online via Blackboard©, our Electronic Delivery System (EDS). The Student Storm Survey©…

  8. Smallpox: Is the Department of Defense Prepared?

    DTIC Science & Technology

    2003-01-01

    ESSENCE Electronic Surveillance System for Early Notification of Community-Based Epidemics EV Eczema vaccinatum FDA Food and Drug Administration GV...polymorphism TK Thymidine kinase viii USAMRIID U.S. Army Medical Research Institute of Infectious Diseases VIG Vaccinia immunoglobulin WMD Weapons of mass...known as vaccinia immunoglobulin (VIG) and the introduction of serologic testing for human immunodeficiency virus (HIV). The Department of Defense (DoD

  9. Adverse Event extraction from Structured Product Labels using the Event-based Text-mining of Health Electronic Records (ETHER)system.

    PubMed

    Pandey, Abhishek; Kreimeyer, Kory; Foster, Matthew; Botsis, Taxiarchis; Dang, Oanh; Ly, Thomas; Wang, Wei; Forshee, Richard

    2018-01-01

    Structured Product Labels follow an XML-based document markup standard approved by the Health Level Seven organization and adopted by the US Food and Drug Administration as a mechanism for exchanging medical products information. Their current organization makes their secondary use rather challenging. We used the Side Effect Resource database and DailyMed to generate a comparison dataset of 1159 Structured Product Labels. We processed the Adverse Reaction section of these Structured Product Labels with the Event-based Text-mining of Health Electronic Records system and evaluated its ability to extract and encode Adverse Event terms to Medical Dictionary for Regulatory Activities Preferred Terms. A small sample of 100 labels was then selected for further analysis. Of the 100 labels, Event-based Text-mining of Health Electronic Records achieved a precision and recall of 81 percent and 92 percent, respectively. This study demonstrated Event-based Text-mining of Health Electronic Record's ability to extract and encode Adverse Event terms from Structured Product Labels which may potentially support multiple pharmacoepidemiological tasks.

  10. Administrative simplification, simplified for Hawai'i.

    PubMed

    Sakamoto, David

    2012-04-01

    The American health care system contains a layer of administrative controls that has become increasingly burdensome to medical practices in terms of uncompensated physician and staff time and practice costs. A primary care physician in solo practice spends between 4 and 10 hours a week directly interacting with health insurance companies and his or her staff will spend an additional 60 hours a week. This reduces patient-care availability, net practice income and physician job satisfaction. A literature review was conducted to determine possible solutions to administrative burdens physicians face in Hawai'i. A total of 51 articles were found matching search criteria with five being reports from major organizations. Twenty-seven articles were found that related to administrative simplification. The "administrative complexity" problem has been defined and its financial impact quantified. Promising solutions have been developed and proposed by private not-for-profit organizations and by the government, both state and federal. A successful administrative simplification plan would: (1) Provide rapid access to insurance information; (2) Allow medical practices to readily track specific claims; (3) Streamline the preauthorization process through the use of decision-support tools at the practice level and by directing interactions through real-time network connections between insurers and provider electronic health records, thus minimizing phone time; (4) Adopt the Universal Provider Datasource system for provider credentialing; and (5) Standardize (to the greatest degree possible) provider/insurer contracts. These solutions are outlined in detail.

  11. Emission analysis of large number of various passenger electronic devices in aircraft

    NASA Astrophysics Data System (ADS)

    Schüür, Jens; Oppermann, Lukas; Enders, Achim; Nunes, Rafael R.; Oertel, Carl-Henrik

    2016-09-01

    The ever increasing use of PEDs (passenger or portable electronic devices) has put pressure on the aircraft industry as well as operators and administrations to reevaluate established restrictions in PED-use on airplanes in the last years. Any electronic device could cause electromagnetic interference to the electronics of the airplane, especially interference at receiving antennas of sensitive wireless navigation and communication (NAV/COM) systems. This paper presents a measurement campaign in an Airbus A320. 69 test passengers were asked to actively use a combination of about 150 electronic devices including many attached cables, preferentially with a high data load on their buses, to provoke maximal emissions. These emissions were analysed within the cabin as well as at the inputs of aircraft receiving antennas outside of the fuselage. The emissions of the electronic devices as well as the background noise are time-variant, so just comparing only one reference and one transmission measurement is not sufficient. Repeated measurements of both cases lead to a more reliable first analysis. Additional measurements of the absolute received power at the antennas of the airplane allow a good estimation of the real interference potential to aircraft NAV/COM systems. Although there were many measured emissions within the cabin, there were no disturbance signals detectable at the aircraft antennas.

  12. Revalidation and electronic cataract surgery audit: a Scottish survey on current practice and opinion.

    PubMed

    Megaw, R; Rane-Malcolm, T; Brannan, S; Smith, R; Sanders, R

    2011-11-01

    To determine current knowledge and opinion on revalidation, and methods of cataract surgery audit in Scotland and to outline the current and future possibilities for electronic cataract surgery audit. In 2010 we conducted a prospective, cross-sectional, Scottish-wide survey on revalidation knowledge and opinion, and cataract audit practice among all senior NHS ophthalmologists. Results were anonymised and recorded manually for analysis. In all, 61% of the ophthalmologists surveyed took part. Only 33% felt ready to take part in revalidation, whereas 76% felt they did not have adequate information about the process. Also, 71% did not feel revalidation would improve patient care, but 85% agreed that cataract surgery audit is essential for ophthalmic practice. In addition, 91% audit their cataract outcomes; 52% do so continuously. Further, 63% audit their subspecialist surgical results. Only 25% audit their cataract surgery practice electronically, and only 12% collect clinical data using a hospital PAS system. Funding and system incompatibility were the main reasons cited for the lack of electronic audit setup. Currently, eight separate hospital IT patient administration systems are used across 14 health boards in Scotland. Revalidation is set to commence in 2012. The Royal College of Ophthalmologists will use cataract outcome audit as a tool to ensure surgical competency for the process. Retrospective manual auditing of cataract outcome is time consuming, and can be avoided with an electronic system. Scottish ophthalmologists view revalidation with scepticism and appear to have inadequate knowledge of the process. However, they strongly agree with the concept of cataract surgery audit. The existing and future electronic applications that may support surgical audit are commercial electronic records, web-based applications, centrally funded software applications, and robust NHS connections between community and hospital.

  13. 75 FR 13131 - General Services Administration Acquisition Regulation; Submission for OMB Review; GSA Advantage...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... Services Administration Acquisition Regulation; Submission for OMB Review; GSA Advantage![reg] and... requirement regarding GSA Advantage![reg] and Electronic Commerce-FACNET. A request for public comments was..., Washington, DC 20405. Please cite OMB Control No. 3090-00XX, GSA Advantage![reg] and Electronic Commerce...

  14. 77 FR 20489 - Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... returns, (3) tax software developers, (4) large and small business, (5) employers and payroll service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  15. 75 FR 4631 - Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... continued input into the development and implementation of the Internal Revenue Service (IRS) strategy for...

  16. 78 FR 10693 - Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... returns, (3) tax software developers, (4) large and small business, (5) employers and payroll service... DEPARTMENT OF THE TREASURY Internal Revenue Service Open Season for Membership to the Electronic Tax Administration Advisory Committee (ETAAC) AGENCY: Internal Revenue Service (IRS), Treasury. ACTION...

  17. 78 FR 53772 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0519... Veterinary Medicine Using the Food and Drug Administration Electronic Submission Gateway AGENCY: Food and... Center for Veterinary Medicine (CVM) accepts certain types of submissions electronically with no...

  18. 75 FR 6037 - Agency Information Collection Activities; Proposed Collection; Comment Request; Guidance for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0034... Slaughter in Electronic Format to the Center for Veterinary Medicine AGENCY: Food and Drug Administration... Format to the Center for Veterinary Medicine.'' DATES: Submit written or electronic comments on the...

  19. 76 FR 41685 - Electronic Substitutions for Form SSA-538

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 416 [Docket No. SSA-2009-0027] RIN 0960-AH02 Electronic Substitutions for Form SSA-538 AGENCY: Social Security Administration. ACTION: Final rule with request for... children alleging disability or continuing disability under title XVI of the Social Security Act (Act...

  20. Adoption of electronic health records: a qualitative study of academic and private physicians and health administrators.

    PubMed

    Grabenbauer, L; Fraser, R; McClay, J; Woelfl, N; Thompson, C B; Cambell, J; Windle, J

    2011-01-01

    Less than 20% of hospitals in the US have an electronic health record (EHR). In this qualitative study, we examine the perspectives of both academic and private physicians and administrators as stakeholders, and their alignment, to explore their perspectives on the use of technology in the clinical environment. Focus groups were conducted with 74 participants who were asked a series of open-ended questions. Grounded theory was used to analyze the transcribed data and build convergent themes. The relevance and importance of themes was constructed by examining frequency, convergence, and intensity. A model was proposed that represents the interactions between themes. Six major themes emerged, which include the impact of EHR systems on workflow, patient care, communication, research/outcomes/billing, education/learning, and institutional culture. Academic and private physicians were confident of the future benefits of EHR systems, yet cautious about the current implementations of EHR, and its impact on interactions with other members of the healthcare team and with patients, and the amount of time necessary to use EHR's. Private physicians differed on education and were uneasy about the steep learning curve necessary for use of new systems. In contrast to physicians, university and hospital administrators are optimistic, and value the availability of data for use in reporting. The results of our study indicate that both private and academic physicians concur on the need for features that maintain and enhance the relationship with the patient and the healthcare team. Resistance to adoption is related to insufficient functionality and its potential negative impact on patient care. Integration of data collection into clinical workflows must consider the unexpected costs of data acquisition.

  1. Information revolution in nursing and health care: educating for tomorrow's challenge.

    PubMed

    Kooker, B M; Richardson, S S

    1994-06-01

    Current emphasis on the national electronic highway and a national health database for comparative health care reporting demonstrates society's increasing reliance on information technology. The efficient electronic processing and managing of data, information, and knowledge are critical for survival in tomorrow's health care organization. To take a leadership role in this information revolution, informatics nurse specialists must possess competencies that incorporate information science, computer science, and nursing science for successful information system development. In selecting an appropriate informatics educational program or to hire an individual capable of meeting this challenge, nurse administrators must look for the following technical knowledge and skill set: information management principles, system development life cycle, programming languages, file design and access, hardware and network architecture, project management skills, and leadership abilities.

  2. Thermal Conductivity within Nanoparticle Powder Beds

    NASA Astrophysics Data System (ADS)

    Wilson, Mark; Chandross, Michael

    Non-equilibrium molecular dynamics is utilized to compute thermal transport properties within nanoparticle powder beds. In the realm of additive manufacturing of metals, the electronic contribution to thermal conduction is critical. To this end, our simulations incorporate the two temperature model, coupling a continuum representation of the electronic thermal contribution and the atomic phonon system. The direct method is used for conductivity determination, wherein thermal gradients between two different temperature heat flux reservoirs are calculated. The approach is demonstrated on several example cases including 304L stainless steel. The results from size distribution variations of mono/poly-disperse systems are extrapolated to predict values at the micron length scale, along with bulk properties at infinite system sizes. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

  3. Health information systems.

    PubMed

    Hovenga, Evelyn J S; Grain, Heather

    2013-01-01

    Health information provides the foundation for all decision making in healthcare whether clinical at the bed side, or at a national government level. This information is generally collected as part of systems which support administrative or clinical workflow and practice. This chapter describes the many and varied features of systems such as electronic health records (EHRs), how they fit with health information systems and how they collectively manage information flow. Systems engineering methods and tools are described together with their use to suit the health industry. This focuses on the need for suitable system architectures and semantic interoperability. These concepts and their relevance to the health industry are explained. The relationship and requirements for appropriate data governance in these systems is also considered.

  4. Structured electronic physiotherapy records.

    PubMed

    Buyl, Ronald; Nyssen, Marc

    2009-07-01

    With the introduction of the electronic health record, physiotherapists too are encouraged to store their patient records in a structured digital format. The typical nature of a physiotherapy treatment requires a specific record structure to be implemented, with special attention to user-friendliness and communication with other healthcare providers. The objective of this study was to establish a framework for the electronic physiotherapy record and to define a model for the interoperability with the other healthcare providers involved in the patients' care. Although we started from the Belgian context, we used a generic approach so that the results can easily be extrapolated to other countries. The framework we establish here defines not only the different building blocks of the electronic physiotherapy record, but also describes the structure and the content of the exchanged data elements. Through a combined effort by all involved parties, we elaborated an eight-level structure for the electronic physiotherapy record. Furthermore we designed a server-based model for the exchange of data between electronic record systems held by physicians and those held by physiotherapists. Two newly defined XML messages enable data interchange: the physiotherapy prescription and the physiotherapy report. We succeeded in defining a solid, structural model for electronic physiotherapist record systems. Recent wide scale implementation of operational elements such as the electronic registry has proven to make the administrative work easier for the physiotherapist. Moreover, within the proposed framework all the necessary building blocks are present for further data exchange and communication with other healthcare parties in the future. Although we completed the design of the structure and already implemented some new aspects of the electronic physiotherapy record, the real challenge lies in persuading the end-users to start using these electronic record systems. Via a quality label certification procedure, based on adequate criteria, the Ministry of Health tries to promote the use of electronic physiotherapy records. We must keep in mind that physiotherapists will show an interest in electronic record keeping, only if this will lead to a positive return for them.

  5. In-orbit performance of the ITOS improved attitude control system with Hall generator brushless motor and earth-splitting technique

    NASA Technical Reports Server (NTRS)

    Peacock, W. M.

    1973-01-01

    The National Aeronautics and Space Administration (NASA), launched ITOS-D with an improved attitude control system. A Hall generator brushless dc torque motor replaced the brush dc torque motor on Tiros-M and ITOS-A. Two CO2 attitude horizon sensors and one mirror replaced the four wideband horizon sensors and two mirrors on ITOS-1 and NOAA-1. Redundant pitch-control electronic boxes containing additional electronic circuitry for earth-splitting and brushless motor electronics were used. A method of generating a spacecraft earth-facing side reference for comparison to the time occurrence of the earth-splitting pulse was used to automatically correct pitch-attitude error. A single rotating flywheel, supported by a single bearing, provided gyroscopic stability and the required momentum interchange to keep one side of the satellite facing the earth. Magnetic torquing against the earth's magnetic field eliminated the requirement for expendable propellants which would limit satellite life in orbit.

  6. Designs for surge immunity in critical electronic facilities

    NASA Technical Reports Server (NTRS)

    Roberts, Edward F., Jr.

    1991-01-01

    In recent years, Federal Aviation Administration (FAA) embarked on a program replacing older tube type electronic equipment with newer solid state equipment. This replacement program dramatically increased the susceptibility of the FAA's facilities to lightning related damages. The proposal is presented of techniques which may be employed to lessen the susceptibility of new FAA electronic facility designs to failures resulting from lightning related surges and transients as well as direct strikes. The general concept espoused is one of a consistent system approach employing both perimeter and internal protection. It compares the technique presently employed to reduce electronic noise with other techniques which reduce noise while lowering susceptibility to lightning related damage. It is anticipated that these techniques will be employed in the design of an Air Traffic Control Tower in a high isokeraunic area. This facility would be subjected to rigorous monitoring over a multi-year period to provide quantitative data hopefully supporting the advantage of this design.

  7. 75 FR 25869 - The National Institutes of Health and the Food and Drug Administration Joint Leadership Council...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... comments to the Division of Dockets Management (HFA- 305), Food and Drug Administration, 5630 Fishers Lane..., an ever-changing economic landscape resulting from globalization, and the prospect for fundamental... Dockets Management (see ADDRESSES) written or electronic comments. Submit a single copy of electronic...

  8. 75 FR 26963 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0043... Electronic Format to the Center for Veterinary Medicine AGENCY: Food and Drug Administration, HHS. ACTION... Submit a Request for a Meeting or Teleconference in Electronic Format to the Center for Veterinary...

  9. 40 CFR 75.21 - Quality assurance and quality control requirements.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... EPA in an electronic format prescribed by the Administrator (see the CAMD Web site http://www.epa.gov... publicly available by posting on EPA Web sites (see the CAMD Web site http://www.epa.gov/airmarkets... submitted electronically by NIST to [email protected]gov, unless otherwise provided by the Administrator, within...

  10. 40 CFR 75.21 - Quality assurance and quality control requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... EPA in an electronic format prescribed by the Administrator (see the CAMD Web site http://www.epa.gov... publicly available by posting on EPA Web sites (see the CAMD Web site http://www.epa.gov/airmarkets... submitted electronically by NIST to [email protected]gov, unless otherwise provided by the Administrator, within...

  11. 40 CFR 75.21 - Quality assurance and quality control requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... EPA in an electronic format prescribed by the Administrator (see the CAMD Web site http://www.epa.gov... publicly available by posting on EPA Web sites (see the CAMD Web site http://www.epa.gov/airmarkets... submitted electronically by NIST to [email protected]gov, unless otherwise provided by the Administrator, within...

  12. PoliNet and Information Utilities: Using Telecommunications in Political Science and Public Administration Education and Research.

    ERIC Educational Resources Information Center

    Vasu, Michael L.; Garson, G. David

    General information utilities and specialized networks, such as PoliNet, provide educators and researchers in public administration and allied fields with a diversity of new tools which include: (1) bibliographic searching; (2) international teleconferencing; (3) electronic news clipping services; (4) electronic mail; and (5) free public domain…

  13. The effect of various types of patients' reminders on the uptake of pneumococcal vaccine in adults: A randomized controlled trial.

    PubMed

    Ghadieh, Alexandra S; Hamadeh, Ghassan N; Mahmassani, Dina M; Lakkis, Najla A

    2015-10-26

    Invasive pneumococcal disease is one of the most important vaccine-preventable diseases threatening the adult community due to missed opportunities for vaccination. This study compares the effect of three different types of patient reminder system on adulthood Streptococcus pneumoniae immunization in a primary care setting. The study targeted patients aged 40 and older eligible for pneumococcal vaccine, but did not receive it yet (89.5% of 3072 patients) based on their electronic medical records in a family medicine center in Beirut. The sample population was randomized using an automated computer randomization system into six equal groups, receiving short phone calls, short text messaging system (sms-text) or e-mails each with or without patient education. Each group received three identical reminders spaced by a period of four weeks. Documentation of vaccine administration was then added to the longitudinal electronic patient record. The primary outcome was the vaccine administration rate in the clinics. Of the eligible patients due for the pneumococcal 23-polyvalent vaccine, 1380 who had mobile phone numbers and e-mails were randomized into six equal intervention groups. The various reminders increased vaccination rate to 14.9%: 16.5% of the short phone calls group, 7.2% of the sms-text group and 5.7% of the e-mail group took the vaccine. The vaccination rate was independent of the age, associated education message and the predisposing condition. Use of electronic text reminders via e-mails and mobile phones seems to be a feasible and sustainable model to increase pneumococcal vaccination rates in a primary care center. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. A Review of Electronic Hand Hygiene Monitoring: Considerations for Hospital Management in Data Collection, Healthcare Worker Supervision, and Patient Perception.

    PubMed

    McGuckin, Maryanne; Govednik, John

    2015-01-01

    Healthcare-associated infections (HAIs) in U.S. acute care hospitals lead to a burden of $96-$147 billion annually on the U.S. health system and affect 1 in 20 hospital patients (Marchetti & Rossiter, 2013). Hospital managers are charged with reducing and eliminating HAIs to cut costs and improve patient outcomes. Healthcare worker (HCW) hand hygiene (HH) practice is the most effective means of preventing the spread of HAIs, but compliance is at or below 50% (McGuckin, Waterman, & Govednik, 2009). For managers to increase the frequency of HCW HH occurrences and improve the quality of HH performance, companies have introduced electronic technologies to assist managers in training, supervising, and gathering data in the patient care setting. Although these technologies offer valuable feedback regarding compliance, little is known in terms of capabilities in the clinical setting. Less is known about HCW or patient attitudes if the system allows feedback to be shared. Early-adopting managers have begun to examine their experiences with HH technologies and publish their findings. We review peer-reviewed research on infection prevention that focused on the capabilities of these electronic systems, as well as the related research on HCW and patient interactions with electronic HH systems. Research suggests that these systems are capable of collecting data, but the results are mixed regarding their impact on HH compliance, reducing HAIs, or both and their costs. Research also indicates that HCWs and patients may not regard the technology as positively as industry or healthcare managers may have intended. When considering the adoption of electronic HH monitoring systems, hospital administrators should proceed with caution.

  15. Needle-free delivery of macromolecules through the skin using controllable jet injectors.

    PubMed

    Hogan, Nora C; Taberner, Andrew J; Jones, Lynette A; Hunter, Ian W

    2015-01-01

    Transdermal delivery of drugs has a number of advantages in comparison to other routes of administration. The mechanical properties of skin, however, impose a barrier to administration and so most compounds are administered using hypodermic needles and syringes. In order to overcome some of the issues associated with the use of needles, a variety of non-needle devices based on jet injection technology has been developed. Jet injection has been used primarily for vaccine administration but has also been used to deliver macromolecules such as hormones, monoclonal antibodies and nucleic acids. A critical component in the more recent success of jet injection technology has been the active control of pressure applied to the drug during the time course of injection. Jet injection systems that are electronically controllable and reversible offer significant advantages over conventional injection systems. These devices can consistently create the high pressures and jet speeds necessary to penetrate tissue and then transition smoothly to a lower jet speed for delivery of the remainder of the desired dose. It seems likely that in the future this work will result in smart drug delivery systems incorporated into personal medical devices and medical robots for in-home disease management and healthcare.

  16. Medication errors with electronic prescribing (eP): Two views of the same picture

    PubMed Central

    2010-01-01

    Background Quantitative prospective methods are widely used to evaluate the impact of new technologies such as electronic prescribing (eP) on medication errors. However, they are labour-intensive and it is not always feasible to obtain pre-intervention data. Our objective was to compare the eP medication error picture obtained with retrospective quantitative and qualitative methods. Methods The study was carried out at one English district general hospital approximately two years after implementation of an integrated electronic prescribing, administration and records system. Quantitative: A structured retrospective analysis was carried out of clinical records and medication orders for 75 randomly selected patients admitted to three wards (medicine, surgery and paediatrics) six months after eP implementation. Qualitative: Eight doctors, 6 nurses, 8 pharmacy staff and 4 other staff at senior, middle and junior grades, and 19 adult patients on acute surgical and medical wards were interviewed. Staff interviews explored experiences of developing and working with the system; patient interviews focused on experiences of medicine prescribing and administration on the ward. Interview transcripts were searched systematically for accounts of medication incidents. A classification scheme was developed and applied to the errors identified in the records review. Results The two approaches produced similar pictures of the drug use process. Interviews identified types of error identified in the retrospective notes review plus two eP-specific errors which were not detected by record review. Interview data took less time to collect than record review, and provided rich data on the prescribing process, and reasons for delays or non-administration of medicines, including "once only" orders and "as required" medicines. Conclusions The qualitative approach provided more understanding of processes, and some insights into why medication errors can happen. The method is cost-effective and could be used to supplement information from anonymous error reporting schemes. PMID:20497532

  17. Cumulative index to NASA Tech Briefs, 1986-1990, volumes 10-14

    NASA Technical Reports Server (NTRS)

    1992-01-01

    Tech Briefs are short announcements of new technology derived from the R&D activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This cumulative index of Tech Briefs contains abstracts and four indexes (subject, personal author, originating center, and Tech Brief number) and covers the period 1986 to 1990. The abstract section is organized by the following subject categories: electronic components and circuits, electronic systems, physical sciences, materials, computer programs, life sciences, mechanics, machinery, fabrication technology, and mathematics and information sciences.

  18. Surviving the Sun's Wrath at Mercury: The MESSENGER Mission

    NASA Astrophysics Data System (ADS)

    DiGregorio, Barry E.

    2008-03-01

    In spite of the best efforts by satellite engineers to construct electronic components capable of surviving the harsh radiation environment of space, satellites continue to fall victim every year to high-energy particles from galactic cosmic rays, solar energetic particle events, and trapped particles in the Earth's magnetic field. According to the U.S. National Oceanic and Atmospheric Administration (NOAA), $500 million in commercial satellite insurance claims were filed between 1994 and 1999 as a direct result of space weather impinging on satellite electronics systems [NOAA, 2006]. NOAA also reported that adverse space weather causes damage to U.S. Department of Defense satellites, amounting to $100 million every year.

  19. NOR-DMARD data management: implementation of data capture from electronic health records.

    PubMed

    Olsen, I C; Haavardsholm, E A; Moholt, E; Kvien, T K; Lie, E

    2014-01-01

    The use of electronic health records (EHR) is an essential part of modern health care, and electronic data capture (EDC) has become essential for managing clinical trials. Usually, these two entities are independent of each other, and transfer from one system to another is done manually. Our aim was to develop a method to capture data directly from the EHR system and transfer them into an EDC system for the NORwegian Disease-Modifying Anti-Rheumatic Drugs (NOR-DMARD) registry. All rheumatology departments contributing to NOR-DMARD had implemented a structured EHR system. Data are extracted locally and securely transferred to the study data management once a month. The study data management then parse the data into a readable format for the EDC and import the data. Once the data is in the EDC, they are available to all authorized researchers and downloadable in a preferred format. From May 2012 to August 2014 almost 6400 visits in 3400 patients treated with biologics have been successfully registered in the EDC system. Previously, NOR-DMARD used standard paper-based case report forms (CRFs), with a substantial cost for data entry. Setting up and maintaining the EDC system required some investments, but the amount saved from avoiding paper handling has made the shift into EDC profitable. In addition to this, gains have been made in administration and data quality. The transition from paper and pencil format to a fully electronic data management system in NOR-DMARD has had obvious advantages regarding feasibility, cost, data quality and accessibility of the data.

  20. Toward best practice: leveraging the electronic patient record as a clinical data warehouse.

    PubMed

    Ledbetter, C S; Morgan, M W

    2001-01-01

    Automating clinical and administrative processes via an electronic patient record (EPR) gives clinicians the point-of-care tools they need to deliver better patient care. However, to improve clinical practice as a whole and then evaluate it, healthcare must go beyond basic automation and convert EPR data into aggregated, multidimensional information. Unfortunately, few EPR systems have the established, powerful analytical clinical data warehouses (CDWs) required for this conversion. This article describes how an organization can support best practice by leveraging a CDW that is fully integrated into its EPR and clinical decision support (CDS) system. The article (1) discusses the requirements for comprehensive CDS, including on-line analytical processing (OLAP) of data at both transactional and aggregate levels, (2) suggests that the transactional data acquired by an OLTP EPR system must be remodeled to support retrospective, population-based, aggregate analysis of those data, and (3) concludes that this aggregate analysis is best provided by a separate CDW system.

  1. Integrating cancer survivors' experiences into UK cancer registries: design and development of the ePOCS system (electronic Patient-reported Outcomes from Cancer Survivors)

    PubMed Central

    Ashley, L; Jones, H; Thomas, J; Forman, D; Newsham, A; Morris, E; Johnson, O; Velikova, G; Wright, P

    2011-01-01

    Background: Understanding the psychosocial challenges of cancer survivorship, and identifying which patients experience ongoing difficulties, is a key priority. The ePOCS (electronic patient-reported outcomes from cancer survivors) project aims to develop and evaluate a cost-efficient, UK-scalable electronic system for collecting patient-reported outcome measures (PROMs), at regular post-diagnostic timepoints, and linking these with clinical data in cancer registries. Methods: A multidisciplinary team developed the system using agile methods. Design entailed process mapping the system's constituent parts, data flows and involved human activities, and undertaking usability testing. Informatics specialists built new technical components, including a web-based questionnaire tool and tracking database, and established component-connecting data flows. Development challenges were overcome, including patient usability and data linkage and security. Results: We have developed a system in which PROMs are completed online, using a secure questionnaire administration tool, accessed via a public-facing website, and the responses are linked and stored with clinical registry data. Patient monitoring and communications are semiautomated via a tracker database, and patient correspondence is primarily Email-based. The system is currently honed for clinician-led hospital-based patient recruitment. Conclusions: A feasibility test study is underway. Although there are possible challenges to sustaining and scaling up ePOCS, the system has potential to support UK epidemiological PROMs collection and clinical data linkage. PMID:22048035

  2. 5 CFR 850.106 - Electronic signatures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Electronic signatures. 850.106 Section... (CONTINUED) ELECTRONIC RETIREMENT PROCESSING General Provisions § 850.106 Electronic signatures. (a) Subject to any provisions prescribed by the Director under § 850.104— (1) An electronic communication may be...

  3. Shaping the Electronic Library--The UW-Madison Approach.

    ERIC Educational Resources Information Center

    Dean, Charles W., Ed.; Frazier, Ken; Pope, Nolan F.; Gorman, Peter C.; Dentinger, Sue; Boston, Jeanne; Phillips, Hugh; Daggett, Steven C.; Lundquist, Mitch; McClung, Mark; Riley, Curran; Allan, Craig; Waugh, David

    1998-01-01

    This special theme section describes the University of Wisconsin-Madison's experience building its Electronic Library. Highlights include integrating resources and services; the administrative framework; the public electronic library, including electronic publishing capability and access to World Wide Web-based and other electronic resources;…

  4. Document Concurrence System

    NASA Technical Reports Server (NTRS)

    Muhsin, Mansour; Walters, Ian

    2004-01-01

    The Document Concurrence System is a combination of software modules for routing users expressions of concurrence with documents. This system enables determination of the current status of concurrences and eliminates the need for the prior practice of manually delivering paper documents to all persons whose approvals were required. This system runs on a server, and participants gain access via personal computers equipped with Web-browser and electronic-mail software. A user can begin a concurrence routing process by logging onto an administration module, naming the approvers and stating the sequence for routing among them, and attaching documents. The server then sends a message to the first person on the list. Upon concurrence by the first person, the system sends a message to the second person, and so forth. A person on the list indicates approval, places the documents on hold, or indicates disapproval, via a Web-based module. When the last person on the list has concurred, a message is sent to the initiator, who can then finalize the process through the administration module. A background process running on the server identifies concurrence processes that are overdue and sends reminders to the appropriate persons.

  5. Administrative Simplification, Simplified for Hawai‘i

    PubMed Central

    2012-01-01

    Background The American health care system contains a layer of administrative controls that has become increasingly burdensome to medical practices in terms of uncompensated physician and staff time and practice costs. A primary care physician in solo practice spends between 4 and 10 hours a week directly interacting with health insurance companies and his or her staff will spend an additional 60 hours a week. This reduces patient-care availability, net practice income and physician job satisfaction. Methods A literature review was conducted to determine possible solutions to administrative burdens physicians face in Hawai‘i. A total of 51 articles were found matching search criteria with five being reports from major organizations. Results Twenty-seven articles were found that related to administrative simplification. The “administrative complexity” problem has been defined and its financial impact quantified. Promising solutions have been developed and proposed by private not-for-profit organizations and by the government, both state and federal. Discussion A successful administrative simplification plan would: (1) Provide rapid access to insurance information; (2) Allow medical practices to readily track specific claims; (3) Streamline the preauthorization process through the use of decision-support tools at the practice level and by directing interactions through real-time network connections between insurers and provider electronic health records, thus minimizing phone time; (4) Adopt the Universal Provider Datasource system for provider credentialing; and (5) Standardize (to the greatest degree possible) provider/insurer contracts. These solutions are outlined in detail. PMID:22737644

  6. An electron spin resonance study for real-time detection of ascorbyl free radicals after addition of dimethyl sulfoxide in murine hippocampus or plasma during kainic acid-induced seizures.

    PubMed

    Matsumoto, Shigekiyo; Shingu, Chihiro; Koga, Hironori; Hagiwara, Satoshi; Iwasaka, Hideo; Noguchi, Takayuki; Yokoi, Isao

    2010-07-01

    Electron spin resonance (ESR)-silent ascorbate solutions generate a detectable, likely concentration-dependent signal of ascorbyl free radicals (AFR) immediately upon addition of a molar excess of dimethyl sulfoxide (DMSO). We aimed to perform quantitative ESR analysis of AFR in real time after addition of DMSO (AFR/DMSO) to evaluate ascorbate concentrations in fresh hippocampus or plasma following systemic administration of kainate in mice. Use of a special tissue-type quartz cell allowed immediate detection of AFR/DMSO ESR spectra in fresh tissues from mice. AFR/DMSO content was increased significantly in fresh hippocampus or plasma obtained during kainate-induced seizures of mice, reaching maximum levels at 90 min after intraperitoneal administration of 50 mg/kg kainic acid. This suggests that oxidative injury of the hippocampus resulted from the accumulation of large amounts of ascorbic acid in the brain after kainic acid administration. AFR/DMSO content measured on an ESR spectrometer can be used for real-time evaluation of ascorbate content in fresh tissue. Due to the simplicity, good performance, low cost and real-time monitoring of ascorbate, this method may be applied to clinical research and treatment in the future.

  7. Opportunities for administrators to promote disease management.

    PubMed

    Kash, Bita A; Gamm, Larry D; Bolin, Jane Nelson; Peck, B Mitchell

    2005-01-01

    Studies of disease management (DM) have shown that patients who participate in such programs achieve better health status and make fewer emergency room visits. Private and government payers have recently increased their efforts to promote DM initiatives through financial incentives to healthcare providers. This article explores opportunities for administrators of health services organizations (HSO) to promote DM in the current political and economic environment. Our survey of professionals (DM leaders, physicians, and DM nurses) in six DM programs reveals these professionals' assessments of the key players and resources that they deem important to their respective DM programs. They view DM programs as heavily dependent on the support of physicians, nurses, and health plan leaders but relatively less so on the support of HSO administrators- a situation that may suggest opportunities for administrators to take on greater leadership in moving the HSO toward developing DM programs. Survey results also indicate a strong need for the integration of resources such as communication systems, electronic medical records, and DM reporting. Taken collectively, these needs suggest a number of strategies for the administrator to play a larger role in supporting the adoption and effective implementation of DM. In the article, we propose that DM programs can benefit substantially from an administrator who can demonstrate a thorough knowledge of DM-related government and private-payer initiatives and who has the ability to provide leadership to develop and implement viable DM programs. Valued contributions that the administrator should bring to the table include support of standardized DM processes, use of practice guidelines, and provision of pertinent information systems.

  8. 49 CFR 220.305 - Use of personal electronic devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.305 Use of personal electronic devices. A railroad operating employee must have each personal electronic device turned off with... 49 Transportation 4 2010-10-01 2010-10-01 false Use of personal electronic devices. 220.305...

  9. 49 CFR 220.305 - Use of personal electronic devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Use of personal electronic devices. 220.305... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.305 Use of personal electronic devices. A railroad operating employee must have each personal electronic device turned off with...

  10. 49 CFR 220.305 - Use of personal electronic devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Use of personal electronic devices. 220.305... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.305 Use of personal electronic devices. A railroad operating employee must have each personal electronic device turned off with...

  11. A Framework for the Design of Service Systems

    NASA Astrophysics Data System (ADS)

    Tan, Yao-Hua; Hofman, Wout; Gordijn, Jaap; Hulstijn, Joris

    We propose a framework for the design and implementation of service systems, especially to design controls for long-term sustainable value co-creation. The framework is based on the software support tool e3-control. To illustrate the framework we use a large-scale case study, the Beer Living Lab, for simplification of customs procedures in international trade. The BeerLL shows how value co-creation can be achieved by reduction of administrative burden in international beer export due to electronic customs. Participants in the BeerLL are Heineken, IBM and Dutch Tax & Customs.

  12. Making Sense of Rocket Science - Building NASA's Knowledge Management Program

    NASA Technical Reports Server (NTRS)

    Holm, Jeanne

    2002-01-01

    The National Aeronautics and Space Administration (NASA) has launched a range of KM activities-from deploying intelligent "know-bots" across millions of electronic sources to ensuring tacit knowledge is transferred across generations. The strategy and implementation focuses on managing NASA's wealth of explicit knowledge, enabling remote collaboration for international teams, and enhancing capture of the key knowledge of the workforce. An in-depth view of the work being done at the Jet Propulsion Laboratory (JPL) shows the integration of academic studies and practical applications to architect, develop, and deploy KM systems in the areas of document management, electronic archives, information lifecycles, authoring environments, enterprise information portals, search engines, experts directories, collaborative tools, and in-process decision capture. These systems, together, comprise JPL's architecture to capture, organize, store, and distribute key learnings for the U.S. exploration of space.

  13. EDI system definition for a European medical device vigilance system.

    PubMed

    Doukidis, G; Pallikarakis, N; Pangalos, G; Vassilacopoulos, G; Pramataris, K

    1996-01-01

    EDI is expected to be the dominant form of business communication between organizations moving to the Electronic Commerce era of 2000. The healthcare sector is already using EDI in the hospital supply function as well as in the clinical area and the reimbursement process. In this paper, we examine the use of EDI in the healthcare administration sector and more specifically its application to the Medical Device Vigilance System. Firstly, the potential of this approach is examined, followed by the definition of the EDI System Reference Model and the specification of the required system architecture. Each of the architecture's components are then explained in more detail, followed by the most important implementation options relating to them.

  14. Incorporating electronic-based and computer-based strategies: graduate nursing courses in administration.

    PubMed

    Graveley, E; Fullerton, J T

    1998-04-01

    The use of electronic technology allows faculty to improve their course offerings. Four graduate courses in nursing administration were contemporized to incorporate fundamental computer-based skills that would be expected of graduates in the work setting. Principles of adult learning offered a philosophical foundation that guided course development and revision. Course delivery strategies included computer-assisted instructional modules, e-mail interactive discussion groups, and use of the electronic classroom. Classroom seminar discussions and two-way interactive video conferencing focused on group resolution of problems derived from employment settings and assigned readings. Using these electronic technologies, a variety of courses can be revised to accommodate the learners' needs.

  15. Costs of health IT: beginning to understand the financial impact of a dental school EHR.

    PubMed

    Spallek, Heiko; Johnson, Lynn; Kerr, Joseph; Rankin, David

    2014-11-01

    Health Information Technology (Health IT) constitutes an integral component of the operations of most academic dental institutions nowadays. However, the expenses associated with the acquisition and the ongoing maintenance of these complex systems have often been buried among costs for other electronic infrastructure systems, distributed across various cost centers including unmeasured central campus support, covered centrally and therefore difficult to quantify, and spread over years, denying school administrators a clear understanding of the resources that have been dedicated to Health IT. The aim of this study was to understand the financial impact of Health IT at four similar U.S. dental schools: two schools using a purchased Electronic Health Record (EHR), and two schools that developed their own EHR. For these schools, the costs of creating ($2.5 million) and sustaining ($174,000) custom EHR software were significantly higher than acquiring ($500,000) and sustaining ($121,000) purchased software. These results are based on historical data and should not be regarded as a gold standard for what a complete Health IT suite should cost. The presented data are intended to inform school administrators about the myriad of costs associated with Health IT and give them a point of reference when comparing costs or making estimates for implementation projects.

  16. Building a Diabetes Registry from the Veterans Health Administration's Computerized Patient Record System

    PubMed Central

    F. O. Kern, Elizabeth; Beischel, Scott; Stalnaker, Randal; Aron, David C.; Kirsh, Susan R.; Watts, Sharon A.

    2008-01-01

    Background Little information is available describing how to implement a disease registry from an electronic patient record system. The aim of this report is to describe the technology, methods, and utility of a diabetes registry populated by the Veterans Health Information Systems Architecture (VistA), which underlies the computerized patient record system of the Veterans Health Administration (VHA) in Veteran Affairs Integrated Service Network 10 (VISN 10). Methods VISN 10 data from VistA were mapped to a relational SQL-based data system using KB_SQL software. Operational definitions for diabetes, active clinical management, and responsible providers were used to create views of patient-level data in the diabetes registry. Query Analyzer was used to access the data views directly. Semicustomizable reports were created by linking the diabetes registry to a Web page using Microsoft asp.net2. A retrospective observational study design was used to analyze trends in the process of care and outcomes. Results Since October 2001, 81,227 patients with diabetes have enrolled in VISN 10: approximately 42,000 are currently under active management by VISN 10 providers. By tracking primary care visits, we assigned 91% to a clinic group responsible for diabetes care. In the Cleveland Veterans Affairs Medical Center (VAMC), the frequency of mean annual hemoglobin A1c levels ≥9% has declined significantly over 5 years. Almost 4000 patients have been seen in diabetes intervention programs in the Cleveland VAMC over the past 4 years. Conclusions A diabetes registry can be populated from the database underlying the VHA electronic patient record database system and linked to Web-based and ad hoc queries useful for quality improvement. PMID:19885172

  17. 78 FR 18364 - Electronic Prescriptions for Controlled Substances Notice of Approved Certification Process

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. DEA-364] Electronic... certification processes for providers of Electronic Prescriptions for Controlled Substances (EPCS) applications... established by Congress. Electronic Prescriptions for Controlled Substances (EPCS) Historically, where federal...

  18. Intranet and village community: optimization of public service based on electronic government at the local level

    NASA Astrophysics Data System (ADS)

    Pradana, G. W.; Fanida, E. H.; Niswah, F.

    2018-01-01

    The demand for good governance is directed towards the realization of efficiency, effectiveness, and clean government. The move is demonstrated through national and regional levels to develop and implement electronic government concepts. Through the development of electronic government is done structuring management systems and work processes in the government environment by optimizing the utilization of information technology. One of the real forms of electronic government (e-Gov) implementation at the local level is the Intranet Sub-District program in Sukodono Sub-District, Sidoarjo. Intranet Sub-District is an innovation whose purpose is to realize the availability of information on the utilization of management, distribution, and storage of official scripts, and also the optimal delivery of information and communication in the implementation of guidance and supervision of local administration. The type of this paper is descriptive with a qualitative approach and focus on the implementation of the Intranet District Program in Sukodono District, Sidoarjo. The findings of the study are the limited number of human resources who have mastered ICT, the uneven network, the adequacy of institutional needs and the existence of budget support from the authorized institution and the information system has not accommodated all the service needs.

  19. 49 CFR 220.303 - General use of electronic devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.303 General use of electronic devices. A railroad operating employee shall not use an electronic device if that use would... 49 Transportation 4 2010-10-01 2010-10-01 false General use of electronic devices. 220.303 Section...

  20. 49 CFR 220.303 - General use of electronic devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false General use of electronic devices. 220.303 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.303 General use of electronic devices. A railroad operating employee shall not use an electronic device if that use would...

  1. 49 CFR 220.303 - General use of electronic devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false General use of electronic devices. 220.303 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.303 General use of electronic devices. A railroad operating employee shall not use an electronic device if that use would...

  2. The design and implementation of hydrographical information management system (HIMS)

    NASA Astrophysics Data System (ADS)

    Sui, Haigang; Hua, Li; Wang, Qi; Zhang, Anming

    2005-10-01

    With the development of hydrographical work and information techniques, the large variety of hydrographical information including electronic charts, documents and other materials are widely used, and the traditional management mode and techniques are unsuitable for the development of the Chinese Marine Safety Administration Bureau (CMSAB). How to manage all kinds of hydrographical information has become an important and urgent problem. A lot of advanced techniques including GIS, RS, spatial database management and VR techniques are introduced for solving these problems. Some design principles and key techniques of the HIMS including the mixed mode base on B/S, C/S and stand-alone computer mode, multi-source & multi-scale data organization and management, multi-source data integration and diverse visualization of digital chart, efficient security control strategies are illustrated in detail. Based on the above ideas and strategies, an integrated system named Hydrographical Information Management System (HIMS) was developed. And the HIMS has been applied in the Shanghai Marine Safety Administration Bureau and obtained good evaluation.

  3. Quetiapine Nanoemulsion for Intranasal Drug Delivery: Evaluation of Brain-Targeting Efficiency.

    PubMed

    Boche, Mithila; Pokharkar, Varsha

    2017-04-01

    To evaluate the possibility of improved drug delivery of quetiapine fumarate (QTP), a nanoemulsion system was developed for intranasal delivery. Effects of different HLBs of Emalex LWIS 10, PEG 400 and Transcutol P, as co-surfactants, were studied on isotropic region of pseudoternary-phase diagrams of nanoemulsion system composed of capmul MCM (CPM) as oil phase, Tween 80 as surfactant and water. Phase behaviour, globule size, transmission electron microscope (TEM) photographs and brain-targeting efficiency of quetiapine nanoemulsion were investigated. In vitro dissolution study of optimised nanoemulsion formulation, with mean diameter 144 ± 0.5 nm, showed more than twofold increase in drug release as compared with pure drug. According to results of in vivo tissue distribution study in Wistar rats, intranasal administration of QTP-loaded nanoemulsion had shorter T max compared with that of intravenous administration. Higher drug transport efficiency (DTE%) and direct nose-to-brain drug transport (DTP%) was achieved by nanoemulsion. The nanoemulsion system may be a promising strategy for brain-targeted delivery of QTP.

  4. Space Weather Operation at KASI With Van Allen Probes Beacon Signals

    NASA Astrophysics Data System (ADS)

    Lee, Jongkil; Kim, Kyung-Chan; Giuseppe, Romeo; Ukhorskiy, Sasha; Sibeck, David; Kessel, Ramona; Mauk, Barry; Giles, Barbara; Gu, Bon-Jun; Lee, Hyesook; Park, Young-Deuk; Lee, Jaejin

    2018-02-01

    The Van Allen Probes (VAPs) are the only modern National Aeronautics and Space Administration (NASA) spacecraft broadcasting real-time data on the Earth's radiation belts for space weather operations. Since 2012, the Korea Astronomy and Space Science Institute (KASI) has contributed to the receipt of these data via a 7 m satellite-tracking antenna and used these beacon data for space weather operations. An approximately 15 min period is required from measurement to acquisition of Level-1 data. In this paper, we demonstrate the use of VAP data for monitoring space weather conditions at geostationary orbit (GEO) by highlighting the Saint Patrick's Day storm of 2015. During that storm, Probe-A observed a significant increase in the relativistic electron flux at 3 RE. Those electrons diffused outward resulting in a large increase of the electron flux >2 MeV at GEO, which potentially threatened satellite operations. Based on this study, we conclude that the combination of VAP data and National Oceanic and Atmospheric Administration-Geostationary Operational Environmental Satellite (NOAA-GOES) data can provide improved space environment information to geostationary satellite operators. In addition, the findings obtained indicate that more data-receiving sites would be necessary and data connections improved if this or a similar system were to be used as an operational data service.

  5. Assessment of the Quality of Electronic Administrative Services in a Greek Higher Education Institution: ? Case Study

    ERIC Educational Resources Information Center

    Papanthymou, Anastasia; Darra, Maria

    2018-01-01

    The basic aim of this paper is to investigate the perceptions, attitudes and experiences of the students of the Department of Primary Education of University of the Aegean about the quality of the provided services to them by the Secretariat of Administrative Electronic Services. The survey was conducted during the second semester of the academic…

  6. Crossing the quality chasm: the role of information technology departments.

    PubMed

    Weir, Charlene R; Hicken, Bret L; Rappaport, Hank Steven; Nebeker, Jonathan R

    2006-01-01

    Integrating information technology (IT) into medical settings is considered essential to transforming hospitals into 21st-century health care institutions. Yet the role of IT departments in maximizing the effectiveness of information systems is not well understood. This article reports a 3-round Delphi panel of Veterans Administration personnel experienced with provider order entry electronic systems. In round 1, 35 administrative, clinical, and IT personnel answered 10 open-ended questions about IT strategies and structures that best support successful transformation. In round 2, panelists rated item importance and ranked proposed strategies. In round 3, panelists received aggregate feedback and rerated the items. Four domains emerged from round 1: IT organization, IT performance monitoring, user-support activities, and core IT responsibilities (eg, computer security, training). In rounds 2 and 3, IT performance monitoring was rated the most important, closely followed by clinical support. Strategies associated with each domain are identified and discussed.

  7. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  8. The implementation and operation of a variable-response electronic throttle control system for a TF-104G aircraft

    NASA Technical Reports Server (NTRS)

    Neal, Bradford; Sengupta, Upal

    1989-01-01

    During some flight programs, researchers have encountered problems in the throttle response characteristics of high-performance aircraft. To study and to help solve these problems, the National Aeronautics and Space Administration Ames Research Center's Dryden Flight Research Facility (Ames-Dryden) conducted a study using a TF-104G airplane modified with a variable-response electronic throttle control system. Ames-Dryden investigated the effects of different variables on engine response and handling qualities. The system provided transport delay, lead and lag filters, second-order lags, command rate and position limits, and variable gain between the pilot's throttle command and the engine fuel controller. These variables could be tested individually or in combination. Ten research flights were flown to gather data on engine response and to obtain pilot ratings of the various system configurations. The results should provide design criteria for engine-response characteristics. The variable-response throttle components and how they were installed in the TF-104G aircraft are described. How the variable-response throttle was used in flight and some of the results of using this system are discussed.

  9. Identification of Physician-Diagnosed Alzheimer's Disease and Related Dementias in Population-Based Administrative Data: A Validation Study Using Family Physicians' Electronic Medical Records.

    PubMed

    Jaakkimainen, R Liisa; Bronskill, Susan E; Tierney, Mary C; Herrmann, Nathan; Green, Diane; Young, Jacqueline; Ivers, Noah; Butt, Debra; Widdifield, Jessica; Tu, Karen

    2016-08-10

    Population-based surveillance of Alzheimer's and related dementias (AD-RD) incidence and prevalence is important for chronic disease management and health system capacity planning. Algorithms based on health administrative data have been successfully developed for many chronic conditions. The increasing use of electronic medical records (EMRs) by family physicians (FPs) provides a novel reference standard by which to evaluate these algorithms as FPs are the first point of contact and providers of ongoing medical care for persons with AD-RD. We used FP EMR data as the reference standard to evaluate the accuracy of population-based health administrative data in identifying older adults with AD-RD over time. This retrospective chart abstraction study used a random sample of EMRs for 3,404 adults over 65 years of age from 83 community-based FPs in Ontario, Canada. AD-RD patients identified in the EMR were used as the reference standard against which algorithms identifying cases of AD-RD in administrative databases were compared. The highest performing algorithm was "one hospitalization code OR (three physician claims codes at least 30 days apart in a two year period) OR a prescription filled for an AD-RD specific medication" with sensitivity 79.3% (confidence interval (CI) 72.9-85.8%), specificity 99.1% (CI 98.8-99.4%), positive predictive value 80.4% (CI 74.0-86.8%), and negative predictive value 99.0% (CI 98.7-99.4%). This resulted in an age- and sex-adjusted incidence of 18.1 per 1,000 persons and adjusted prevalence of 72.0 per 1,000 persons in 2010/11. Algorithms developed from health administrative data are sensitive and specific for identifying older adults with AD-RD.

  10. The work practice of medical secretaries and the implementation of electronic health records in Denmark.

    PubMed

    Bertelsen, Pernille; Nøhr, Christian

    The introduction of electronic health records will entail substantial organisational changes to the clinical and administrative staff in hospitals. Hospital owners in Denmark have predicted that these changes will render up to half of medical secretaries redundant. The present study however shows that medical secretaries have a great variety of duties, and often act as the organisational "glue" or connecting thread between other professional groups at the hospital. The aim of this study is to obtain a detailed understanding of the pluralism of work tasks the medical secretaries perform. It is concluded that clinicians as well as nurses depend on medical secretaries, and therefore to reduce the number of secretaries because electronic health record systems are implemented needs very careful thinking, planning and discussion with the other professions involved.

  11. The effect of information technology on hospital performance.

    PubMed

    Williams, Cynthia; Asi, Yara; Raffenaud, Amanda; Bagwell, Matt; Zeini, Ibrahim

    2016-12-01

    While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals. Inputs considered were full time equivalents, hospital size, and technology inputs. Technology inputs included personal health records (PHR), electronic medical records (EMRs), computerized physician order entry systems (CPOEs), and electronic access to diagnostic results. Output variables were measures of quality, hospital readmission and mortality rate. The analysis was conducted in a two-stage methodology: Data Envelopment Analysis (DEA) and Automatic Interaction Detector Analysis (AID), decision tree regression (DTreg). Overall, we found that electronic access to diagnostic results systems was the most influential technological characteristics; however organizational characteristics were more important than technological inputs. Hospitals that had the highest levels of quality indicated no excess in the use of technology input, averaging one use of a technology component. This study indicates that prudent consideration of organizational characteristics and technology is needed before investing in innovative programs.

  12. Spatial Control of Laser Wakefield Accelerated Electron Beams

    NASA Astrophysics Data System (ADS)

    Maksimchuk, A.; Behm, K.; Zhao, T.; Joglekar, A. S.; Hussein, A.; Nees, J.; Thomas, A. G. R.; Krushelnick, K.; Elle, J.; Lucero, A.; Samarin, G. M.; Sarry, G.; Warwick, J.

    2017-10-01

    The laser wakefield experiments to study and control spatial properties of electron beams were performed using HERCULES laser at the University of Michigan at power of 100 TW. In the first experiment multi-electron beam generation was demonstrated using co-propagating, parallel laser beams with a π-phase shift mirror and showing that interaction between the wakefields can cause injection to occur for plasma and laser parameters in which a single wakefield displays no significant injection. In the second experiment a magnetic triplet quadrupole system was used to refocus and stabilize electron beams at the distance of 60 cm from the interaction region. This produced a 10-fold increase in remote gamma-ray activation of 63Cu using a lead converter. In the third experiment measurements of un-trapped electrons with high transverse momentum produce a 500 mrad (FWHM) ring. This ring is formed by electrons that receive a forward momentum boost by traversing behind the bubble and its size is inversely proportional to the plasma density. The characterization of divergence and charge of this electron ring may reveal information about the wakefield structure and trapping potential. Supported by U.S. Department of Energy and the National Nuclear Security Administration and Air Force Office of Scientific Research.

  13. Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing) systems.

    PubMed

    Cresswell, Kathrin; Coleman, Jamie; Smith, Pam; Swainson, Charles; Slee, Ann; Sheikh, Aziz

    2016-07-04

    Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems) are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals), setting comparators to measure progress (i.e. baseline measurements) and clear standards guiding data management so that data are comparable across settings. A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The move towards more sophisticated closed-loop systems that integrate prescribing, administration and dispensing, as well as increasingly empowered patients accessing their data through portals and portable devices, will accelerate these developments. Meaningful analysis of data will be the key to realise benefits associated with systems.

  14. It is more efficient to type: innovative self-registration and appointment self-arrival system improves the patient reception process.

    PubMed

    Knight, Vickie; Guy, Rebecca J; Handan, Wand; Lu, Heng; McNulty, Anna

    2014-06-01

    In 2010, we introduced an express sexually transmitted infection/HIV testing service at a large metropolitan sexual health clinic, which significantly increased clinical service capacity. However, it also increased reception staff workload and caused backlogs of patients waiting to register or check in for appointments. We therefore implemented a new electronic self-registration and appointment self-arrival system in March 2012 to increase administrative efficiency and reduce waiting time for patients. We compared the median processing time overall and for each step of the registration and arrival process as well as the completeness of patient contact information recorded, in a 1-week period before and after the redesign of the registration system. χ2 Test and rank sum tests were used. Before the redesign, the median processing time was 8.33 minutes (interquartile range [IQR], 6.82-15.43), decreasing by 30% to 5.83 minutes (IQR, 4.75-7.42) when the new electronic self-registration and appointment self-arrival system was introduced (P < 0.001). The largest gain in efficiency was in the time taken to prepare the medical record for the clinician, reducing from a median of 5.31 minutes (IQR, 4.02-8.29) to 0.57 minutes (IQR, 0.38-1) in the 2 periods. Before implementation, 20% of patients provided a postal address and 31% an e-mail address, increasing to 60% and 70% post redesign, respectively (P < 0.001). Our evaluation shows that an electronic patient self-registration and appointment self-arrival system can improve clinic efficiency and save patient time. Systems like this one could be used by any outpatient service with large patient volumes as an integrated part of the electronic patient management system or as a standalone feature.

  15. 49 CFR 220.307 - Use of railroad-supplied electronic devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.307 Use of railroad-supplied electronic devices. (a) General restriction. A railroad operating employee... 49 Transportation 4 2010-10-01 2010-10-01 false Use of railroad-supplied electronic devices. 220...

  16. A Study on the Attitudes of Students, Instructors, and Educational Principals to Electronic Administration of Final-Semester Examinations in Payame Noor University in Iran

    ERIC Educational Resources Information Center

    Omidian, Faranak; Nedayeh Ali, Farzaneh

    2015-01-01

    The aim of this study was to investigate the attitudes of students, instructors, and educational principals to electronic administration of final-semester examinations at undergraduate and post- graduate levels in Payame Noor University in Khuzestan. The statistical population of this study consisted of all educational principals, instructors, of…

  17. Evaluating Maintenance Performance: Test Administrator's Manual and Test Subject's Instructions for Criterion Referenced Job Task Performance Tests for Electronic Maintenance. Final Report.

    ERIC Educational Resources Information Center

    Shriver, Edgar L.; And Others

    This document furnishes a complete copy of the Test Subject's Instructions and the Test Administrator's Handbook for a battery of criterion referenced Job Task Performance Tests (JTPT) for electronic maintenance. General information is provided on soldering, Radar Set AN/APN-147(v), Radar Set Special Equipment, Radar Set Bench Test Set-Up, and…

  18. Children's hospitals and PACS: six profiles of planning and implementation.

    PubMed

    Keen, C

    1999-01-01

    Six pediatric hospitals were interviewed at length about the status of PACS in their facilities. Children's Hospital Medical Center in Cincinnati, Ohio entered electronic imaging communications in 1993. Several nearby clinics were connected through teleradiology and by 1998, the radiology department had developed a business plan for the implementation of PACS. Two hospitals in Atlanta, Egleston Hospital and Scottish Rite Children's. Medical Center, merged in 1998 to become one entity with two medical campuses. They now treat 60 percent of Atlanta's pediatric patients. Merging incompatible systems has been the administrator's most immediate problem. One director of imaging services is responsible for the recently merged Mary Bridge Children's Hospital and Tacoma General Hospital, plus a network of clinics and medical facilities scatted throughout Tacoma and the South Puget Sound area in Washington state. A state-of-the-art mini-PACS and teleradiology system were implemented at Primary Children's Medical Center, Salt Lake City, in 1991. Over the years, it has added modalities into an electronic system that now results in significantly improved use of physicians' time and patient relations. St. Louis Children's Hospital, with both a director of radiology and a PACS administrator, has implemented teleradiology and an ultrasound mini-PACS, and has plans for an enterprise-wide PACS. Children's Hospital in Birmingham, Ala., a major trauma center, provides specialized pediatric care to nearly all 67 counties in Alabama. With a 20-year history of online computerization, it is now reengineering its emergency department and will implement CR there first.

  19. 78 FR 77171 - Proposed Disposal of George H.W. Bush and Clinton Administration Electronic Backup Tapes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION [NARA-2014-011] Proposed Disposal of George H.W. Bush... George H.W. Bush and Clinton Administration Disaster Recovery Backup Tapes; final agency action. SUMMARY... collection of disaster recovery backup tapes from the George H.W. Bush and Clinton administrations under the...

  20. 78 FR 28228 - Guidance for Industry and Food and Drug Administration Staff on Best Practices for Conducting and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0057] Guidance for Industry and Food and Drug Administration Staff on Best Practices for Conducting and Reporting Pharmacoepidemiologic Safety Studies Using Electronic Healthcare Data; Availability AGENCY: Food and Drug Administration...

  1. Achieving Interoperability Through Base Registries for Governmental Services and Document Management

    NASA Astrophysics Data System (ADS)

    Charalabidis, Yannis; Lampathaki, Fenareti; Askounis, Dimitris

    As digital infrastructures increase their presence worldwide, following the efforts of governments to provide citizens and businesses with high-quality one-stop services, there is a growing need for the systematic management of those newly defined and constantly transforming processes and electronic documents. E-government Interoperability Frameworks usually cater to the technical standards of e-government systems interconnection, but do not address service composition and use by citizens, businesses, or other administrations.

  2. Electronic tongue: An analytical gustatory tool

    PubMed Central

    Latha, Rewanthwar Swathi; Lakshmi, P. K.

    2012-01-01

    Taste is an important organoleptic property governing acceptance of products for administration through mouth. But majority of drugs available are bitter in taste. For patient acceptability and compliance, bitter taste drugs are masked by adding several flavoring agents. Thus, taste assessment is one important quality control parameter for evaluating taste-masked formulations. The primary method for the taste measurement of drug substances and formulations is by human panelists. The use of sensory panelists is very difficult and problematic in industry and this is due to the potential toxicity of drugs and subjectivity of taste panelists, problems in recruiting taste panelists, motivation and panel maintenance are significantly difficult when working with unpleasant products. Furthermore, Food and Drug Administration (FDA)-unapproved molecules cannot be tested. Therefore, analytical taste-sensing multichannel sensory system called as electronic tongue (e-tongue or artificial tongue) which can assess taste have been replacing the sensory panelists. Thus, e-tongue includes benefits like reducing reliance on human panel. The present review focuses on the electrochemical concepts in instrumentation, performance qualification of E-tongue, and applications in various fields. PMID:22470887

  3. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  4. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  5. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  6. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  7. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Access to electronic records. 228.205 Section 228... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49...

  8. 76 FR 19147 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives... Electronic Records Archives (ACERA). The meeting has been consolidated into one day. This meeting will be... number of individuals planning to attend must be submitted to the Electronic Records Archives Program at...

  9. 5 CFR 582.204 - Electronic disbursement.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Electronic disbursement. 582.204 Section... GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process § 582.204 Electronic disbursement. The party... funds remitted by electronic funds transfer, rather than by paper check. The request shall include the...

  10. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Access to electronic records. 228.205 Section 228... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49...

  11. 5 CFR 582.204 - Electronic disbursement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Electronic disbursement. 582.204 Section... GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process § 582.204 Electronic disbursement. The party... funds remitted by electronic funds transfer, rather than by paper check. The request shall include the...

  12. 5 CFR 582.204 - Electronic disbursement.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Electronic disbursement. 582.204 Section... GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process § 582.204 Electronic disbursement. The party... funds remitted by electronic funds transfer, rather than by paper check. The request shall include the...

  13. 5 CFR 582.204 - Electronic disbursement.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Electronic disbursement. 582.204 Section... GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process § 582.204 Electronic disbursement. The party... funds remitted by electronic funds transfer, rather than by paper check. The request shall include the...

  14. 5 CFR 582.204 - Electronic disbursement.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Electronic disbursement. 582.204 Section... GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process § 582.204 Electronic disbursement. The party... funds remitted by electronic funds transfer, rather than by paper check. The request shall include the...

  15. Optical Response of Warm Dense Matter Using Real-Time Electron Dynamics

    NASA Astrophysics Data System (ADS)

    Baczewski, Andrew; Shulenburger, Luke; Desjarlais, Michael; Magyar, Rudolph

    2014-03-01

    The extreme temperatures and solid-like densities in warm dense matter present a unique challenge for theory, wherein neither conventional models from condensed matter nor plasma physics capture all of the relevant phenomenology. While Kubo-Greenwood DFT calculations have proven capable of reproducing optical properties of WDM, they require a significant number of virtual orbitals to reach convergence due to their perturbative nature. Real-time TDDFT presents a complementary framework with a number of computationally favorable properties, including reduced cost complexity and better scalability, and has been used to reproduce the optical response of finite and ordered extended systems. We will describe the use of Ehrenfest-TDDFT to evolve coupled electron-nuclear dynamics in WDM systems, and the subsequent evaluation of optical response functions from the real-time electron dynamics. The advantages and disadvantages of this approach will be discussed relative to the current state-of-the-art. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Security Administration under contract DE-AC04-94AL85000.

  16. Developing a NASA Lead-Free Policy for Electronics - Lessons Learned

    NASA Technical Reports Server (NTRS)

    Sampson, Michael J.

    2008-01-01

    The National Aeronautics and Space Administration (NASA) is not required by United States or international law to use lead-free (Pb-free) electronic systems but international pressure in the world market is making it increasingly important that NASA have a Pb-free policy. In fact, given the international nature of the electronics market, all organizations need a Pb-free policy. This paper describes the factors which must be taken into account in formulating the policy, the tools to aid in structuring the policy and the unanticipated and difficult challenges encountered. NASA is participating in a number of forums and teams trying to develop effective approaches to controlling Pb-free adoption in high reliability systems. The activities and status of the work being done by these teams will be described. NASA also continues to gather information on metal whiskers, particularly tin based, and some recent examples will be shared. The current lack of a policy is resulting in "surprises" and the need to disposition undesirable conditions on a case-by-case basis. This is inefficient, costly and can result in sub-optimum outcomes.

  17. Factors affecting registered nurses' use of medication administration technology in acute care settings: A systematic review.

    PubMed

    San, Tay Hui; Lin, Serena Koh Siew; Fai, Chan Moon

    Information technology to aid reduction in medication errors has been encouraged over the years and one of them is the medication administration technology. It consists of the electronic Medication Administration Record, Bar-Code Medication Administration system and Automated Medication Dispensing system. Studies had examined the effectiveness and impact of this technology to reduce medication error. However, user's acceptance towards this technology has often been neglected. To date, no systematic review has been undertaken to examine the possible factors that affect nurses' use of this technology in the acute care settings. The objective of this systematic review was to explore and determine the factors that affect nurses' use of medication administration technology in the acute care settings. All quantitative studies published in English which examined factors affecting nurses' use of the medication administration technology were considered.Primary focus was on registered nurses with experience of operating medication administration technology in the acute care settings. Other healthcare personnel were excluded.This review considered studies that evaluated factors affecting nurses' use of the medication administration technology.The outcome measures of interest were the factors that affect nurses' use of the medication administration technology in the acute care settings. The search was conducted across published and unpublished databases. A search was conducted in JBI Library of Systematic Reviews, The Cochrane Library, CINAHL, MEDLINE, Scopus, ScienceDirect, Wiley InterScience, SpringerLink, PsycINFO (ovid), Web of science, ProQuest Dissertations and Theses, and MedNar. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review, using the standardised critical appraisal instruments developed by the Joanna Briggs Institute. Quantitative data were extracted from papers included in the review using a standardised data extraction tool developed by the JBI. Findings were presented in narrative summary due to heterogeneity of the study designs. Six descriptive studies were included in this review. Nurses' use of the technology can be influenced by a combination of complex and inter-related factors, such as organisational factors, and user and system characteristics. In order to successfully implement medication administration technology, system, user and organisational factors have to be collaborated concurrently.Users' needs should be accommodated when designing the system features. Prior to system implementation, institutions should consider the users' demographical characteristics and provide adequate preparations and training. A supportive culture from the institution and colleagues is also important.There is a significant need for further research in this field. Further research to discover potential factors in different settings, locations and countries are suggested. Studies to evaluate nurses' use of the technology at regular intervals are also required.

  18. Insights from advanced analytics at the Veterans Health Administration.

    PubMed

    Fihn, Stephan D; Francis, Joseph; Clancy, Carolyn; Nielson, Christopher; Nelson, Karin; Rumsfeld, John; Cullen, Theresa; Bates, Jack; Graham, Gail L

    2014-07-01

    Health care has lagged behind other industries in its use of advanced analytics. The Veterans Health Administration (VHA) has three decades of experience collecting data about the veterans it serves nationwide through locally developed information systems that use a common electronic health record. In 2006 the VHA began to build its Corporate Data Warehouse, a repository for patient-level data aggregated from across the VHA's national health system. This article provides a high-level overview of the VHA's evolution toward "big data," defined as the rapid evolution of applying advanced tools and approaches to large, complex, and rapidly changing data sets. It illustrates how advanced analysis is already supporting the VHA's activities, which range from routine clinical care of individual patients--for example, monitoring medication administration and predicting risk of adverse outcomes--to evaluating a systemwide initiative to bring the principles of the patient-centered medical home to all veterans. The article also shares some of the challenges, concerns, insights, and responses that have emerged along the way, such as the need to smoothly integrate new functions into clinical workflow. While the VHA is unique in many ways, its experience may offer important insights for other health care systems nationwide as they venture into the realm of big data. Project HOPE—The People-to-People Health Foundation, Inc.

  19. The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations.

    PubMed

    Davis, Jullet A

    For many service-oriented firms, knowledge is a key commodity, and the process by which knowledge is codified is critical for firm survival. The administrator or top manager acts as the repository and disseminator of organizational knowledge. The purpose of this project is to examine the association between the administrator's educational attainment and innovation in residential care facilities. The study hypothesized that administrator academic education and certification or licensure would be positively associated with facility innovation. Data for this project comes from the 2010 National Survey of Residential Care Facilities. There were 2277 facilities included in the sample (weighted 30 811). Innovation, the dependent variable, was operationalized using 5 dichotomized measures: clinical information systems, pharmaceutical information systems, electronic health records, providing adult day care, and providing respite care. The data were analyzed using logistic regression. Overall, the results reveal that college education or certification/licensure increased the likelihood of technology use. In addition, those with a high school diploma and certification/licensure were more likely to use technology than were individuals who had, at a minimum, some college. The services models were not significant. It may be that the resources necessary to implement information systems vary substantially from the resources necessary to provide services.

  20. Round window administration of gentamicin: a new method for the study of ototoxicity of cochlear hair cells.

    PubMed

    Husmann, K R; Morgan, A S; Girod, D A; Durham, D

    1998-11-01

    Damage to inner ear sensory hair cells after systemic administration of ototoxic drugs has been documented in humans and animals. Birds have the ability to regenerate new hair cells to replace those damaged by drugs or noise. Unfortunately, the systemic administration of gentamicin damages both ears in a variable fashion with potentially confounding systemic drug effects. We developed a method of direct application of gentamicin to one cochlea of hatchling chickens, allowing the other ear to serve as a within-animal control. We tested variables including the vehicle for application, location of application, dosage, and duration of gentamicin exposure. After 5 or 28 days survival, the percent length damage to the cochlea and regeneration of hair cells was evaluated using scanning electron microscopy. Controls consisted of the opposite unexposed cochlea and additional animals which received saline instead of gentamicin. Excellent damage was achieved using gentamicin-soaked Gelfoam pledgets applied to the round window membrane. The percent length damage could be varied from 15 to 100% by changing the dosage of gentamicin, with exposures as short as 30 min. No damage was observed in control animals. Regeneration of hair cells was observed in both the base and apex by 28 days survival.

  1. Utilizing findings from the APACHE III research to develop operational information system for the ICU--the APACHE III ICU Management System.

    PubMed Central

    Knaus, W. A.; Draper, E. A.; Wagner, D. P.

    1991-01-01

    The APACHE III data base reflects the disease, physiologic status, and outcome data from 17,400 ICU patients at 40 hospitals, 26 of which were randomly selected from representative geographic regions, bed size, and teaching status. This provides a nationally representative standard for measuring several important aspects of ICU performance. Results from the study have now been used to develop an automated information system to provide real time information about expected ICU patient outcome, length of stay, production cost, and ICU performance. The information system provides several new capabilities to ICU clinicians, clinic, and hospital administrators. Among the system's capabilities are: the ability to compare local ICU performance against predetermined criteria; the ability to forecast nursing requirements; and, the ability to make both individual and group patient outcome predictions. The system also provides improved administrative support by tracking ICU charges at the point of origin and reduces staff workload eliminating the requirement for several manually maintained logs and patient lists. APACHE III has the capability to electronically interface with and utilize data already captured in existing hospital information systems, automated laboratory information systems, and patient monitoring systems. APACHE III will also be completely integrated with several CIS vendors' products. PMID:1807779

  2. Developing Surveillance Methodology for Agricultural and Logging Injury in New Hampshire Using Electronic Administrative Data Sets.

    PubMed

    Scott, Erika E; Hirabayashi, Liane; Krupa, Nicole L; Sorensen, Julie A; Jenkins, Paul L

    2015-08-01

    Agriculture and logging rank among industries with the highest rates of occupational fatality and injury. Establishing a nonfatal injury surveillance system is a top priority in the National Occupational Research Agenda. Sources of data such as patient care reports (PCRs) and hospitalization data have recently transitioned to electronic databases. Using narrative and location codes from PCRs, along with International Classification of Diseases, 9th Revision, external cause of injury codes (E-codes) in hospital data, researchers are designing a surveillance system to track farm and logging injury. A total of 357 true agricultural or logging cases were identified. These data indicate that it is possible to identify agricultural and logging injury events in PCR and hospital data. Multiple data sources increase catchment; nevertheless, limitations in methods of identification of agricultural and logging injury contribute to the likely undercount of injury events.

  3. Development and evaluation of nursing user interface screens using multiple methods.

    PubMed

    Hyun, Sookyung; Johnson, Stephen B; Stetson, Peter D; Bakken, Suzanne

    2009-12-01

    Building upon the foundation of the Structured Narrative Electronic Health Record (EHR) model, we applied theory-based (combined Technology Acceptance Model and Task-Technology Fit Model) and user-centered methods to explore nurses' perceptions of functional requirements for an electronic nursing documentation system, design user interface screens reflective of the nurses' perspectives, and assess nurses' perceptions of the usability of the prototype user interface screens. The methods resulted in user interface screens that were perceived to be easy to use, potentially useful, and well-matched to nursing documentation tasks associated with Nursing Admission Assessment, Blood Administration, and Nursing Discharge Summary. The methods applied in this research may serve as a guide for others wishing to implement user-centered processes to develop or extend EHR systems. In addition, some of the insights obtained in this study may be informative to the development of safe and efficient user interface screens for nursing document templates in EHRs.

  4. Quality and efficiency successes leveraging IT and new processes.

    PubMed

    Chaiken, Barry P; Christian, Charles E; Johnson, Liz

    2007-01-01

    Today, healthcare annually invests billions of dollars in information technology, including clinical systems, electronic medical records and interoperability platforms. While continued investment and parallel development of standards are critical to secure exponential benefits from clinical information technology, intelligent and creative redesign of processes through path innovation is necessary to deliver meaningful value. Reports from two organizations included in this report review the steps taken to reinvent clinical processes that best leverage information technology to deliver safer and more efficient care. Good Samaritan Hospital, Vincennes, Indiana, implemented electronic charting, point-of-care bar coding of medications prior to administration, and integrated clinical documentation for nursing, laboratory, radiology and pharmacy. Tenet Healthcare, during its implementation and deployment of multiple clinical systems across several hospitals, focused on planning that included team-based process redesign. In addition, Tenet constructed valuable and measurable metrics that link outcomes with its strategic goals.

  5. A cloud on the horizon-a survey into the use of electronic vaping devices for recreational drug and new psychoactive substance (NPS) administration.

    PubMed

    Blundell, M; Dargan, P; Wood, D

    2018-01-01

    There is limited published scientific data on vaping recreational drugs other than cannabis. A recent review suggested that 15% of people vaping cannabis have also vaped a synthetic cannabinoid receptor agonist (SCRA) and identified over 300 Internet reports of e-liquid manufacture of recreational drugs and/or new psychoactive substances (NPS). To determine the prevalence of use of electronic vaping devices for recreational drug and NPS delivery in the UK. A voluntary online survey using a convenience sample of UK adult participants (aged 16 years old and over) identified by a market research company. Data was collected regarding demographics, smoking history, electronic vaping device history and recreational drug/NPS use and route of administration. There were 2501 respondents. The mean (±SD) age was 46.2 ± 16.8 years old. The commonest lifetime recreational drug used was Cannabis (818, 32.7%). The majority of respondents had smoked (1545, 61.8%) with 731 (29.2%) being current smokers. The most commonly used SCRA product was 'Spice Gold' (173, 6.9%) and SCRA compound was ADB-CHMICA (48, 1.9%). 861 (34.4%) had used an electronic vaping device; 340 (13.6%) having used them for recreational drug administration; 236 (9.4%) reporting current use. The commonest lifetime recreational drug to be vaped was cannabis (155, 65.7%), with electronic cigarettes (230, 48.2%) being the commonest reported route of SCRA compound administration. 9.4% of respondents currently use electronic vaping devices for recreational drug administration with 6.2% reporting lifetime cannabis vaping use. Further larger scale studies are required to help inform the appropriate treatment and primary prevention strategies. © The Author 2017. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  6. 7 CFR 735.400 - Administration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

  7. 7 CFR 735.400 - Administration.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 7 2014-01-01 2014-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

  8. 7 CFR 735.400 - Administration.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 7 2012-01-01 2012-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

  9. 7 CFR 735.400 - Administration.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 7 2011-01-01 2011-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

  10. Integrating mHealth in Oncology: Experience in the Province of Trento.

    PubMed

    Galligioni, Enzo; Piras, Enrico Maria; Galvagni, Michele; Eccher, Claudio; Caramatti, Silvia; Zanolli, Daniela; Santi, Jonni; Berloffa, Flavio; Dianti, Marco; Maines, Francesca; Sannicolò, Mirella; Sandri, Marco; Bragantini, Lara; Ferro, Antonella; Forti, Stefano

    2015-05-13

    The potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system. Here we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home. The STM system is fully integrated with the electronic oncological patient record. After the prescription of chemotherapy, specific barcodes are automatically associated with the patient and each drug, and a bedside barcode reader checks the patient, nurse, infusion bag, and drug sequence in order to trace the entire administration process, which is then entered in the patient's record. The usability and acceptability of the system was investigated by means of a modified questionnaire administered to nurses. The home monitoring system consists of a mobile phone or tablet diary app, which allows patients to record their state of health, the medications taken, their side effects, and a Web dashboard that allows health professionals to check the patient data and monitor toxicity and treatment adherence. A built-in rule-based alarm module notifies health care professionals of critical conditions. Initially developed for chronic patients, the system has been subsequently customized in order to monitor home treatments with capecitabine or sunitinib in cancer patients (Onco-TreC). The STM system never failed to match the patient/nurse/drug sequence association correctly, and proved to be accurate and reliable in tracing and recording the entire administration process. The questionnaires revealed that the users were generally satisfied and had a positive perception of the system's usefulness and ease of use, and the quality of their working lives. The pilot studies with the home monitoring system with 43 chronic patients have shown that the approach is reliable and useful for clinicians and patients, but it is also necessary to pay attention to the expectations that mHealth solutions may raise in users. The Onco-TreC version has been successfully laboratory tested, and is now ready for validation. The STM and Onco-TreC systems are fully integrated with our complex and composite information system, which guarantees privacy, security, interoperability, and real-time communications between patients and health professionals. They need to be validated in order to confirm their positive contribution to the safer administration of anticancer drugs.

  11. 75 FR 21367 - Advanced Electronics, Inc.; Boston, MA; Notice of Negative Determination on Remand

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-59,517] Advanced Electronics, Inc... Employees of Advanced Electronics, Inc. v. United States Secretary of Labor (Court No. 06-00337). On July 18... former workers of Advanced Electronics, Inc., Boston, Massachusetts (subject firm). The Department's...

  12. 77 FR 12312 - Electronic Submission of Nonclinical Study Data; Notice of Pilot Project

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-29

    ...] Electronic Submission of Nonclinical Study Data; Notice of Pilot Project AGENCY: Food and Drug Administration... the electronic submission of nonclinical study data using the Standard for Exchange of Nonclinical Data (SEND), a new electronic data standard format, which can be used to support review activity...

  13. 49 CFR 220.315 - Operational tests and inspections; further restrictions on use of electronic devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... restrictions on use of electronic devices. 220.315 Section 220.315 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD COMMUNICATIONS Electronic Devices § 220.315 Operational tests and inspections; further restrictions on use of electronic...

  14. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  15. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  16. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  17. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  18. Implementation of Electronic Commerce in the Department of Defense and the National Aeronautics and Space Administration.

    DTIC Science & Technology

    1996-12-01

    President Clinton’s Executive Memorandum of 26 October 1993 mandated that all Federal Government agencies implement Electronic Commerce (EC) in order... Electronic Commerce /Electronic Data Interchange (EC/EDI) architecture. The NASA employed an Internet based tool, the NASA Acquisition Internet Service

  19. 21 CFR 211.68 - Automatic, mechanical, and electronic equipment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Automatic, mechanical, and electronic equipment. 211.68 Section 211.68 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Equipment § 211.68 Automatic, mechanical, and electronic equipment. (a) Automatic, mechanical, or electronic...

  20. 21 CFR 211.68 - Automatic, mechanical, and electronic equipment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Automatic, mechanical, and electronic equipment. 211.68 Section 211.68 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Equipment § 211.68 Automatic, mechanical, and electronic equipment. (a) Automatic, mechanical, or electronic...

  1. Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries.

    PubMed

    Mears, Simon C; Pantle, Hardin A; Bessman, Edward S; Lifchez, Scott D

    2015-05-01

    Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors' institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED. The authors hypothesized that select injuries could be safely managed in the ED by using an electronic system to ensure appropriate follow-up care. Using Kaizen methodology, a multidisciplinary group (including ED staff, orthopedics, plastic surgery, pediatrics, nursing, radiology, therapy, and administration) met to improve care for select musculoskeletal injuries. A system was agreed on in which ED providers managed select musculoskeletal injuries without subspecialist consultation. Follow-up was organized using an electronic system, which facilitated communication between the ED staff and the secretarial staff of the subspecialist departments. Over a 1-year period, 150 patients were treated using this system. Charts and radiographs were reviewed for missed injuries. Radiographic review revealed 2 missed injuries. One patient had additional back pain and a lumbar spine fracture was found during the subspecialist follow-up visit; it was treated nonoperatively. Another patient appeared to have scapholunate widening on the injury radiograph that was not appreciated in the ED. Of the 150 patients, 51 were seen in follow-up by a subspecialist at the authors' institution. An electronic system to organize follow-up with a subspecialist allowed the ED providers to deliver safe and effective care for simple musculoskeletal injuries. Copyright 2015, SLACK Incorporated.

  2. 21 CFR 1304.06 - Records and reports for electronic prescriptions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... of this chapter. (c) As required by § 1311.205 of this chapter, a pharmacy that processes electronic... Administration pursuant to §§ 1311.150 and 1311.215 of this chapter. (e) An electronic prescription or pharmacy...

  3. 21 CFR 1304.06 - Records and reports for electronic prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... of this chapter. (c) As required by § 1311.205 of this chapter, a pharmacy that processes electronic... Administration pursuant to §§ 1311.150 and 1311.215 of this chapter. (e) An electronic prescription or pharmacy...

  4. 21 CFR 1304.06 - Records and reports for electronic prescriptions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of this chapter. (c) As required by § 1311.205 of this chapter, a pharmacy that processes electronic... Administration pursuant to §§ 1311.150 and 1311.215 of this chapter. (e) An electronic prescription or pharmacy...

  5. 21 CFR 1304.06 - Records and reports for electronic prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of this chapter. (c) As required by § 1311.205 of this chapter, a pharmacy that processes electronic... Administration pursuant to §§ 1311.150 and 1311.215 of this chapter. (e) An electronic prescription or pharmacy...

  6. 49 CFR 234.315 - Electronic recordkeeping.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Electronic recordkeeping. 234.315 Section 234.315 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... railroad adequately limits and controls accessibility to the records retained in its electronic database...

  7. 49 CFR 234.315 - Electronic recordkeeping.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Electronic recordkeeping. 234.315 Section 234.315 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... railroad adequately limits and controls accessibility to the records retained in its electronic database...

  8. 49 CFR 234.315 - Electronic recordkeeping.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Electronic recordkeeping. 234.315 Section 234.315 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... railroad adequately limits and controls accessibility to the records retained in its electronic database...

  9. Use of administrative and electronic health record data for development of automated algorithms for childhood diabetes case ascertainment and type classification: the SEARCH for Diabetes in Youth Study

    PubMed Central

    Zhong, Victor W.; Pfaff, Emily R.; Beavers, Daniel P.; Thomas, Joan; Jaacks, Lindsay M.; Bowlby, Deborah A.; Carey, Timothy S.; Lawrence, Jean M.; Dabelea, Dana; Hamman, Richard F.; Pihoker, Catherine; Saydah, Sharon H.; Mayer-Davis, Elizabeth J.

    2014-01-01

    Background The performance of automated algorithms for childhood diabetes case ascertainment and type classification may differ by demographic characteristics. Objective This study evaluated the potential of administrative and electronic health record (EHR) data from a large academic care delivery system to conduct diabetes case ascertainment in youth according to type, age and race/ethnicity. Subjects 57,767 children aged <20 years as of December 31, 2011 seen at University of North Carolina Health Care System in 2011 were included. Methods Using an initial algorithm including billing data, patient problem lists, laboratory test results and diabetes related medications between July 1, 2008 and December 31, 2011, presumptive cases were identified and validated by chart review. More refined algorithms were evaluated by type (type 1 versus type 2), age (<10 versus ≥10 years) and race/ethnicity (non-Hispanic white versus “other”). Sensitivity, specificity and positive predictive value were calculated and compared. Results The best algorithm for ascertainment of diabetes cases overall was billing data. The best type 1 algorithm was the ratio of the number of type 1 billing codes to the sum of type 1 and type 2 billing codes ≥0.5. A useful algorithm to ascertain type 2 youth with “other” race/ethnicity was identified. Considerable age and racial/ethnic differences were present in type-non-specific and type 2 algorithms. Conclusions Administrative and EHR data may be used to identify cases of childhood diabetes (any type), and to identify type 1 cases. The performance of type 2 case ascertainment algorithms differed substantially by race/ethnicity. PMID:24913103

  10. Failures and anomalies attributed to spacecraft charging

    NASA Technical Reports Server (NTRS)

    Leach, R. D.; Alexander, M. B. (Editor)

    1995-01-01

    The effects of spacecraft charging can be very detrimental to electronic systems utilized in space missions. Assuring that subsystems and systems are protected against charging is an important engineering function necessary to assure mission success. Spacecraft charging is expected to have a significant role in future space activities and programs. Objectives of this reference publication are to present a brief overview of spacecraft charging, to acquaint the reader with charging history, including illustrative cases of charging anomalies, and to introduce current spacecraft charging prevention activities of the Electromagnetics and Environments Branch, Marshall Space Flight Center (MSFC), National Aeronautics and Space Administration (NASA).

  11. From hospital information system components to the medical record and clinical guidelines & protocols.

    PubMed

    Veloso, M; Estevão, N; Ferreira, P; Rodrigues, R; Costa, C T; Barahona, P

    1997-01-01

    This paper introduces an ongoing project towards the development of a new generation HIS, aiming at the integration of clinical and administrative information within a common framework. Its design incorporates explicit knowledge about domain objects and professional activities to be processed by the system together with related knowledge management services and act management services. The paper presents the conceptual model of the proposed HIS architecture, that supports a rich and fully integrated patient data model, enabling the implementation of a dynamic electronic patient record tightly coupled with computerised guideline knowledge bases.

  12. The impact of interoperability of electronic health records on ambulatory physician practices: a discrete-event simulation study.

    PubMed

    Zhou, Yuan; Ancker, Jessica S; Upadhye, Mandar; McGeorge, Nicolette M; Guarrera, Theresa K; Hegde, Sudeep; Crane, Peter W; Fairbanks, Rollin J; Bisantz, Ann M; Kaushal, Rainu; Lin, Li

    2013-01-01

    The effect of health information technology (HIT) on efficiency and workload among clinical and nonclinical staff has been debated, with conflicting evidence about whether electronic health records (EHRs) increase or decrease effort. None of this paper to date, however, examines the effect of interoperability quantitatively using discrete event simulation techniques. To estimate the impact of EHR systems with various levels of interoperability on day-to-day tasks and operations of ambulatory physician offices. Interviews and observations were used to collect workflow data from 12 adult primary and specialty practices. A discrete event simulation model was constructed to represent patient flows and clinical and administrative tasks of physicians and staff members. High levels of EHR interoperability were associated with reduced time spent by providers on four tasks: preparing lab reports, requesting lab orders, prescribing medications, and writing referrals. The implementation of an EHR was associated with less time spent by administrators but more time spent by physicians, compared with time spent at paper-based practices. In addition, the presence of EHRs and of interoperability did not significantly affect the time usage of registered nurses or the total visit time and waiting time of patients. This paper suggests that the impact of using HIT on clinical and nonclinical staff work efficiency varies, however, overall it appears to improve time efficiency more for administrators than for physicians and nurses.

  13. An Investigation of General Aviation Problems and Issues: An Integration of Pilot-Cockpit Interface Research

    NASA Technical Reports Server (NTRS)

    Bortolussi, Michael R.

    1997-01-01

    The General Aviation (GA) industry has suffered a ten-year decline in the number of airplanes sold. This decline is due mainly to the increase cost associated with purchasing, insuring, maintaining, operating, and pilot training a GA airplane. In response to this decline the Federal Aviation Administration (FAA) and the National Aeronautics and Space Administration (NASA) developed a program (Advanced General Aviation Transport Experiments - AGATE) to address these issues. The purpose of AGATE focused within this report is to reduce the costs to acquire and maintain instrument-flight-proficiency. The AGATE program defined four elements necessary to accomplish these goals: (1) new and intuitive cockpit displays and controls, (2) situation technologies for weather, traffic, and navigation, (3) expert systems for system monitoring, and (4) reduced cost training methods. One recognized need for the GA pilot and airplane is to provide cockpit displays and systems already available to transport category airplane. These displays such as Electronic Flight and Instrument System (EFIS), graphic weather and traffic displays, and flight management systems. The goal of this grant was to develop the AGATE GA Display Evaluation Workstation as a tool to test these existing and emerging technologies in the GA environment.

  14. Impact of Adoption of a Comprehensive Electronic Health Record on Nursing Work and Caring Efficacy.

    PubMed

    Schenk, Elizabeth; Schleyer, Ruth; Jones, Cami R; Fincham, Sarah; Daratha, Kenn B; Monsen, Karen A

    2018-04-23

    Nurses in acute care settings are affected by the technologies they use, including electronic health records. This study investigated the impacts of adoption of a comprehensive electronic health record by measuring nursing locations and interventions in three units before and 12 months after adoption. Time-motion methodology with a handheld recording platform based on Omaha System standardized terminology was used to collect location and intervention data. In addition, investigators administered the Caring Efficacy Scale to better understand the effects of the electronic health record on nursing care efficacy. Several differences were noted after the electronic health record was adopted. Nurses spent significantly more time in patient rooms and less in other measured locations. They spent more time overall performing nursing interventions, with increased time in documentation and medication administration, but less time reporting and providing patient-family teaching. Both before and after electronic health record adoption, nurses spent most of their time in case management interventions (coordinating, planning, and communicating). Nurses showed a slight decrease in perceived caring efficacy after adoption. While initial findings demonstrated a trend toward increased time efficiency, questions remain regarding nurse satisfaction, patient satisfaction, quality and safety outcomes, and cost.

  15. The effect of potential electronic nicotine delivery system regulations on nicotine product selection.

    PubMed

    Pesko, Michael F; Kenkel, Donald S; Wang, Hua; Hughes, Jenna M

    2016-04-01

    To estimate the effect of potential regulations of electronic nicotine delivery systems (ENDS) among adult smokers, including increasing taxes, reducing flavor availability and adding warning labels communicating various levels of risk. We performed a discrete choice experiment (DCE) among a national sample of 1200 adult smokers. We examined heterogeneity in policy responses by age, cigarette quitting interest and current ENDS use. Our experiment overlapped January 2015 by design, providing exogenous variation in cigarette quitting interest from New Year resolutions. KnowledgePanel, an online panel of recruited respondents. A total of 1200 adult smokers from the United States. Hypothetical purchase choice of cigarettes, nicotine replacement therapy and a disposable ENDS. Increasing ENDS prices from $3 to $6 was associated with a 13.6 percentage point reduction in ENDS selection (P < 0.001). Restricting flavor availability in ENDS to tobacco and menthol was associated with a 2.1 percentage point reduction in ENDS selection (P < 0.001). The proposed Food and Drug Administration (FDA) warning label was associated with a 1.1 percentage point reduction in ENDS selection (P < 0.05) and the MarkTen warning label with a 5.1 percentage point reduction (P < 0.001). We estimated an ENDS price elasticity of -1.8 (P < 0.001) among adult smokers. Statistically significant interaction terms (P < 0.001) imply that price responsiveness was higher among adult smokers 18-24 years of age, smokers who have vaped over the last month and smokers with above the median quitting interest. Young adult smokers were 3.7 percentage points more likely to choose ENDS when multiple flavors were available than older adults (P < 0.001). Young adult smokers and those with above the median cigarette quitting interest were also more likely to reduce cigarette selection and increase ENDS selection in January 2015 (P < 0.001), potentially in response to New Year's resolutions to quit smoking. Increased taxes, a proposed US Food and Drug Administration warning label for electronic nicotine delivery systems and a more severe warning label may discourage adult smokers from switching to electronic nicotine delivery systems. Reducing the availability of flavors may reduce ENDS use by young adult smokers. © 2015 Society for the Study of Addiction.

  16. 48 CFR 15.203 - Requests for proposals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... information regarding cost comparisons between Government and contractor performance. (c) Electronic commerce... RFP shall specify the electronic commerce method(s) that offerors may use (see subpart 4.5). (d... and suitability of electronic commerce methods; and (iv) Adequacy of administrative procedures and...

  17. 76 FR 411 - Regulatory Guidance Concerning Electronic Signatures and Documents

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-04

    ... Concerning Electronic Signatures and Documents AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of regulatory guidance. SUMMARY: FMCSA issues regulatory guidance concerning the... regulatory guidance concerning the use of electronic signatures and documents to comply with FMCSA...

  18. 32 CFR 2001.23 - Classification marking in the electronic environment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.23 Classification marking in the electronic environment. (a) General. Classified national security information in the electronic environment shall be: (1...

  19. 32 CFR 2001.23 - Classification marking in the electronic environment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.23 Classification marking in the electronic environment. (a) General. Classified national security information in the electronic environment shall be: (1...

  20. 32 CFR 2001.23 - Classification marking in the electronic environment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.23 Classification marking in the electronic environment. (a) General. Classified national security information in the electronic environment shall be: (1...

  1. 32 CFR 2001.23 - Classification marking in the electronic environment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.23 Classification marking in the electronic environment. (a) General. Classified national security information in the electronic environment shall be: (1...

  2. 32 CFR 2001.23 - Classification marking in the electronic environment.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Identification and Markings § 2001.23 Classification marking in the electronic environment. (a) General. Classified national security information in the electronic environment shall be: (1...

  3. The use of information technology to enhance patient safety and nursing efficiency.

    PubMed

    Lee, Tso-Ying; Sun, Gi-Tseng; Kou, Li-Tseng; Yeh, Mei-Ling

    2017-10-23

    Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this. The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan. This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, bar code scanning, shift handover, and information and communication integration. Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34). Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment.

  4. Pilot Study of iPad Incorporation Into Graduate Medical Education.

    PubMed

    Lobo, Mark J; Crandley, Edwin F; Rumph, Jake S; Kirk, Susan E; Dunlap, Neal E; Rahimi, Asal S; Turner, A Benton; Larner, James M; Read, Paul W

    2013-03-01

    Increased documentation and charting requirements are challenging for residents, given duty hour limits. Use of mobile electronic devices may help residents complete these tasks efficiently. To collect initial data on usage rates, information technology (IT) support requirements, and resident use of iPads during training. In this pilot study, we provided 12 residents/fellows from various specialties at the University of Virginia with an iPad with IT support. The system used a virtual private network with access to the institution's electronic health record. Participants were allowed to develop their own methods and systems for personalized iPad use, and after 9 months they provided data on the utility of the iPad. Feedback from the IT team also was obtained. Average iPad use was 2.1 h/d (range, 0.5-6 h/d). The average self-reported reduction in administrative work due to the iPad was 2.7 h/wk (range, 0-9 h/wk). A total of 75% (9 of 12) of the users would recommend universal adoption among residents and fellows. More than 90% (11 of 12) of users reported the iPad would improve communication for coordination of care. A total of 68% (8 of 12) of users reported that an iPad facilitated their activities as educators of medical students and junior residents. Residents cited slow data entry into the electronic health record and hospital areas lacking Wi-Fi connectivity as potential drawbacks to iPad use. The IT team reported minimal support time for device setup, maintenance, and upgrades, and limited security risks. The iPad may contribute to increased clinical efficiency, reduced hours spent on administrative tasks, and enhanced educational opportunities for residents, with minimal IT support.

  5. A technology ecosystem perspective on hospital management information systems: lessons from the health literature.

    PubMed

    Bain, Christopher A; Standing, Craig

    2009-01-01

    Hospital managers have a large range of information needs including quality metrics, financial reports, access information needs, educational, resourcing and decision support needs. Currently these needs involve interactions by managers with numerous disparate systems, both electronic such as SAP, Oracle Financials, PAS' (patient administration systems) like HOMER, and relevant websites; and paper-based systems. Hospital management information systems (HMIS) can be thought of sitting within a Technology Ecosystem (TE). In addition, Hospital Management Information Systems (HMIS) could benefit from a broader and deeper TE model, and the HMIS environment may in fact represents its own TE (the HMTE). This research will examine lessons from the health literature in relation to some of these issues, and propose an extension to the base model of a TE.

  6. 77 FR 76049 - Draft Guidance for Industry on Electronic Source Data in Clinical Investigations; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ..., Office of Planning & Informatics, Center for Drug Evaluation and Research, Food and Drug Administration... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0643...: Food and Drug Administration, HHS. ACTION: Notice; correction. [[Page 76050

  7. 76 FR 5402 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Gear...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... (DOL) hereby announces the submission of the Occupational Safety and Health Administration (OSHA... Officer for the Department of Labor, Occupational Safety and Health Administration (OSHA), Office of... electronic submission of responses. Agency: Occupational Safety and Health Administration (OSHA). Title of...

  8. 77 FR 5060 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Bloodborne...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... of Labor (DOL) is submitting the Occupational Safety and Health Administration (OSHA) sponsored..., Occupational Safety and Health Administration (OSHA), Office of Management and Budget, Room 10235, Washington... electronic submission of responses. Agency: Occupational Safety and Health Administration (OSHA). Title of...

  9. 75 FR 81660 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Logging...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ..., Attn: OMB Desk Officer for the Department of Labor, Occupational Safety and Health Administration (OSHA...., permitting electronic submission of responses. Agency: Occupational Safety and Health Administration (OSHA... of Labor (DOL) hereby announces the submission of the Occupational Safety and Health Administration...

  10. 77 FR 3499 - Sony Electronics, Inc., Including On-Site Leased Workers From Selectremedy Park Ridge, NJ...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-24

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,501M] Sony Electronics, Inc... Electronics, Inc., SEL Headquarters, including on-site leased workers of SelectRemedy, StaffMark, and Payrolling.com , San Diego, California (TA-W-71,501); Sony Electronics, Inc., including on-site leased...

  11. An Economic Assessment of Electronic Text. Report Number Six of the Electronic Text Report Series.

    ERIC Educational Resources Information Center

    Carey, John

    This report outlines economic components that will eventually contribute to large models of electronic text services in institutions of higher education, and provides a simple and practical assessment of economic issues associated with electronic text for college administrators, faculty, and planners. This assessment constitutes a layman's guide…

  12. 36 CFR § 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements apply to electronic records? § 1235.44 Section § 1235.44 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO THE NATIONAL... requirements apply to electronic records? (a) Each agency must retain a copy of permanent electronic records...

  13. 76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration... Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review... were granted power of attorney by veterans who have medical information recorded in VHA electronic...

  14. 36 CFR § 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements for managing electronic mail records? § 1236.22 Section § 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT... management requirements for electronic mail records: (1) The names of sender and all addressee(s) and date...

  15. 36 CFR § 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements for managing unstructured electronic records? § 1236.24 Section § 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for...

  16. We Work with Them? Healthcare Workers Interpretation of Organizational Relations Mined from Electronic Health Records

    PubMed Central

    Chen, You; Lorenzi, Nancy; Nyemba, Steve; Schildcrout, Jonathan S.; Malin, Bradley

    2014-01-01

    Objective Models of healthcare organizations (HCOs) are often defined up front by a select few administrative officials and managers. However, given the size and complexity of modern healthcare systems, this practice does not scale easily. The goal of this work is to investigate the extent to which organizational relationships can be automatically learned from utilization patterns of electronic health record (EHR) systems. Method We designed an online survey to solicit the perspectives of employees of a large academic medical center. We surveyed employees from two administrative areas: 1) Coding & Charge Entry and 2) Medical Information Services and two clinical areas: 3) Anesthesiology and 4) Psychiatry. To test our hypotheses we selected two administrative units that have work-related responsibilities with electronic records; however, for the clinical areas we selected two disciplines with very different patient responsibilities and whose accesses and people who accessed were similar. We provided each group of employees with questions regarding the chance of interaction between areas in the medical center in the form of association rules (e.g., Given someone from Coding & Charge Entry accessed a patient’s record, what is the chance that someone from Medical Information Services access the same record?). We compared the respondent predictions with the rules learned from actual EHR utilization using linear-mixed effects regression models. Results The findings from our survey confirm that medical center employees can distinguish between association rules of high and non-high likelihood when their own area is involved. Moreover, they can make such distinctions between for any HCO area in this survey. It was further observed that, with respect to highly likely interactions, respondents from certain areas were significantly better than other respondents at making such distinctions and certain areas’ associations were more distinguishable than others. Conclusions These results illustrate that EHR utilization patterns may be consistent with the expectations of HCO employees. Our findings show that certain areas in the HCO are easier than others for employees to assess, which suggests that automated learning strategies may yield more accurate models of healthcare organizations than those based on the perspectives of a select few individuals. PMID:24845147

  17. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  18. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  19. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  20. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

Some links on this page may take you to non-federal websites. Their policies may differ from this site.
Top