Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry.

PubMed

Harper, Marvin B; Longhurst, Christopher A; McGuire, Troy L; Tarrago, Rod; Desai, Bimal R; Patterson, Al

2014-03-01

The study aims to develop a core set of pediatric drug-drug interaction (DDI) pairs for which electronic alerts should be presented to prescribers during the ordering process. A clinical decision support working group composed of Children's Hospital Association (CHA) members was developed. CHA Pharmacists and Chief Medical Information Officers participated. Consensus was reached on a core set of 19 DDI pairs that should be presented to pediatric prescribers during the order process. We have provided a core list of 19 high value drug pairs for electronic drug-drug interaction alerts to be recommended for inclusion as high value alerts in prescriber order entry software used with a pediatric patient population. We believe this list represents the most important pediatric drug interactions for practical implementation within computerized prescriber order entry systems.

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

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.

Usability Evaluation at the Point-of-Care: A Method to Identify User Information Needs in CPOE Applications

PubMed Central

Washburn, Jeff; Fiol, Guilherme Del; Rocha, Roberto A.

2006-01-01

Point of care usability evaluation may help identify information needs that occur during the process of providing care. We describe the process of using usability-specific recording software to record Computerized Physician Order Entry (CPOE) ordering sessions on admitted adult and pediatric patients at two urban tertiary hospitals in the Intermountain Healthcare system of hospitals. PMID:17238756

Inside EUREKA. The California Career Information System.

ERIC Educational Resources Information Center

Banaghan, Bill; And Others

A computerized career information system named EUREKA has been developed for California. It originated in 1975-76 under the direction of the Bay Area Computer Educators and since that time has received state and VEA funding. It consists of two major components, Quest and information files. Quest asks users twenty-one questions in order to…

Mixed results in the safety performance of computerized physician order entry.

PubMed

Metzger, Jane; Welebob, Emily; Bates, David W; Lipsitz, Stuart; Classen, David C

2010-04-01

Computerized physician order entry is a required feature for hospitals seeking to demonstrate meaningful use of electronic medical record systems and qualify for federal financial incentives. A national sample of sixty-two hospitals voluntarily used a simulation tool designed to assess how well safety decision support worked when applied to medication orders in computerized order entry. The simulation detected only 53 percent of the medication orders that would have resulted in fatalities and 10-82 percent of the test orders that would have caused serious adverse drug events. It is important to ascertain whether actual implementations of computerized physician order entry are achieving goals such as improved patient safety.

An automated library financial management system

NASA Technical Reports Server (NTRS)

Dueker, S.; Gustafson, L.

1977-01-01

A computerized library acquisition system developed for control of informational materials acquired at NASA Ames Research Center is described. The system monitors the acquisition of both library and individual researchers' orders and supplies detailed financial, statistical, and bibliographical information. Applicability for other libraries and the future availability of the program is discussed.

77 FR 25710 - Agency Information Collection Extension

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-01

... Accident/Incident Reporting System (CAIRS); Occurrence Reporting and Processing System (ORPS); Noncompliance Tracking System (NTS); Radiation Exposure Monitoring System (REMS); Annual Fire Protection Summary... following additional authorities: Computerized Accident/Incident Reporting System (CAIRS): DOE Order 231.1B...

A mapping of information security in health Information Systems in Latin America and Brazil.

PubMed

Pereira, Samáris Ramiro; Fernandes, João Carlos Lopes; Labrada, Luis; Bandiera-Paiva, Paulo

2013-01-01

In health, Information Systems are patient records, hospital administration or other, have advantages such as cost, availability and integration. However, for these benefits to be fully met, it is necessary to guarantee the security of information maintained and provided by the systems. The lack of security can lead to serious consequences such as lawsuits and induction to medical errors. The management of information security is complex and is used in various fields of knowledge. Often, it is left in the background for not being the ultimate goal of a computer system, causing huge financial losses to corporations. This paper by systematic review methodologies, presented a mapping in the literature, in order to identify the most relevant aspects that are addressed by security researchers of health information, as to the development of computerized systems. They conclude through the results, some important aspects, for which the managers of computerized health systems should remain alert.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... magnetic media, such as magnetic tapes or magnetic diskettes, containing the computerized information at.... The computerized magnetic media shall be prepared and delivered at the committee's expense and shall... Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal...

Protecting Privacy in Computerized Medical Information.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This report analyzes the implications of computerized medical information and the challenges it brings to individual privacy. The report examines the nature of the privacy interest in health care information and the current state of the law protecting that information; the nature of proposals to computerize health care information and the…

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

15 CFR 950.9 - Computerized Environmental Data and Information Retrieval Service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Information Retrieval Service. 950.9 Section 950.9 Commerce and Foreign Trade Regulations Relating to Commerce... Computerized Environmental Data and Information Retrieval Service. The Environmental Data Index (ENDEX... computerized, information retrieval service provides a parallel subject-author-abstract referral service. A...

Computerized tomography versus magnetic resonance imaging: a comparative study in hypothalamic-pituitary and parasellar pathology.

PubMed

Webb, S M; Ruscalleda, J; Schwarzstein, D; Calaf-Alsina, J; Rovira, A; Matos, G; Puig-Domingo, M; de Leiva, A

1992-05-01

We wished to analyse the relative value of computerized tomography and magnetic resonance in patients referred for evaluation of pituitary and parasellar lesions. We performed a separate evaluation by two independent neuroradiologists of computerized tomography and magnetic resonance images ordered numerically and anonymously, with no clinical data available. We studied 40 patients submitted for hypothalamic-pituitary study; 31 were carried out preoperatively, of which histological confirmation later became available in 14. The remaining nine patients were evaluated postoperatively. Over 40 parameters relating to the bony margins, cavernous sinuses, carotid arteries, optic chiasm, suprasellar cisterns, pituitary, pituitary stalk and extension of the lesion were evaluated. These reports were compared with the initial ones offered when the scans were ordered, and with the final diagnosis. Concordance between initial computerized tomography and magnetic resonance was observed in 27 cases (67.5%); among the discordant cases computerized tomography showed the lesion in two, magnetic resonance in 10, while in the remaining case reported to harbour a microadenoma on computerized tomography the differential diagnosis between a true TSH-secreting microadenoma and pituitary resistance to thyroid hormones is still unclear. Both neuroradiologists coincided in their reports in 32 patients (80%); when the initial report was compared with those of the neuroradiologists, concordance was observed with at least one of them in 34 instances (85%). Discordant results were observed principally in microadenomas secreting ACTH or PRL and in delayed puberty. In the eight patients with Cushing's disease (histologically confirmed in six) magnetic resonance was positive in five and computerized tomography in two; the abnormal image correctly identified the side of the lesion at surgery. In patients referred for evaluation of Cushing's syndrome or hyperprolactinaemia (due to microadenomas) or after surgery, magnetic resonance is clearly preferable to computerized tomography. In macroadenomas both scans are equally diagnostic but magnetic resonance offers more information on pituitary morphology and neighbouring structures. Nevertheless, there are cases in which the results of computerized tomography and magnetic resonance will complement each other, since different parameters are analysed with each examination and discordant results are encountered.

An Analysis of the External Environmental and Internal Organizational Factors Associated with Adoption of the Electronic Health Record

ERIC Educational Resources Information Center

Kruse, Clemens Scott

2013-01-01

Despite a Presidential Order in 2004 that launched national incentives for the use of health information technology, specifically the Electronic Health Record (EHR), adoption of the EHR has been slow. This study attempts to quantify factors associated with adoption of the EHR and Computerized Provider Order Entry (CPOE) by combining multiple…

An overview of selected information storage and retrieval issues in computerized document processing

NASA Technical Reports Server (NTRS)

Dominick, Wayne D. (Editor); Ihebuzor, Valentine U.

1984-01-01

The rapid development of computerized information storage and retrieval techniques has introduced the possibility of extending the word processing concept to document processing. A major advantage of computerized document processing is the relief of the tedious task of manual editing and composition usually encountered by traditional publishers through the immense speed and storage capacity of computers. Furthermore, computerized document processing provides an author with centralized control, the lack of which is a handicap of the traditional publishing operation. A survey of some computerized document processing techniques is presented with emphasis on related information storage and retrieval issues. String matching algorithms are considered central to document information storage and retrieval and are also discussed.

[Computerized acquisition and elaboration of clinical data in Rheumatology during ten years: state of art and prospectives

PubMed

Troise Rioda, W.; Nervetti, A.

2001-01-01

The well known complexity to collect the clinical data of patients and in particular in the area of rheumatology push us to develop a computerized clinical chart in order to facilitate the classification, evaluation and monitoring of these patients. The proposed computerized clinical chart is easy to use but at the same time is a very potent tool that allow the clinicians to organize the classic rheumatological pathologies as well as the more complexes or even rare. The proposed clinical chart is based on a relational database (FileMaker Pro 5.0v1) available for both the actual operative systems implemented on personal computers (Windows and Macintosh); this allow the full compatibility among the two systems, the possibility of exchanging data without any loss of information. The computerized clinical chart is structured on modules for specific pathologies and for homogeneous groups of illnesses. Basically the modules are defined correlated files of data for a specific pathology but that can be used also as a common pool for different pathologies. Our experience, based on ten years of use, indicates in the computerized rheumatological clinical chart an indispensable tool for rheumatologists with a real friendly use.

3D multimodal cardiac data reconstruction using angiography and computerized tomographic angiography registration.

PubMed

Moosavi Tayebi, Rohollah; Wirza, Rahmita; Sulaiman, Puteri S B; Dimon, Mohd Zamrin; Khalid, Fatimah; Al-Surmi, Aqeel; Mazaheri, Samaneh

2015-04-22

Computerized tomographic angiography (3D data representing the coronary arteries) and X-ray angiography (2D X-ray image sequences providing information about coronary arteries and their stenosis) are standard and popular assessment tools utilized for medical diagnosis of coronary artery diseases. At present, the results of both modalities are individually analyzed by specialists and it is difficult for them to mentally connect the details of these two techniques. The aim of this work is to assist medical diagnosis by providing specialists with the relationship between computerized tomographic angiography and X-ray angiography. In this study, coronary arteries from two modalities are registered in order to create a 3D reconstruction of the stenosis position. The proposed method starts with coronary artery segmentation and labeling for both modalities. Then, stenosis and relevant labeled artery in X-ray angiography image are marked by a specialist. Proper control points for the marked artery in both modalities are automatically detected and normalized. Then, a geometrical transformation function is computed using these control points. Finally, this function is utilized to register the marked artery from the X-ray angiography image on the computerized tomographic angiography and get the 3D position of the stenosis lesion. The result is a 3D informative model consisting of stenosis and coronary arteries' information from the X-ray angiography and computerized tomographic angiography modalities. The results of the proposed method for coronary artery segmentation, labeling and 3D reconstruction are evaluated and validated on the dataset containing both modalities. The advantage of this method is to aid specialists to determine a visual relationship between the correspondent coronary arteries from two modalities and also set up a connection between stenosis points from an X-ray angiography along with their 3D positions on the coronary arteries from computerized tomographic angiography. Moreover, another benefit of this work is that the medical acquisition standards remain unchanged, which means that no calibration in the acquisition devices is required. It can be applied on most computerized tomographic angiography and angiography devices.

Computerized N-acetylcysteine physician order entry by template protocol for acetaminophen toxicity.

PubMed

Thompson, Trevonne M; Lu, Jenny J; Blackwood, Louisa; Leikin, Jerrold B

2011-01-01

Some medication dosing protocols are logistically complex for traditional physician ordering. The use of computerized physician order entry (CPOE) with templates, or order sets, may be useful to reduce medication administration errors. This study evaluated the rate of medication administration errors using CPOE order sets for N-acetylcysteine (NAC) use in treating acetaminophen poisoning. An 18-month retrospective review of computerized inpatient pharmacy records for NAC use was performed. All patients who received NAC for the treatment of acetaminophen poisoning were included. Each record was analyzed to determine the form of NAC given and whether an administration error occurred. In the 82 cases of acetaminophen poisoning in which NAC was given, no medication administration errors were identified. Oral NAC was given in 31 (38%) cases; intravenous NAC was given in 51 (62%) cases. In this retrospective analysis of N-acetylcysteine administration using computerized physician order entry and order sets, no medication administration errors occurred. CPOE is an effective tool in safely executing complicated protocols in an inpatient setting.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... conform to the technical specifications, including file requirements, described in the Federal Election Commission's Computerized Magnetic Media Requirements for title 26 Candidates/Committees Receiving Federal... outstanding campaign obligations. (b) Organization of computerized information and technical specifications...

Computerized method for detection of vertebral fractures on lateral chest radiographs based on morphometric data

NASA Astrophysics Data System (ADS)

Kasai, Satoshi; Li, Feng; Shiraishi, Junji; Li, Qiang; Straus, Christopher; Vokes, Tamara; MacMahon, Heber; Doi, Kunio

2007-03-01

Vertebral fractures are the most common osteoporosis-related fractures. It is important to detect vertebral fractures, because they are associated with increased risk of subsequent fractures, and because pharmacologic therapy can reduce the risk of subsequent fractures. Although vertebral fractures are often not clinically recognized, they can be visualized on lateral chest radiographs taken for other purposes. However, only 15-60% of vertebral fractures found on lateral chest radiographs are mentioned in radiology reports. The purpose of this study was to develop a computerized method for detection of vertebral fractures on lateral chest radiographs in order to assist radiologists' image interpretation. Our computerized method is based on the automated identification of upper and lower vertebral edges. In order to develop the scheme, radiologists provided morphometric data for each identifiable vertebra, which consisted of six points for each vertebra, for 25 normals and 20 cases with severe fractures. Anatomical information was obtained from morphometric data of normal cases in terms of vertebral heights, heights of vertebral disk spaces, and vertebral centerline. Computerized detection of vertebral fractures was based on the reduction in the heights of fractured vertebrae compared to adjacent vertebrae and normal reference data. Vertebral heights from morphometric data on normal cases were used as reference. On 138 chest radiographs (20 with fractures) the sensitivity of our method for detection of fracture cases was 95% (19/20) with 0.93 (110/118) false-positives per image. In conclusion, the computerized method would be useful for detection of potentially overlooked vertebral fractures on lateral chest radiographs.

Exploiting Semantic Web Technologies to Develop OWL-Based Clinical Practice Guideline Execution Engines.

PubMed

Jafarpour, Borna; Abidi, Samina Raza; Abidi, Syed Sibte Raza

2016-01-01

Computerizing paper-based CPG and then executing them can provide evidence-informed decision support to physicians at the point of care. Semantic web technologies especially web ontology language (OWL) ontologies have been profusely used to represent computerized CPG. Using semantic web reasoning capabilities to execute OWL-based computerized CPG unties them from a specific custom-built CPG execution engine and increases their shareability as any OWL reasoner and triple store can be utilized for CPG execution. However, existing semantic web reasoning-based CPG execution engines suffer from lack of ability to execute CPG with high levels of expressivity, high cognitive load of computerization of paper-based CPG and updating their computerized versions. In order to address these limitations, we have developed three CPG execution engines based on OWL 1 DL, OWL 2 DL and OWL 2 DL + semantic web rule language (SWRL). OWL 1 DL serves as the base execution engine capable of executing a wide range of CPG constructs, however for executing highly complex CPG the OWL 2 DL and OWL 2 DL + SWRL offer additional executional capabilities. We evaluated the technical performance and medical correctness of our execution engines using a range of CPG. Technical evaluations show the efficiency of our CPG execution engines in terms of CPU time and validity of the generated recommendation in comparison to existing CPG execution engines. Medical evaluations by domain experts show the validity of the CPG-mediated therapy plans in terms of relevance, safety, and ordering for a wide range of patient scenarios.

In-Process Items on LCS.

ERIC Educational Resources Information Center

Russell, Thyra K.

Morris Library at Southern Illinois University computerized its technical processes using the Library Computer System (LCS), which was implemented in the library to streamline order processing by: (1) providing up-to-date online files to track in-process items; (2) encouraging quick, efficient accessing of information; (3) reducing manual files;…

El Camino Hospital: using health information technology to promote patient safety.

PubMed

Bukunt, Susan; Hunter, Christine; Perkins, Sharon; Russell, Diana; Domanico, Lee

2005-10-01

El Camino Hospital is a leader in the use of health information technology to promote patient safety, including bar coding, computerized order entry, electronic medical records, and wireless communications. Each year, El Camino Hospital's board of directors sets performance expectations for the chief executive officer, which are tied to achievement of local, regional, and national safety and quality standards, including the six Institute of Medicine quality dimensions. He then determines a set of explicit quality goals and measurable actions, which serve as guidelines for the overall hospital. The goals and progress reports are widely shared with employees, medical staff, patients and families, and the public. For safety, for example, the medication error reduction team tracks and reviews medication error rates. The hospital has virtually eliminated transcription errors through its 100% use of computerized physician order entry. Clinical pathways and standard order sets have reduced practice variation, providing a safer environment. Many projects focused on timeliness, such as emergency department wait time, lab turnaround time, and pneumonia time to initial antibiotic. Results have been mixed, with projects most successful when a link was established with patient outcomes, such as in reducing time to percutaneous transluminal coronary angioplasty for patients with acute myocardial infarction.

Computerized Physician Order Entry

PubMed Central

Khanna, Raman; Yen, Tony

2014-01-01

Computerized physician order entry (CPOE) has been promoted as an important component of patient safety, quality improvement, and modernization of medical practice. In practice, however, CPOE affects health care delivery in complex ways, with benefits as well as risks. Every implementation of CPOE is associated with both generally recognized and unique local factors that can facilitate or confound its rollout, and neurohospitalists will often be at the forefront of such rollouts. In this article, we review the literature on CPOE, beginning with definitions and proceeding to comparisons to the standard of care. We then proceed to discuss clinical decision support systems, negative aspects of CPOE, and cultural context of CPOE implementation. Before concluding, we follow the experiences of a Chief Medical Information Officer and neurohospitalist who rolled out a CPOE system at his own health care organization and managed the resulting workflow changes and setbacks. PMID:24381708

Word Lists and Languages. Technical Report No. 2.

ERIC Educational Resources Information Center

Grimes, Joseph E.

In order to store sociolinguistic information about the world's languages, Cornell University, The University of Oklahoma, and the Summer Institute of Linguistics formed a computerized data base. This report summarizes work done by that project. The first part of the report contains data on the languages of the world. The complete data base,…

Computerization of the Newspaper in the 1980s.

ERIC Educational Resources Information Center

Garrison, Bruce

A review of the literature on the computerization of newspaper newsrooms shows that since 1960, computers have assumed an increasingly important role in information collection, news writing and editing, pagination, and news transmission. When newspaper libraries are computerized, reporters are able to find information more quickly and to use…

Computerized decision support for medication dosing in renal insufficiency: a randomized, controlled trial.

PubMed

Terrell, Kevin M; Perkins, Anthony J; Hui, Siu L; Callahan, Christopher M; Dexter, Paul R; Miller, Douglas K

2010-12-01

Emergency physicians prescribe several discharge medications that require dosage adjustment for patients with renal disease. The hypothesis for this research was that decision support in a computerized physician order entry system would reduce the rate of excessive medication dosing for patients with renal impairment. This was a randomized, controlled trial in an academic emergency department (ED), in which computerized physician order entry was used to write all prescriptions for patients being discharged from the ED. The sample included 42 physicians who were randomized to the intervention (21 physicians) or control (21 physicians) group. The intervention was decision support that provided dosing recommendations for targeted medications for patients aged 18 years and older when the patient's estimated creatinine clearance level was below the threshold for dosage adjustment. The primary outcome was the proportion of targeted medications that were excessively dosed. For 2,783 (46%) of the 6,015 patient visits, the decision support had sufficient information to estimate the patient's creatinine clearance level. The average age of these patients was 46 years, 1,768 (64%) were women, and 1,523 (55%) were black. Decision support was provided 73 times to physicians in the intervention group, who excessively dosed 31 (43%) prescriptions. In comparison, control physicians excessively dosed a significantly larger proportion of medications: 34 of 46, 74% (effect size=31%; 95% confidence interval 14% to 49%; P=.001). Emergency physicians often prescribed excessive doses of medications that require dosage adjustment for renal impairment. Computerized physician order entry with decision support significantly reduced excessive dosing of targeted medications. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Principles for a Successful Computerized Physician Order Entry Implementation

PubMed Central

Ash, Joan S.; Fournier, Lara; Stavri, P. Zoë; Dykstra, Richard

2003-01-01

To identify success factors for implementing computerized physician order entry (CPOE), our research team took both a top-down and bottom-up approach and reconciled the results to develop twelve overarching principles to guide implementation. A consensus panel of experts produced ten Considerations with nearly 150 sub-considerations, and a three year project using qualitative methods at multiple successful sites for a grounded theory approach yielded ten general themes with 24 sub-themes. After reconciliation using a meta-matrix approach, twelve Principles, which cluster into groups forming the mnemonic CPOE emerged. Computer technology principles include: temporal concerns; technology and meeting information needs; multidimensional integration; and costs. Personal principles are: value to users and tradeoffs; essential people; and training and support. Organizational principles include: foundational underpinnings; collaborative project management; terms, concepts and connotations; and improvement through evaluation and learning. Finally, Environmental issues include the motivation and context for implementing such systems. PMID:14728129

Computerized physician order entry: promise, perils, and experience.

PubMed

Khanna, Raman; Yen, Tony

2014-01-01

Computerized physician order entry (CPOE) has been promoted as an important component of patient safety, quality improvement, and modernization of medical practice. In practice, however, CPOE affects health care delivery in complex ways, with benefits as well as risks. Every implementation of CPOE is associated with both generally recognized and unique local factors that can facilitate or confound its rollout, and neurohospitalists will often be at the forefront of such rollouts. In this article, we review the literature on CPOE, beginning with definitions and proceeding to comparisons to the standard of care. We then proceed to discuss clinical decision support systems, negative aspects of CPOE, and cultural context of CPOE implementation. Before concluding, we follow the experiences of a Chief Medical Information Officer and neurohospitalist who rolled out a CPOE system at his own health care organization and managed the resulting workflow changes and setbacks.

Information Retrieval Performance of Probabilistically Generated, Problem-Specific Computerized Provider Order Entry Pick-Lists: A Pilot Study

PubMed Central

Rothschild, Adam S.; Lehmann, Harold P.

2005-01-01

Objective: The aim of this study was to preliminarily determine the feasibility of probabilistically generating problem-specific computerized provider order entry (CPOE) pick-lists from a database of explicitly linked orders and problems from actual clinical cases. Design: In a pilot retrospective validation, physicians reviewed internal medicine cases consisting of the admission history and physical examination and orders placed using CPOE during the first 24 hours after admission. They created coded problem lists and linked orders from individual cases to the problem for which they were most indicated. Problem-specific order pick-lists were generated by including a given order in a pick-list if the probability of linkage of order and problem (PLOP) equaled or exceeded a specified threshold. PLOP for a given linked order-problem pair was computed as its prevalence among the other cases in the experiment with the given problem. The orders that the reviewer linked to a given problem instance served as the reference standard to evaluate its system-generated pick-list. Measurements: Recall, precision, and length of the pick-lists. Results: Average recall reached a maximum of .67 with a precision of .17 and pick-list length of 31.22 at a PLOP threshold of 0. Average precision reached a maximum of .73 with a recall of .09 and pick-list length of .42 at a PLOP threshold of .9. Recall varied inversely with precision in classic information retrieval behavior. Conclusion: We preliminarily conclude that it is feasible to generate problem-specific CPOE pick-lists probabilistically from a database of explicitly linked orders and problems. Further research is necessary to determine the usefulness of this approach in real-world settings. PMID:15684134

[Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

PubMed

Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

2009-10-01

The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

45 CFR 307.11 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2014 CFR

2014-10-01

... (2) The capability to perform the following tasks with the frequency and in the manner required under... business days after receipt of notice of income, and the income source subject to withholding from a court... orders through an automated information network in meeting paragraph (e)(2)(ii) of this section provided...

45 CFR 307.11 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2010 CFR

2010-10-01

...; (ii) Social security numbers; (iii) Dates of birth; (iv) Case identification numbers; (v) Other... collected amounts; (v) The birth date and, beginning no later than October 1, 1999, the name and social... orders through an automated information network in meeting paragraph (e)(2)(ii) of this section provided...

12 CFR 978.8 - Computer data.

Code of Federal Regulations, 2010 CFR

2010-01-01

... security of the computerized data stored in a Bank's computer and restrict access to such data in order to... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Computer data. 978.8 Section 978.8 Banks and... REQUESTS FOR INFORMATION § 978.8 Computer data. Nothing in this part shall preclude a Bank from arranging...

12 CFR 978.8 - Computer data.

Code of Federal Regulations, 2011 CFR

2011-01-01

... security of the computerized data stored in a Bank's computer and restrict access to such data in order to... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Computer data. 978.8 Section 978.8 Banks and... REQUESTS FOR INFORMATION § 978.8 Computer data. Nothing in this part shall preclude a Bank from arranging...

12 CFR 978.8 - Computer data.

Code of Federal Regulations, 2013 CFR

2013-01-01

... security of the computerized data stored in a Bank's computer and restrict access to such data in order to... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Computer data. 978.8 Section 978.8 Banks and... REQUESTS FOR INFORMATION § 978.8 Computer data. Nothing in this part shall preclude a Bank from arranging...

12 CFR 978.8 - Computer data.

Code of Federal Regulations, 2012 CFR

2012-01-01

... security of the computerized data stored in a Bank's computer and restrict access to such data in order to... 12 Banks and Banking 8 2012-01-01 2012-01-01 false Computer data. 978.8 Section 978.8 Banks and... REQUESTS FOR INFORMATION § 978.8 Computer data. Nothing in this part shall preclude a Bank from arranging...

[Survey on computerized immunization registries in Italy].

PubMed

Alfonsi, V; D'Ancona, F; Ciofi degli Atti, M L

2008-01-01

Computerized immunization registries are essential for conducting and monitoring vaccination programs. In fact, they enable to improve vaccine offering to target population, generating needed-immunization lists and assessing levels of vaccination coverage. In 2007, a national survey on immunization registries was conducted in Italy. In February 2007, all the 21 Regional Health Authorities (RHAs) completed and returned an ad hoc questionnaire. In June 2007, RHAs were further contacted by telephone in order to verify and update the information provided in questionnaires. In 9 Italian Regions (42.8%), vaccination registries are computerized in all Local Health Units (LHUs). In five of these Regions, all LHUs use the same software, while in the remaining four Regions, different softwares are in use. In six additional Regions (28.6%), only some LHUs use computerized immunization registries (range 61.5%-95%). In the remaining 6 Regions (28.6%), which are all in Southern Italy, there are no computerised immunization registries at all. In total, computerised immunization registries cover 126/180 Italian LHUs (70%); in 76/126 (60%) of these LUHs, immunization registries are linked with population registries. This survey shows the need to improve the implementation of computerised immunization registries in Italy, especially in Southern Regions.

Vocational Education as an Innovation in the Republic of China--Computerization of School Administration.

ERIC Educational Resources Information Center

Chang, Frank Tien-Jin

Computerized school administration has become one of the most crucial innovations in vocational education in Taiwan in the Republic of China. As these educators begin to design or purchase computerized information systems for their own schools, they must first define their specific information needs. Next, they should pay attention to…

Computerized provider order entry systems - Research imperatives and organizational challenges facing pathology services.

PubMed

Georgiou, Andrew; Westbrook, Johanna; Braithwaite, Jeffrey

2010-07-13

Information and communication technologies (ICT) are contributing to major changes taking place in pathology and within health services more generally. In this article, we draw on our research experience for over 7 years investigating the implementation and diffusion of computerized provider order entry (CPOE) systems to articulate some of the key informatics challenges confronting pathology laboratories. The implementation of these systems, with their improved information management and decision support structures, provides the potential for enhancing the role that pathology services play in patient care pathways. Beyond eliminating legibility problems, CPOE systems can also contribute to the efficiency and safety of healthcare, reducing the duplication of test orders and diminishing the risk of misidentification of patient samples and orders. However, despite the enthusiasm for CPOE systems, their diffusion across healthcare settings remains variable and is often beset by implementation problems. Information systems like CPOE may have the ability to integrate work, departments and organizations, but unfortunately, health professionals, departments and organizations do not always want to be integrated in ways that information systems allow. A persistent theme that emerges from the research evidence is that one size does not fit all, and system success or otherwise is reliant on the conditions and circumstances in which they are located. These conditions and circumstances are part of what is negotiated in the complex, messy and challenging area of ICT implementation. The solution is not likely to be simple and easy, but current evidence suggests that a combination of concerted efforts, better research designs, more sophisticated theories and hypotheses as well as more skilled, multidisciplinary research teams, tackling this area of study will bring substantial benefits, improving the effectiveness of pathology services, and, as a direct corollary, the quality of patient care.

Evaluation of the Salt Lake City Computerized Rider Information System

DOT National Transportation Integrated Search

1985-11-01

The Utah Transit Authority (UTA) Computerized Rider Information System (CRIS) project involved the installation of an automated telephone service to quickly provide bus stop-specific schedule and service information to residents throughout the Author...

The effects of mild and severe traumatic brain injury on speed of information processing as measured by the computerized tests of information processing (CTIP).

PubMed

Tombaugh, Tom N; Rees, Laura; Stormer, Peter; Harrison, Allyson G; Smith, Andra

2007-01-01

In spite of the fact that reaction time (RT) measures are sensitive to the effects of traumatic brain injury (TBI), few RT procedures have been developed for use in standard clinical evaluations. The computerized test of information processing (CTIP) [Tombaugh, T. N., & Rees, L. (2000). Manual for the computerized tests of information processing (CTIP). Ottawa, Ont.: Carleton University] was designed to measure the degree to which TBI decreases the speed at which information is processed. The CTIP consists of three computerized programs that progressively increase the amount of information that is processed. Results of the current study demonstrated that RT increased as the difficulty of the CTIP tests increased (known as the complexity effect), and as severity of injury increased (from mild to severe TBI). The current study also demonstrated the importance of selecting a non-biased measure of variability. Overall, findings suggest that the CTIP is an easy to administer and sensitive measure of information processing speed.

Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units.

PubMed

Hoonakker, Peter L T; Carayon, Pascale; Brown, Roger L; Cartmill, Randi S; Wetterneck, Tosha B; Walker, James M

2013-01-01

Implementation of Computerized Provider Order Entry (CPOE) has many potential advantages. Despite the potential benefits of CPOE, several attempts to implement CPOE systems have failed or met with high levels of user resistance. Implementation of CPOE can fail or meet high levels of user resistance for a variety of reasons, including lack of attention to users' needs and the significant workflow changes required by CPOE. User satisfaction is a critical factor in information technology implementation. Little is known about how end-user satisfaction with CPOE changes over time. To examine ordering provider and nurse satisfaction with CPOE implementation over time. We conducted a repeated cross-sectional questionnaire survey in four intensive care units of a large hospital. We analyzed the questionnaire data as well as the responses to two open-ended questions about advantages and disadvantages of CPOE. Users were moderately satisfied with CPOE and there were interesting differences between user groups: ordering providers and nurses. User satisfaction with CPOE did not change over time for providers, but it did improve significantly for nurses. Results also show that nurses and providers are satisfied with different aspects of CPOE.

Mosquito Information Management Project (MIMP): Application of a Computerized General Purpose Information Management System (SELGEM) to Medically Important Arthropods (Diptera: culicidae).

DTIC Science & Technology

1984-08-01

4 MOSQUITO INFORMATION MANAGEMENT PROJECT (MIMP): *APPLICATION OF A COMPUTERIZED GENERAL PURPOSE I INFORMATION MANAGEMENT SYSTEM (SELGEM) TO...1983 to August 1984 INFORMATION MANAGEMENT SYSTEM (SELGEM) TO MEDI- 6 EFRIGOG EOTNME * CALLY IMPORTANT ARTHROPODS (DIPTERA: CULICIDAE) .v PEnRMN OG

The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature.

PubMed

Georgiou, Andrew; Prgomet, Mirela; Paoloni, Richard; Creswick, Nerida; Hordern, Antonia; Walter, Scott; Westbrook, Johanna

2013-06-01

We undertake a systematic review of the quantitative literature related to the effect of computerized provider order entry systems in the emergency department (ED). We searched MEDLINE, EMBASE, Inspec, CINAHL, and CPOE.org for English-language studies published between January 1990 and May 2011. We identified 1,063 articles, of which 22 met our inclusion criteria. Sixteen used a pre/post design; 2 were randomized controlled trials. Twelve studies reported outcomes related to patient flow/clinical work, 7 examined decision support systems, and 6 reported effects on patient safety. There were no studies that measured decision support systems and its effect on patient flow/clinical work. Computerized provider order entry was associated with an increase in time spent on computers (up to 16.2% for nurses and 11.3% for physicians), with no significant change in time spent on patient care. Computerized provider order entry with decision support systems was related to significant decreases in prescribing errors (ranging from 17 to 201 errors per 100 orders), potential adverse drug events (0.9 per 100 orders), and prescribing of excessive dosages (31% decrease for a targeted set of renal disease medications). There are tangible benefits associated with computerized provider order entry/decision support systems in the ED environment. Nevertheless, when considered as part of a framework of technical, clinical, and organizational components of the ED, the evidence base is neither consistent nor comprehensive. Multimethod research approaches (including qualitative research) can contribute to understanding of the multiple dimensions of ED care delivery, not as separate entities but as essential components of a highly integrated system of care. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Legal Issues for an Integrated Information Center.

ERIC Educational Resources Information Center

Rees, Warren; And Others

1991-01-01

The ability to collect, store, retrieve, and combine information in computerized databases has magnified the potential for misuse of information. Laws have begun to deal with these new threats by expanding rights of privacy, copyright, misrepresentation, products liability, and defamation. Laws regarding computerized databases are certain to…

Computerizing medical records in Japan.

PubMed

Yasunaga, Hideo; Imamura, Tomoaki; Yamaki, Shintaro; Endo, Hiroyoshi

2008-10-01

The present study reports the current status of computerizing medical records in Japan. In 2001, the Ministry of Health, Labour and Welfare formulated the Grand Design for the Development of Information Systems in the Healthcare and Medical Fields. The Grand Design stated a numerical target for "spreading the use of electronic medical records (EMR) in at least 60% of Japan's hospitals with 400 or more beds by 2006." The objective of this study was to examine the extent to which EMR and order entry systems (OES) have been adopted as of February 2007 and to evaluate the Japanese government's policy regarding the computerization of medical records. We conducted a postal survey targeting medical institutions throughout Japan. In February 2007, we mailed self-administered questionnaires to all 1574 hospitals with 300 or more beds, and to a random selection of 1000 hospitals with less than 300 beds in addition to 4000 clinics. Responses were received from 812 (51.6%), 504 (50.5%), and 1769 (44.8%), respectively. We asked questions concerning: (i) the extent to which EMR and OES had been introduced; (ii) the reasons why certain institutions had not introduced EMR and (iii) the subjective evaluation of the efficacy and cost-effectiveness of EMR. The percentage of institutions that had introduced EMR as of February 2007 was 10.0% for hospitals and 10.1% for clinics. Even the percentage for hospitals with 400 or more beds was just 31.2%, illustrating that the government's target had not been reached. The most common reason given for not introducing EMR was: "The cost is high" which was observed in 82.0% of hospitals. It was considered that the introduction of EMR could improve 'inter-hospital networks', and 'time efficiency for physicians' by around 45% and 25% of hospitals, respectively. Healthcare information computerization in Japan is behind schedule because the introductory costs are high. For the computerization of healthcare information to be further promoted, prices of EMR systems should be lowered to a level which individual hospitals can afford. Furthermore, the communication between EMR systems should be further standardized to secure functional and semantic interoperability in Japan.

The Relationship of Item-Level Response Times with Test-Taker and Item Variables in an Operational CAT Environment. LSAC Research Report Series.

ERIC Educational Resources Information Center

Swygert, Kimberly A.

In this study, data from an operational computerized adaptive test (CAT) were examined in order to gather information concerning item response times in a CAT environment. The CAT under study included multiple-choice items measuring verbal, quantitative, and analytical reasoning. The analyses included the fitting of regression models describing the…

Documentation for the machine-readable version of A Catalogue of Extragalactic Radio Source Identifications (Veron-Cetty and Veron 1983)

NASA Technical Reports Server (NTRS)

Warren, W. H., Jr.

1983-01-01

Detailed descriptions of the data and reference files of the updated and final version of the machine-readable catalog are given. The computerized catalog has greatly expanded since the original published version (1974), and additional information is given. A separate reference file contains bibliographical citations ordered simultaneously by numerical reference and alphabetically by author.

Item Selection Criteria with Practical Constraints for Computerized Classification Testing

ERIC Educational Resources Information Center

Lin, Chuan-Ju

2011-01-01

This study compares four item selection criteria for a two-category computerized classification testing: (1) Fisher information (FI), (2) Kullback-Leibler information (KLI), (3) weighted log-odds ratio (WLOR), and (4) mutual information (MI), with respect to the efficiency and accuracy of classification decision using the sequential probability…

Oak Ridge Computerized Hierarchical Information System (ORCHIS) status report, July 1973

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

Brooks, A.A.

1974-01-01

This report summarizes the concepts, software, and contents of the Oak Ridge Computerized Hierarchical Information System. This data analysis and text processing system was developed as an integrated, comprehensive information processing capability to meet the needs of an on-going multidisciplinary research and development organization. (auth)

Computerized management information systems and organizational structures

NASA Technical Reports Server (NTRS)

Zannetos, Z. S.; Sertel, M. R.

1970-01-01

The computerized management of information systems and organizational structures is discussed. The subjects presented are: (1) critical factors favoring centralization and decentralization of organizations, (2) classification of organizations by relative structure, (3) attempts to measure change in organization structure, and (4) impact of information technology developments on organizational structure changes.

Application of a Computerized General Purpose Information Management System (SELGEM) to Medically Important Arthropods (Diptera: Culcidae).

DTIC Science & Technology

1980-06-01

COMPUTERIZED GENERAL PURPOSE INFORMATION MANAGEMENT SYSTEM (SELGE.M) TO KEDICALLY IMPORTANT ARTHROPODS (DIPTERA: CULICIDAE) Annual Report Terry L. Erwin June...GENERAL PURPOSE INFORMATION MANAGEMENT SYSTEM Annual--1 September 1979- (SEIGEM) TO MEDICALLY ThWORTANT ARTHROPODS 30 May 1980 (DIPTERA: CULICIDAE) 6

Application of a Computerized General Purpose Information Management System (SELGEM) (SELf-GEnerating Master) to Medically Important Arthropods (Diptera: Culicidae).

DTIC Science & Technology

1981-08-01

APPLICATION OF A COMPUTERIZED GENERAL PURPOSE INFORMATION MANAGEMENT SYSTEM (SELGEM) TO MEDICALLY IMPORTANT ARTHROPODS (DIPTERA: CULICIDAE) I’ Annual Report...Bailey. 1981. Application of a com- puterized information management system (SELGEM) to medically important arthropods (National Museum Mosquito

Significant reduction in red blood cell transfusions in a general hospital after successful implementation of a restrictive transfusion policy supported by prospective computerized order auditing.

PubMed

Yerrabothala, Swaroopa; Desrosiers, Kevin P; Szczepiorkowski, Zbigniew M; Dunbar, Nancy M

2014-10-01

Our hospital transfusion policy was recently revised to recommend single-unit red blood cell transfusion (RBC TXN) for nonbleeding inpatients when the hemoglobin (Hb) level is not more than 7 g/dL. Our computerized provider order entry system was reconfigured to provide real-time decision support using prospective computerized order auditing based on the most recent Hb level and to remove the single-click ordering option for 2-unit RBC TXNs to enhance compliance. This study was undertaken to assess the impact of these changes on hospital transfusion practice. This study analyzed the total number of transfusion events, proportion of single and 2-unit transfusions and the Hb transfusion trigger in the preimplementation period (October 2011-March 2012) compared to the postimplementation period (October 2012-March 2013). In the postimplementation period the total number of RBC units transfused/1000 patient-days decreased from 60.8 to 44.2 (p < 0.0001). The proportion of 2-unit TXNs decreased from 47% to 15% (p < 0.0001). We also observed significant decreases in pretransfusion Hb triggers. Implementation of restrictive transfusion policy supported by prospective computerized order auditing has resulted in significantly decreased RBC utilization at our institution. © 2014 AABB.

BanTeC: a software tool for management of corneal transplantation.

PubMed

López-Alvarez, P; Caballero, F; Trias, J; Cortés, U; López-Navidad, A

2005-11-01

Until recently, all cornea information at our tissue bank was managed manually, no specific database or computer tool had been implemented to provide electronic versions of documents and medical reports. The main objective of the BanTeC project was therefore to create a computerized system to integrate and classify all the information and documents used in the center in order to facilitate management of retrieved, transplanted corneal tissues. We used the Windows platform to develop the project. Microsoft Access and Microsoft Jet Engine were used at the database level and Data Access Objects was the chosen data access technology. In short, the BanTeC software seeks to computerize the tissue bank. All the initial stages of the development have now been completed, from specification of needs, program design and implementation of the software components, to the total integration of the final result in the real production environment. BanTeC will allow the generation of statistical reports for analysis to improve our performance.

11 CFR 9033.12 - Production of computerized information.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Disbursements made and reimbursements received for the cost of transportation, ground services and facilities...'s software capabilities, such as user guides, technical manuals, formats, layouts and other... software and the computerized information prepared or maintained by the committee. ...

The evolution of the market for commercial computerized physician order entry and computerized decision support systems for prescribing.

PubMed

Mozaffar, Hajar; Williams, Robin; Cresswell, Kathrin; Morrison, Zoe; Bates, David W; Sheikh, Aziz

2016-03-01

To understand the evolving market of commercial off-the-shelf Computerized Physician Order Entry (CPOE) and Computerized Decision Support (CDS) applications and its effects on their uptake and implementation in English hospitals. Although CPOE and CDS vendors have been quick to enter the English market, uptake has been slow and uneven. To investigate this, the authors undertook qualitative ethnography of vendors and adopters of hospital CPOE/CDS systems in England. The authors collected data from semi-structured interviews with 11 individuals from 4 vendors, including the 2 most entrenched suppliers, and 6 adopter hospitals, and 21 h of ethnographic observation of 2 user groups, and 1 vendor event. The research and analysis was informed by insights from studies of the evolution of technology fields and the emergence of generic COTS enterprise solutions. Four key themes emerged: (1) adoption of systems that had been developed outside of England, (2) vendors' configuration and customization strategies, (3) localized adopter practices vs generic systems, and (4) unrealistic adopter demands. Evidence for our over-arching finding concerning the current immaturity of the market was derived from vendors' strategies, adopters' reactions to the technology, and policy makers' incomplete insights. The CPOE/CDS market in England is still in an emergent phase. The rapid entrance of diverse products, triggered by federal policy initiatives, has resulted in premature adoption of systems that do not yet adequately meet the needs of hospitals. Vendors and adopters lacked understanding of how to design and implement generic solutions to meet diverse user needs. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sustained User Engagement in Health Information Technology: The Long Road from Implementation to System Optimization of Computerized Physician Order Entry and Clinical Decision Support Systems for Prescribing in Hospitals in England.

PubMed

Cresswell, Kathrin M; Lee, Lisa; Mozaffar, Hajar; Williams, Robin; Sheikh, Aziz

2017-10-01

To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. Six hospitals in England, United Kingdom. Qualitative case study. We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals. Thematic analysis was initially undertaken within individual cases, followed by cross-case comparisons. We conducted 173 interviews, conducted 24 observations, and collected 17 documents between 2011 and 2015. We found that perceived individual and safety benefits among different user groups tended to facilitate engagement in some, while other less engaged groups developed resistance and unsanctioned workarounds if systems were perceived to be inadequate. We identified both the opportunity and need for sustained engagement across user groups around system enhancement (e.g., through customizing software) and the development of user competencies and effective use. There is an urgent need to move away from an episodic view of engagement focused on the preimplementation phase, to more continuous holistic attempts to engage with and respond to end-users. © Health Research and Educational Trust.

Impact of Hospital Information Systems on Emergency Patient Processing

PubMed Central

Rusnak, James E.

1981-01-01

The Emergency Department offers the Hospital Information System's designer some unique problems to solve in the operational areas of patient registration, order entry, charge recording, and treatment processing. In a number of instances, Hospital Information Systems implementers have encountered serious difficulties in trying to design system components to support the requirements of the Emergency Services Department's operations. Washington Hospital has developed a very effective system for Emergency Services. The system's features are designed to meet the special requirements of the department and to maximize the use of the data captured by the Hospital Information System. The system supports accurate and timely charging for services. The treatment of the patient has been dramatically improved through the use of a computerized order processing and control. The installed systems resulted in a higher quality of care and cost effective operations.

Immunization Information System and Informatics to Promote Immunizations: Perspective From Minnesota Immunization Information Connection.

PubMed

Muscoplat, Miriam Halstead; Rajamani, Sripriya

2017-01-01

The vision for management of immunization information is availability of real-time consolidated data and services for all ages, to clinical, public health, and other stakeholders. This is being executed through Immunization Information Systems (IISs), which are population-based and confidential computerized systems present in most US states and territories. Immunization Information Systems offer many functionalities, such as immunization assessment reports, client follow-up, reminder/recall feature, vaccine management tools, state-supplied vaccine ordering, comprehensive immunization history, clinical decision support/vaccine forecasting and recommendations, data processing, and data exchange. This perspective article will present various informatics tools in an IIS, in the context of the Minnesota Immunization Information Connection.

Knowledge Translation of the PERC Rule for Suspected Pulmonary Embolism: A Blueprint for Reducing the Number of CT Pulmonary Angiograms.

PubMed

Drescher, Michael J; Fried, Jeremy; Brass, Ryan; Medoro, Amanda; Murphy, Timothy; Delgado, João

2017-10-01

Computerized decision support decreases the number of computed tomography pulmonary angiograms (CTPA) for pulmonary embolism (PE) ordered in emergency departments, but it is not always well accepted by emergency physicians. We studied a department-endorsed, evidence-based clinical protocol that included the PE rule-out criteria (PERC) rule, multi-modal education using principles of knowledge translation (KT), and clinical decision support embedded in our order entry system, to decrease the number of unnecessary CTPA ordered. We performed a historically controlled observational before-after study for one year pre- and post-implementation of a departmentally-endorsed protocol. We included patients > 18 in whom providers suspected PE and who did not have a contraindication to CTPA. Providers entered clinical information into a diagnostic pathway via computerized order entry. Prior to protocol implementation, we provided education to ordering providers. The primary outcome measure was the number of CTPA ordered per 1,000 visits one year before vs. after implementation. CTPA declined from 1,033 scans for 98,028 annual visits (10.53 per 1,000 patient visits (95% CI [9.9-11.2]) to 892 scans for 101,172 annual visits (8.81 per 1,000 patient visits (95% CI [8.3-9.4]) p<0.001. The absolute reduction in PACT ordered was 1.72 per 1,000 visits (a 16% reduction). Patient characteristics were similar for both periods. Knowledge translation clinical decision support using the PERC rule significantly reduced the number of CTPA ordered.

Computerized Information Management in Long-Term Care: A Case Study. Technical Report No. 303.

ERIC Educational Resources Information Center

Zawadski, Rick T.; Gee, Stephen

This technical report describes the computerized information management system used at the Community Care Organization for Dependent Adults (CCODA) of the On Lok Senior Health Services in San Francisco's Chinatown (California). A background perspective on information systems in business, government, hospitals, and local community service agencies…

Application of a Computerized General Purpose Information Management System (SELGEM) (SELf-GEnerating Master) to Medically Important Arthropods (Diptera: Culicidae).

DTIC Science & Technology

1982-07-01

GENERAL PURPOSE INFORMATION MANAGEMENT SYSTEM (SELGEM) TO MEDICALLY 0 IMPORTANT ARTHROPODS (DIPTERA: CULICIDAE) oAnnual Report Terry L. Erwin July...APPLICATION OF A COMPUTERIZED GENERAL PURPOSE Annual Report INFORMATION MANAGEMENT SYSTEM (SELGEM) TO July 1981 to June 1982 MEDICALLY IMPORTANT ARTHROPODS

Computerized Information and Support for Patients with Breast Cancer or HIV Infection.

ERIC Educational Resources Information Center

Rolnick, Sharon J.; Owens, Betta; Botta, Renee; Sathe, Laurie; Hawkins, Robert; Cooper, Leah; Kelley, Mary; Gustafson, David

1999-01-01

Use of the Comprehensive Health Enhancement Support System, a computerized information system, by patients with breast cancer or HIV was compared. Groups differed in the frequency of access and use of certain aspects (e.g., discussion groups). Identification of patient concerns provided useful information for system improvements. (SK)

Evaluation of computerized health management information system for primary health care in rural India

PubMed Central

2010-01-01

Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS), New Delhi has a computerized Health Management Information System (HMIS) since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors) and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR) 1674,217 (USD 35,622). Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213). The annual savings is around INR 894,283 (USD 11,924). Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision. PMID:21078203

45 CFR 307.13 - Security and confidentiality for computerized support enforcement systems in operation after...

Code of Federal Regulations, 2010 CFR

2010-10-01

... ENFORCEMENT SYSTEMS § 307.13 Security and confidentiality for computerized support enforcement systems in... systems in operation after October 1, 1997. (a) Information integrity and security. Have safeguards... 45 Public Welfare 2 2010-10-01 2010-10-01 false Security and confidentiality for computerized...

A First Life with Computerized Business Simulations

ERIC Educational Resources Information Center

Thavikulwat, Precha

2011-01-01

The author discusses the theoretical lens, origins, and environment of his work on computerized business simulations. Key ideas that inform his work include the two dimensions (control and interaction) of computerized simulation, the two ways of representing a natural process (phenotypical and genotypical) in a simulation, which he defines as a…

Computerized analysis of fetal heart rate variability signal during the stages of labor.

PubMed

Annunziata, Maria Laura; Tagliaferri, Salvatore; Esposito, Francesca Giovanna; Giuliano, Natascia; Mereghini, Flavia; Di Lieto, Andrea; Campanile, Marta

2016-03-01

To analyze computerized cardiotocographic (cCTG) parameters (baseline fetal heart rate, baseline FHR; short term variability, STV; approximate entropy, ApEn; low frequency, LF; movement frequency, MF; high frequency, HF) in physiological pregnancy in order to correlate them with the stages of labor. This could provide more information for understanding the mechanisms of nervous system control of FHR during labor progression. A total of 534 pregnant women were monitored on cCTG from the 37th week before the onset of spontaneous labor and during the first and the second stage of labor. Statistical analysis was performed using Kruskal-Wallis test and Wilcoxon rank-sum test with the Bonferroni adjusted α (< 0.05). Statistically significant differences were seen between baseline FHR, MF and HF (P < 0.001), in which the first two were reduced and the third was increased when compared between pre-labor, and the first and second stages of labor. Differences between some of the stages were found for ApEn, LF and for LF/(HF + MF), where the first and the third were reduced and the second was increased. cCTG modifications during labor may reflect the physiologic increased activation of the autonomous nervous system. Using computerized fetal heart rate analysis during labor it may be possible to obtain more information from the fetal cardiac signal, in comparison with the traditional tracing. © 2016 Japan Society of Obstetrics and Gynecology.

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

Informap... a computerized information system for fire planning and fire control

Treesearch

Theodore G. Storey; Ross D. Carder; Ernest T. Tolin

1969-01-01

INFORMAP (Information Necessary for Optimum Resource Management and Protection) is a computerized system under development for storing, manipulating, retrieving, and displaying data for fire planning and fire control. A prototype for planning applications has been developed and tested. It is programed in Fortran IV for the IBM 7040 computer, and displays information in...

A Computerized Information System Model for Decision Making for the Oklahoma State Department of Vocational and Technical Education.

ERIC Educational Resources Information Center

Smith, Hubert Gene

The objectives of the study presented in the dissertation were to identify present and anticipated information requirements of the various departments within the Oklahoma State Department of Vocational and Technical Education, to design a computerized information system model utilizing an integrated systems concept to meet information…

A survey of medical informatics in Belgium.

PubMed

Roger, F H; Behets, M; Andre, J; de Moor, G; Sevens, C; Willems, J L

1987-01-01

The Belgian Society for Medical Informatics (MIM) organized a survey in 1986 in order to assess the present state of development of medical informatics in Belgium. Questionnaires were sent to hospitals, laboratories, private practitioners and pharmacists, as well as to social security organizations and software industries. The response rate was higher in hospitals (93%) than in any other category. Results showed a large number of computerized hospitals (93% of general acute care hospitals and 91% of psychiatric hospitals). There has been a sharp increase (+ 15%) in computerization of the admission, accounting and billing procedures since 1985, most likely in relation with administrative rules issued by the Belgian Government. The same trend (+ 20%) has been observed for computer applications in clinical laboratories, between 1984 and 1985. There is almost one computer terminal for ten beds in the hospitals with more than 200 beds in 1986. This figure exemplifies the present trend to on-line access to data. Computerized instrumental aids to medicine such as text processing, imaging or computerized interpretation of signals have known a rapid extension during recent years, although less comprehensive than administrative applications in hospitals and in social security organizations. The present state of other applications in medicine (general practice, pharmacy, etc.) was more difficult to assess as those information systems remain more pinpointed. In all medical fields, there appears to be a new rise in computer programs offered by software companies.

The Effects of Computerized Information Systems on Juvenile Courts

ERIC Educational Resources Information Center

Albrecht, Gary L.

1976-01-01

Organizational theorists alternatively hypothesized that computerized information systems (CIS) will produce no necessary changes, centralization, or decentralization in juvenile courts. This hypothesis is supported by the results of a four year study on the phenomenon. Suggestions are offered for improving the juvenile judicial system through…

How will computerization revolutionize managed care?

PubMed

Trabin, T

1994-01-01

Computerization of behavioral health care information systems is revolutionizing how payors, managed care companies, and providers exchange information. In this article, an imaginary scenario is depicted of how patient data will be accessed and communicated to facilitate care management of behavioral health care services in the near future.

Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

PubMed

Haynes, R Brian; Wilczynski, Nancy L

2010-02-05

Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses. A decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.

Guidelines for the Development of Computerized Student Information Systems.

ERIC Educational Resources Information Center

Armes, Nancy, Ed.; And Others

Designed to provide guidelines for the development of computerized student information systems, this report raises policy issues and questions to be resolved at the campus level and describes a variety of computer-generated reports and records that can assist in educational decision making and planning. Introductory material discusses the…

HL7 Structured Product Labeling - electronic prescribing information for provider order entry decision support.

PubMed

Schadow, Gunther

2005-01-01

Prescribing errors are an important cause of adverse events, and lack of knowledge of the drug is a root cause for prescribing errors. The FDA is issuing new regulations that will make the drug labels much more useful not only to physicians, but also to computerized order entry systems that support physicians to practice safe prescribing. For this purpose, FDA works with HL7 to create the Structured Product Label (SPL) standard that includes a document format as well as a drug knowledge representation, this poster introduces the basic concepts of SPL.

The VA Computerized Patient Record — A First Look

PubMed Central

Anderson, Curtis L.; Meldrum, Kevin C.

1994-01-01

In support of its in-house DHCP Physician Order Entry/Results Reporting application, the VA is developing the first edition of a Computerized Patient Record. The system will feature a physician-oriented interface with real time, expert system-based order checking, a controlled vocabulary, a longitudinal repository of patient data, HL7 messaging support, a clinical reminder and warning system, and full integration with existing VA applications including lab, pharmacy, A/D/T, radiology, dietetics, surgery, vitals, allergy tracking, discharge summary, problem list, progress notes, consults, and online physician order entry. PMID:7949886

Computerizing Maintenance Management Improves School Processes.

ERIC Educational Resources Information Center

Conroy, Pat

2002-01-01

Describes how a Computerized Maintenance Management System (CMMS), a centralized maintenance operations database that facilitates work order procedures and staff directives, can help individual school campuses and school districts to manage maintenance. Presents the benefits of CMMS and things to consider in CMMS selection. (EV)

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat.

PubMed

Joshi, Anuradha; Buch, Jatin; Kothari, Nitin; Shah, Nishal

2016-06-01

Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patient's age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice.

Evaluation of Hand Written and Computerized Out-Patient Prescriptions in Urban Part of Central Gujarat

PubMed Central

Buch, Jatin; Kothari, Nitin; Shah, Nishal

2016-01-01

Introduction Prescription order is an important therapeutic transaction between physician and patient. A good quality prescription is an extremely important factor for minimizing errors in dispensing medication and it should be adherent to guidelines for prescription writing for benefit of the patient. Aim To evaluate frequency and type of prescription errors in outpatient prescriptions and find whether prescription writing abides with WHO standards of prescription writing. Materials and Methods A cross-sectional observational study was conducted at Anand city. Allopathic private practitioners practising at Anand city of different specialities were included in study. Collection of prescriptions was started a month after the consent to minimize bias in prescription writing. The prescriptions were collected from local pharmacy stores of Anand city over a period of six months. Prescriptions were analysed for errors in standard information, according to WHO guide to good prescribing. Statistical Analysis Descriptive analysis was performed to estimate frequency of errors, data were expressed as numbers and percentage. Results Total 749 (549 handwritten and 200 computerised) prescriptions were collected. Abundant omission errors were identified in handwritten prescriptions e.g., OPD number was mentioned in 6.19%, patient’s age was mentioned in 25.50%, gender in 17.30%, address in 9.29% and weight of patient mentioned in 11.29%, while in drug items only 2.97% drugs were prescribed by generic name. Route and Dosage form was mentioned in 77.35%-78.15%, dose mentioned in 47.25%, unit in 13.91%, regimens were mentioned in 72.93% while signa (direction for drug use) in 62.35%. Total 4384 errors out of 549 handwritten prescriptions and 501 errors out of 200 computerized prescriptions were found in clinicians and patient details. While in drug item details, total number of errors identified were 5015 and 621 in handwritten and computerized prescriptions respectively. Conclusion As compared to handwritten prescriptions, computerized prescriptions appeared to be associated with relatively lower rates of error. Since out-patient prescription errors are abundant and often occur in handwritten prescriptions, prescribers need to adapt themselves to computerized prescription order entry in their daily practice. PMID:27504305

Design and implementation of a hospital information system for the Palestine Red Crescent Society in Lebanon.

PubMed

Rossi, L; Materia, E; Hourani, A; Yousef, H; Racalbuto, V; Venier, C; Osman, M

2009-01-01

A case-mix hospital information system was designed and implemented in Palestine Red Crescent Society hospitals in order to support the network of Palestinian hospitals in Lebanon and to improve the health of refugees in the country. The system is based on routine collection of essential administrative and clinical data for each episode of hospitalization, relying on internationally accepted diagnostic codes. It is a computerized, user-friendly information system that is a stepping-stone towards better hospital management and evaluation of quality of care. It is also a useful model for the development of hospital information systems in Lebanon and in the Near East.

Data Mining on Numeric Error in Computerized Physician Order Entry System Prescriptions.

PubMed

Wu, Xue; Wu, Changxu

2017-01-01

This study revealed the numeric error patterns related to dosage when doctors prescribed in computerized physician order entry system. Error categories showed that the '6','7', and '9' key produced a higher incidence of errors in Numpad typing, while the '2','3', and '0' key produced a higher incidence of errors in main keyboard digit line typing. Errors categorized as omission and substitution were higher in prevalence than transposition and intrusion.

Prevention of prescription errors by computerized, on-line, individual patient related surveillance of drug order entry.

PubMed

Oliven, A; Zalman, D; Shilankov, Y; Yeshurun, D; Odeh, M

2002-01-01

Computerized prescription of drugs is expected to reduce the number of many preventable drug ordering errors. In the present study we evaluated the usefullness of a computerized drug order entry (CDOE) system in reducing prescription errors. A department of internal medicine using a comprehensive CDOE, which included also patient-related drug-laboratory, drug-disease and drug-allergy on-line surveillance was compared to a similar department in which drug orders were handwritten. CDOE reduced prescription errors to 25-35%. The causes of errors remained similar, and most errors, on both departments, were associated with abnormal renal function and electrolyte balance. Residual errors remaining on the CDOE-using department were due to handwriting on the typed order, failure to feed patients' diseases, and system failures. The use of CDOE was associated with a significant reduction in mean hospital stay and in the number of changes performed in the prescription. The findings of this study both quantity the impact of comprehensive CDOE on prescription errors and delineate the causes for remaining errors.

Clinical evaluation of the WOMAC 3.0 OA Index in numeric rating scale format using a computerized touch screen version.

PubMed

Theiler, R; Spielberger, J; Bischoff, H A; Bellamy, N; Huber, J; Kroesen, S

2002-06-01

The Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index is a previously described self-administered questionnaire covering three domains: pain, stiffness and function. It has been validated in patients with osteoarthritis (OA) of the hip or knee in a paper-based format. To validate the WOMAC 3.0 using a numerical rating scale in a computerized touch screen format allowing immediate evaluation of the questionnaire. In the computed version cartoons, written and audio instruments were included in order facilitate application. Fifty patients, demographically balanced, with radiographically proven primary hip or knee OA completed the classical paper and the new computerized WOMAC version. Subjects were randomized either to paper format or computerized format first to balance possible order effects. The intra-class correlation coefficients for pain, stiffness and function values were 0.915, 0.745 and 0.940, respectively. The Spearman correlation coefficients for pain, stiffness and function were 0.88, 0.77 and 0.87, respectively. These data indicate that the computerized WOMAC OA index 3.0 is comparable to the paper WOMAC in all three dimensions. The computerized version would allow physicians to get an immediate result and if present a direct comparison with a previous exam. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.

Impact of Computerized Provider Order Entry on Pharmacist Productivity

PubMed Central

Hatfield, Mark D.; Cox, Rodney; Mhatre, Shivani K.; Flowers, W. Perry

2014-01-01

Abstract Purpose: To examine the impact of computerized provider order entry (CPOE) implementation on average time spent on medication order entry and the number of order actions processed. Methods: An observational time and motion study was conducted from March 1 to March 17, 2011. Two similar community hospital pharmacies were compared: one without CPOE implementation and the other with CPOE implementation. Pharmacists in the central pharmacy department of both hospitals were observed in blocks of 1 hour, with 24 hours of observation in each facility. Time spent by pharmacists on distributive, administrative, clinical, and miscellaneous activities associated with order entry were recorded using time and motion instrument documentation. Information on medication order actions and order entry/verifications was obtained using the pharmacy network system. Results: The mean ± SD time spent by pharmacists per hour in the CPOE pharmacy was significantly less than the non-CPOE pharmacy for distributive activities (43.37 ± 7.75 vs 48.07 ± 8.61) and significantly greater than the non-CPOE pharmacy for administrative (8.58 ± 5.59 vs 5.72 ± 6.99) and clinical (7.38 ± 4.27 vs 4.22 ± 3.26) activities. The CPOE pharmacy was associated with a significantly higher number of order actions per hour (191.00 ± 82.52 vs 111.63 ± 25.66) and significantly less time spent (in minutes per hour) on order entry and order verification combined (28.30 ± 9.25 vs 36.56 ± 9.14) than the non-CPOE pharmacy. Conclusion: The implementation of CPOE facilitated pharmacists to allocate more time to clinical and administrative functions and increased the number of order actions processed per hour, thus enhancing workflow efficiency and productivity of the pharmacy department. PMID:24958959

Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

PubMed

Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

2013-12-01

We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p < 0.0001). The percentage of heeded alerts increased during the adaptive alert period (24.3% vs. 17.1%, respectively, p = 0.004). A significant percentage (45%) of other plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

Information integrity and privacy for computerized medical patient records

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

Gallegos, J.; Hamilton, V.; Gaylor, T.

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

HEALTH C.H.I.P.s: Opportunistic Community Use of Computerized Health Information Programs

ERIC Educational Resources Information Center

Radvan, Deborah; Wiggers, John; Hazell, Trevor

2004-01-01

Computerized health information programs have been shown to have potential to improve knowledge, attitudes and behavior. However, relatively little is known regarding their capacity to engage the public for opportunistic, spontaneous use in community settings. Two studies were undertaken to provide insight to this practical issue. An intercept…

A Computerized Information Retrieval System for the Technical Assistance Center Clearinghouse: A Feasibility Study.

ERIC Educational Resources Information Center

Buckley, Joseph J.

This report first analyzes the need for a Technical Assistance Center (TAC) Clearinghouse, which would provide a range of services including question answering for state and local education agencies, workshop preparation assistance, and literature surveys. Addressing the question of feasibility of a computerized information retrieval system for…

A Mixture Rasch Model-Based Computerized Adaptive Test for Latent Class Identification

ERIC Educational Resources Information Center

Jiao, Hong; Macready, George; Liu, Junhui; Cho, Youngmi

2012-01-01

This study explored a computerized adaptive test delivery algorithm for latent class identification based on the mixture Rasch model. Four item selection methods based on the Kullback-Leibler (KL) information were proposed and compared with the reversed and the adaptive KL information under simulated testing conditions. When item separation was…

Evaluation of the Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) as a Measure of Treatment Effectiveness with Psychiatric Inpatients

ERIC Educational Resources Information Center

Kinnaman, Joanna E. Strong; Farrell, Albert D.; Bisconer, Sarah W.

2006-01-01

Assessment procedures to evaluate inpatient treatment effectiveness can provide information to inform clinical practice. The Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER) represents a standardized approach to assess patients' target problems that combines elements of individualized and nomothetic approaches.…

Modifications and integration of the electronic tracking board in a pediatric emergency department.

PubMed

Dexheimer, Judith W; Kennebeck, Stephanie

2013-07-01

Electronic health records (EHRs) are used for data storage; provider, laboratory, and patient communication; clinical decision support; procedure and medication orders; and decision support alerts. Clinical decision support is part of any EHR and is designed to help providers make better decisions. The emergency department (ED) poses a unique environment to the use of EHRs and clinical decision support. Used effectively, computerized tracking boards can help improve flow, communication, and the dissemination of pertinent visit information between providers and other departments in a busy ED. We discuss the unique modifications and decisions made in the implementation of an EHR and computerized tracking board in a pediatric ED. We discuss the changing views based on provider roles, customization to the user interface including the layout and colors, decision support, tracking board best practices collected from other institutions and colleagues, and a case study of using reminders on the electronic tracking board to drive pain reassessments.

Nursing informatics: the trend of the future.

PubMed

Nagelkerk, J; Ritola, P M; Vandort, P J

1998-01-01

Nursing informatics is a combination of computer, information, and nursing sciences. This new and expanding field addresses the efficient and effective use of information for nurses. Preparing nurses for computerization is essential to confront an explosion of sophisticated computerized technology in the workplace. It is critical in a competitive health care market for preparing nurses to use the most cost-effective methods. A model is presented that identifies six essential factors for preparing nurses for computerization. Strong leadership, effective communication, organized training sessions, established time frames, planned change, and tailored software are the essential factors to consider for development of a successful educational program.

Cognitive analysis of physicians' medication ordering activity.

PubMed

Pelayo, Sylvia; Leroy, Nicolas; Guerlinger, Sandra; Degoulet, Patrice; Meaux, Jean-Jacques; Beuscart-Zéphir, Marie-Catherine

2005-01-01

Computerized Physician Order Entry (CPOE) addresses critical functions in healthcare systems. As the name clearly indicates, these systems focus on order entry. With regard to medication orders, such systems generally force physicians to enter exhaustively documented orders. But a cognitive analysis of the physician's medication ordering task shows that order entry is the last (and least) important step of the entire cognitive therapeutic decision making task. We performed a comparative analysis of these complex cognitive tasks in two working environments, computer-based and paper-based. The results showed that information gathering, selection and interpretation are critical cognitive functions to support the therapeutic decision making. Thus the most important requirement from the physician's perspective would be an efficient display of relevant information provided first in the form of a summarized view of the patient's current treatment, followed by in a more detailed focused display of those items pertinent to the current situation. The CPOE system examined obviously failed to provide the physicians this critical summarized view. Following these results, consistent with users' complaints, the Company decided to engage in a significant re-engineering process of their application.

Computerized pharmacy surveillance and alert system for drug-related problems.

PubMed

Ferrández, O; Urbina, O; Grau, S; Mateu-de-Antonio, J; Marin-Casino, M; Portabella, J; Mojal, S; Riu, M; Salas, E

2017-04-01

Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment. Most of these applications have utilized a small range of drugs with alerts and/or types of alert. The objective of this study was to describe the implementation of a PWS integrated in the electronic medical record (EMR). The PWS was developed in 2003-2004. Pharmacological information to generate drug alerts was entered on demographic data, drug dosage, laboratory tests related to the prescribed drug and drug combinations (interactions, duplications and necessary combinations). The PWS was applied in the prescription reviews conducted in patients admitted to the hospital in 2012. Information on 83% of the drugs included in the pharmacopeia was introduced into the PWS, allowing detection of 2808 potential DRPs, representing 79·1% of all potential DRPs detected during the study period. Twenty per cent of PWS DRPs were clinically relevant, requiring pharmacist intervention. The PWS detected most potential DRPs, thus increasing inpatient safety. The detection ability of the PWS was higher than that reported for other tools described in the literature. © 2017 John Wiley & Sons Ltd.

Electronic Chemotherapy Order Entry: A Major Cancer Center's Implementation

PubMed Central

Sklarin, Nancy T.; Granovsky, Svetlana; O'Reilly, Eileen M.; Zelenetz, Andrew D.

2011-01-01

Implementation of a computerized provider order entry system for complex chemotherapy regimens at a large cancer center required intense effort from a multidisciplinary team of clinical and systems experts with experience in all facets of the chemotherapy process. The online tools had to resemble the paper forms used at the time and parallel the successful established process as well as add new functionality. Close collaboration between the institution and the vendor was necessary. This article summarizes the institutional efforts, challenges, and collaborative processes that facilitated universal chemotherapy computerized electronic order entry across multiple sites during a period of several years. PMID:22043182

Electronic Chemotherapy Order Entry: A Major Cancer Center's Implementation.

PubMed

Sklarin, Nancy T; Granovsky, Svetlana; O'Reilly, Eileen M; Zelenetz, Andrew D

2011-07-01

Implementation of a computerized provider order entry system for complex chemotherapy regimens at a large cancer center required intense effort from a multidisciplinary team of clinical and systems experts with experience in all facets of the chemotherapy process. The online tools had to resemble the paper forms used at the time and parallel the successful established process as well as add new functionality. Close collaboration between the institution and the vendor was necessary. This article summarizes the institutional efforts, challenges, and collaborative processes that facilitated universal chemotherapy computerized electronic order entry across multiple sites during a period of several years.

45 CFR 307.11 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2011 CFR

2011-10-01

... violence or child abuse); (xi) Indication of an order; (xii) Locate request type (optional); (xiii) Locate... to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT...

45 CFR 307.11 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2013 CFR

2013-10-01

... violence or child abuse); (xi) Indication of an order; (xii) Locate request type (optional); (xiii) Locate... to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT...

45 CFR 307.11 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2012 CFR

2012-10-01

... violence or child abuse); (xi) Indication of an order; (xii) Locate request type (optional); (xiii) Locate... to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT...

Assembling a Computerized Adaptive Testing Item Pool as a Set of Linear Tests

ERIC Educational Resources Information Center

van der Linden, Wim J.; Ariel, Adelaide; Veldkamp, Bernard P.

2006-01-01

Test-item writing efforts typically results in item pools with an undesirable correlational structure between the content attributes of the items and their statistical information. If such pools are used in computerized adaptive testing (CAT), the algorithm may be forced to select items with less than optimal information, that violate the content…

Wood transportation systems-a spin-off of a computerized information and mapping technique

Treesearch

William W. Phillips; Thomas J. Corcoran

1978-01-01

A computerized mapping system originally developed for planning the control of the spruce budworm in Maine has been extended into a tool for planning road net-work development and optimizing transportation costs. A budgetary process and a mathematical linear programming routine are used interactively with the mapping and information retrieval capabilities of the system...

Effects of Content Balancing and Item Selection Method on Ability Estimation in Computerized Adaptive Tests

ERIC Educational Resources Information Center

Sahin, Alper; Ozbasi, Durmus

2017-01-01

Purpose: This study aims to reveal effects of content balancing and item selection method on ability estimation in computerized adaptive tests by comparing Fisher's maximum information (FMI) and likelihood weighted information (LWI) methods. Research Methods: Four groups of examinees (250, 500, 750, 1000) and a bank of 500 items with 10 different…

Wilderness Management... A Computerized System for Summarizing Permit Information

Treesearch

Gary H. Elsner

1972-01-01

Permits were first needed for visits to wilderness areas in California during summer 1971. A computerized system for analyzing these permits and summarizing information from them has been developed. It produces four types of summary tables: point-of-origin of visitors; daily variation in total number of persons present; variations in group size; and variations in...

Economic, Educational, and Personal Implications of Implementing Computerized Guidance Information Systems. Information System for Vocational Decisions.

ERIC Educational Resources Information Center

Tiedeman, David V.

The author asserts that financial support of guidance activities, the job of the counselor, and counselors themselves will all have to change if computerized guidance support systems are to come into widespread use. The potential costs, benefits, and operating economics are discussed. Needed educational reorganization is dealt with on several…

An electronic safety screening process during inpatient computerized physician order entry improves the efficiency of magnetic resonance imaging exams.

PubMed

Schneider, Erika; Ruggieri, Paul; Fromwiller, Lauren; Underwood, Reginald; Gurland, Brooke; Yurkschatt, Cynthia; Kubiak, Kevin; Obuchowski, Nancy A

2013-12-01

Delays between order and magnetic resonance (MR) exam often result when using the conventional paper-based MR safety screening process. The impact of an electronic MR safety screening process imbedded in a computerized physician order entry (CPOE) system was evaluated. Retrospective chart review of 4 months of inpatient MR exam orders and reports was performed before and after implementation of electronic MR safety documentation. Time from order to MR exam completion, time from MR exam completion to final radiology report, and time from first order to final report were analyzed by exam anatomy. Length of stay (LOS) and date of service within the admission were also analyzed. We evaluated 1947 individual MR orders in 1549 patients under an institutional review board exemption and a waiver of informed consent. Implementation of the electronic safety screening process resulted in a significant decrease of 1.1 hours (95% confidence interval 1.0-1.3 hours) in the mean time between first order to final report and a nonsignificant decrease of 0.8 hour in the median time from first order to exam end. There was a 1-day reduction (P = .697) in the time from admission to the MR exam compared to the paper process. No significant change in LOS was found except in neurological intensive care patients imaged within the first 24 hours of their admission, where a mean 0.9-day decrease was found. Benefits of an electronic process for MR safety screening include enabling inpatients to have decreased time to MR exams, thus enabling earlier diagnosis and treatment and reduced LOS. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Designing Computerized Decision Support That Works for Clinicians and Families

PubMed Central

Fiks, Alexander G.

2011-01-01

Evidence-based decision-making is central to the practice of pediatrics. Clinical trials and other biomedical research provide a foundation for this process, and practice guidelines, drawing from their results, inform the optimal management of an increasing number of childhood health problems. However, many clinicians fail to adhere to guidelines. Clinical decision support delivered using health information technology, often in the form of electronic health records, provides a tool to deliver evidence-based information to the point of care and has the potential to overcome barriers to evidence-based practice. An increasing literature now informs how these systems should be designed and implemented to most effectively improve outcomes in pediatrics. Through the examples of computerized physician order entry, as well as the impact of alerts at the point of care on immunization rates, the delivery of evidence-based asthma care, and the follow-up of children with attention deficit hyperactivity disorder, the following review addresses strategies for success in using these tools. The following review argues that, as decision support evolves, the clinician should no longer be the sole target of information and alerts. Through the Internet and other technologies, families are increasingly seeking health information and gathering input to guide health decisions. By enlisting clinical decision support systems to deliver evidence-based information to both clinicians and families, help families express their preferences and goals, and connect families to the medical home, clinical decision support may ultimately be most effective in improving outcomes. PMID:21315295

Effectiveness of Provider Education Followed by Computerized Provider Order Entry Alerts in Reducing Inappropriate Red Blood Cell Transfusion.

PubMed

Patel, Vijay M; Rains, Anna W; Clark, Christopher T

2016-01-01

To reduce the rate of inappropriate red blood cell transfusion, a provider education program, followed by alerts in the computerized provider order entry system (CPOE), was established to encourage AABB transfusion guidelines. Metrics were established for nonemergent inpatient transfusions. Service lines with high order volume were targeted with formal education regarding AABB 2012 transfusion guidelines. Transfusion orders were reviewed in real time with email communications sent to ordering providers falling outside of AABB recommendations. After 12 months of provider education, alerts were activated in CPOE. With provider education alone, the incidence of pretransfusion hemoglobin levels greater than 8 g/dL decreased from 16.64% to 6.36%, posttransfusion hemoglobin levels greater than 10 g/dL from 14.03% to 3.78%, and number of nonemergent two-unit red blood cell orders from 45.26% to 22.66%. Red blood cell utilization decreased by 13%. No additional significant reduction in nonemergent two-unit orders was observed with CPOE alerts. Provider education, an effective and low-cost method, should be considered as a first-line method for reducing inappropriate red blood cell transfusion rates in stable adult inpatients. Alerts in the computerized order entry system did not significantly lower the percentage of two-unit red blood cells orders but may help to maintain educational efforts.

Computerized provider order entry in the clinical laboratory

PubMed Central

Baron, Jason M.; Dighe, Anand S.

2011-01-01

Clinicians have traditionally ordered laboratory tests using paper-based orders and requisitions. However, paper orders are becoming increasingly incompatible with the complexities, challenges, and resource constraints of our modern healthcare systems and are being replaced by electronic order entry systems. Electronic systems that allow direct provider input of diagnostic testing or medication orders into a computer system are known as Computerized Provider Order Entry (CPOE) systems. Adoption of laboratory CPOE systems may offer institutions many benefits, including reduced test turnaround time, improved test utilization, and better adherence to practice guidelines. In this review, we outline the functionality of various CPOE implementations, review the reported benefits, and discuss strategies for using CPOE to improve the test ordering process. Further, we discuss barriers to the implementation of CPOE systems that have prevented their more widespread adoption. PMID:21886891

Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

PubMed

Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

2014-07-01

Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and useful ways. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Stabilometer Computerized Analog Recording System for Studying Gross Motor Skill Learning

ERIC Educational Resources Information Center

Chasey, William C., Jr.; And Others

1976-01-01

The stabilometer computerized analog recording system (SCARS) provides for storing analog and digital information on a single channel audio tape recorder at lower cost and greater versatility than other systems. (MB)

Guided medication dosing for elderly emergency patients using real-time, computerized decision support.

PubMed

Griffey, Richard T; Lo, Helen G; Burdick, Elisabeth; Keohane, Carol; Bates, David W

2012-01-01

To evaluate the impact of a real-time computerized decision support tool in the emergency department that guides medication dosing for the elderly on physician ordering behavior and on adverse drug events (ADEs). A prospective controlled trial was conducted over 26 weeks. The status of the decision support tool alternated OFF (7/17/06-8/29/06), ON (8/29/06-10/10/06), OFF (10/10/06-11/28/06), and ON (11/28/06-1/16/07) in consecutive blocks during the study period. In patients ≥65 who were ordered certain benzodiazepines, opiates, non-steroidals, or sedative-hypnotics, the computer application either adjusted the dosing or suggested a different medication. Physicians could accept or reject recommendations. The primary outcome compared medication ordering consistent with recommendations during ON versus OFF periods. Secondary outcomes included the admission rate, emergency department length of stay for discharged patients, 10-fold dosing orders, use of a second drug to reverse the original medication, and rate of ADEs using previously validated explicit chart review. 2398 orders were placed for 1407 patients over 1548 visits. The majority (49/53; 92.5%) of recommendations for alternate medications were declined. More orders were consistent with dosing recommendations during ON (403/1283; 31.4%) than OFF (256/1115; 23%) periods (p≤0.0001). 673 (43%) visits were reviewed for ADEs. The rate of ADEs was lower during ON (8/237; 3.4%) compared with OFF (31/436; 7.1%) periods (p=0.02). The remaining secondary outcomes showed no difference. Single institution study, retrospective chart review for ADEs. Though overall agreement with recommendations was low, real-time computerized decision support resulted in greater acceptance of medication recommendations. Fewer ADEs were observed when computerized decision support was active.

[Requirements for the successful implementation of unity of care: study of a computer-assisted dispensation of pharmaceuticals].

PubMed

Lezin, B; Thouin, A; Besnehard, J; Lobbedez, T; Ollivier, C; Ryckelynck, J P

1999-08-01

Even though computerized workstations bring undisputed benefits in nursing units, introducing them is still hard when most of the staff members have to share the workstation. We took advantage of the implementation of the drug prescription software SAUPHIX in a nephrology department to better define the encountered difficulties. The workstation described in this paper is shared by physicians who enter their prescriptions (proprietary names, doses, routes of administration), nurses who use dosage schedules for drug administration, and the chemist who has authority to control prescription orders. Six months after the implementation of the workstation, physicians and nurses had to fill out an anonymous questionnaire aimed at assessing each function of the software. Prescriptions proved to be more accurate and legible, while management of drugs was more precise. However, interns complained that entering data was time consuming. Furthermore, they raised objections to control of prescription orders. Nurses criticized dosage schedules, the primary reason being that they had to change their practice. The convenience of notebooks was questioned by both physicians and nurses who would have preferred a greater number of desktop computers at their disposition. The implementation of a computerized workstation requires information, diplomacy and negotiations to obtain real implication of the staff. Tasks and schedules must be specified for everybody. The system has to be carefully customized, according to the requirement of the unit. Computers must be properly chosen and allocated in sufficient number. Finally, appropriate preparation, staff training and follow-up of the computerized system are essential.

Research Priorities in Environmental Risk Assessment. Workshop on Research Needs in Environmental Toxicology and Chemistry Held in Breckenridge, Colorado on August 16-21, 1987

DTIC Science & Technology

1988-06-30

accordance with SETAC’s goal of providing a forum for communication among professionals involved with the use, protection, and management of the...templated action. Risk assessment provides technical input to risk management , the process of making decisions about the acceptability of risks and the need... management and computerized information-processing capabilities needed for risk assessment is also essential. Aquatic Toxicology In order to quantify and

A Review of Computerized Team Performance Measures to Identify Military-Relevant, Low-to-Medium Fidelity Tests of Small Group Effectiveness during Shared Information Processing

DTIC Science & Technology

2012-05-01

Alexandria, Virginia 22314. Orders will be expedited if placed through the librarian or other person designated to request documents from DTIC...an official Department of the Army position, policy, or decision, unless so designated by other official documentation. Citation of trade names in...teamwork and evaluate the effectiveness of team training methods (Baker and Salas, 1997). Additionally, good measures of team performance should aid the

Case Studies in Practical Career Guidance, Number 5: Computerized Vocational Information System Willowbrook High School, Villa Park, Illinois.

ERIC Educational Resources Information Center

Arutunian, Carol Ann

The Computerized Vocational Information System (CVIS) at Willowbrook High School in Villa Park, Illinois, uses the computer as a tool to help each student explore a wide range of occupations and educational opportunities with some feedback from his own record of ability, achievement, and interest. Computer-based guidance systems are considered a…

Placement Decisions for First-Time-in-College Students Using the Computerized Placement Test. Information Capsule.

ERIC Educational Resources Information Center

Bashford, Joanne

This information capsule explores the effectiveness of score ranges on the Computerized Placement Test (CPT), used to assess the skills of entry-level students at Miami-Dade Community College and place first-time-in-college students in classes. Data are provided for students entering in Fall terms 1996 and 1997 showing the number of students…

SYN-OP-SYS™: A Computerized Management Information System for Quality Assurance and Risk Management

PubMed Central

Thomas, David J.; Weiner, Jayne; Lippincott, Ronald C.

1985-01-01

SYN·OP·SYS™ is a computerized management information system for quality assurance and risk management. Computer software for the efficient collection and analysis of “occurrences” and the clinical data associated with these kinds of patient events is described. The system is evaluated according to certain computer design criteria, and the system's implementation is assessed.

Measuring value for money: a scoping review on economic evaluation of health information systems.

PubMed

Bassi, Jesdeep; Lau, Francis

2013-01-01

To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Forty-two papers were selected and 33 were deemed high quality (scores ≥ 8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified.

Computerized Orders with Standardized Concentrations Decrease Dispensing Errors of Continuous Infusion Medications for Pediatrics

PubMed Central

Sowan, Azizeh K.; Vaidya, Vinay U.; Soeken, Karen L.; Hilmas, Elora

2010-01-01

OBJECTIVES The use of continuous infusion medications with individualized concentrations may increase the risk for errors in pediatric patients. The objective of this study was to evaluate the effect of computerized prescriber order entry (CPOE) for continuous infusions with standardized concentrations on frequency of pharmacy processing errors. In addition, time to process handwritten versus computerized infusion orders was evaluated and user satisfaction with CPOE as compared to handwritten orders was measured. METHODS Using a crossover design, 10 pharmacists in the pediatric satellite within a university teaching hospital were given test scenarios of handwritten and CPOE order sheets and asked to process infusion orders using the pharmacy system in order to generate infusion labels. Participants were given three groups of orders: five correct handwritten orders, four handwritten orders written with deliberate errors, and five correct CPOE orders. Label errors were analyzed and time to complete the task was recorded. RESULTS Using CPOE orders, participants required less processing time per infusion order (2 min, 5 sec ± 58 sec) compared with time per infusion order in the first handwritten order sheet group (3 min, 7 sec ± 1 min, 20 sec) and the second handwritten order sheet group (3 min, 26 sec ± 1 min, 8 sec), (p<0.01). CPOE eliminated all error types except wrong concentration. With CPOE, 4% of infusions processed contained errors, compared with 26% of the first group of handwritten orders and 45% of the second group of handwritten orders (p<0.03). Pharmacists were more satisfied with CPOE orders when compared with the handwritten method (p=0.0001). CONCLUSIONS CPOE orders saved pharmacists' time and greatly improved the safety of processing continuous infusions, although not all errors were eliminated. pharmacists were overwhelmingly satisfied with the CPOE orders PMID:22477811

The Development of COBOL and RPG Instructional Modules to Audit Computerized Accounting Systems.

ERIC Educational Resources Information Center

Skudrna, Vincent J.

1982-01-01

Details steps involved (as found in the literature) in the systems approach to design and develop instruction in order to provide a rationale for the development of instructional modules in COBOL and RPG to teach accounting students how to audit computerized accounting systems. Outlines of two modules are appended. (EAO)

An overview of Virginia's computerized crash records systems.

DOT National Transportation Integrated Search

1995-01-01

This report identifies the various components of Virginia's computerized crash records systems and explains how these components process crash data. Emphasis has been placed on recording information that was previously not documented. Most of the sta...

Computerized parts list system coordinates engineering releases, parts control, and manufacturing planning

NASA Technical Reports Server (NTRS)

Horton, W.; Kinsey, M.

1967-01-01

Computerized parts list system compiles and summarize all pertinent and available information on complex new systems. The parts list system consists of three computer subroutines - list of parts, parts numerical sequence list, and specifications list.

Implementation of an integrated computerized prescriber order-entry system for chemotherapy in a multisite safety-net health system.

PubMed

Chung, Clement; Patel, Shital; Lee, Rosetta; Fu, Lily; Reilly, Sean; Ho, Tuyet; Lionetti, Jason; George, Michael D; Taylor, Pam

2018-03-15

The development of a computerized prescriber order-entry (CPOE) system for chemotherapy in a multisite safety-net health system and the challenges to its successful implementation are described. Before CPOE for chemotherapy was first implemented and embedded in the electronic medical record system of Harris Health System (HHS), pharmacy personnel relied on regimen-specific preprinted order sets. However, due to differences in practice styles and workflow logistics, the paper orders across the 3 facilities were mostly site specific, with varying clinical content. Many of these order sets had not been approved by the oncology subcommittee. In addition, disparities in clinical knowledge and lack of communication contributed to inconsistencies in order set development. Led by medical directors from medical oncology departments at the 3 facilities, pharmacy administrators, and information technology representatives, HHS committed resources to supporting the adoption and use of a CPOE system for chemotherapy. Five practical lessons of broad applicability have been learned: engagement of interprofessional stakeholders, optimization of workflow before CPOE implementation, requirement of verification tool for CPOE, consolidation of protocols, and commitment to ongoing training and support. Evaluation of the CPOE system demonstrated a systemwide reduction in medication errors by 75% ( p < 0.05). Satisfaction with the CPOE system varied among sites and was unchanged institutionwide 6 months after the CPOE implementation. The development and implementation of CPOE for chemotherapy at a multisite safety-net health system created opportunities to optimize patient care and reduce variations through interprofessional collaborations. Initial evaluation suggested that CPOE reduced the medication-order error rate and improved user satisfaction in 1 of 3 facilities. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Application of a computerized environmental information system to master and sector planning

NASA Technical Reports Server (NTRS)

Stewart, J. C.

1978-01-01

A computerized composite mapping system developed as an aid in the land use decision making process is described. Emphasis is placed on consideration of the environment in urban planning. The presence of alluvium, shallow bedrock, surface water, and vegetation growth are among the environmental factors considered. An analysis of the Shady Grove Sector planning is presented as an example of the use of computerized composite mapping for long range planning.

Accounting Information Systems in Healthcare: A Review of the Literature.

PubMed

Hammour, Hadal; Househ, Mowafa; Razzak, Hira Abdul

2017-01-01

As information technology progresses in Saudi Arabia, the manual accounting systems have become graduallyinadequate for decision needs. Subsequently, private and public healthcare divisions in Saudi Arabia perceive Computerized accounting information system (CAIS) as a vehicle to safeguard efficient and effective flow of information during the analysis, processes, and recording of financial data. Efficient and effective flow of information improvesthe decision making of staff, thereby improving the capability of health care sectors to reduce cost of the medical services.In this paper, we define computerized accounting systems from the point of view of health informatics. Also, the challenges and benefits of supporting CAIS applications in hospitals of Saudi Arabia. With these elements, we conclude that CAIS in Saudi Arabia can serve as a valuable tool for evaluating and controlling the cost of medical services in healthcare sectors. Supplementary education on the significance of having systems of computerized accounting within hospitals for nurses, doctors, and accountants with other health care staff is warranted in future.

Evaluation of real-time clinical decision support systems for platelet and cryoprecipitate orders.

PubMed

Collins, Ryan A; Triulzi, Darrell J; Waters, Jonathan H; Reddy, Vivek; Yazer, Mark H

2014-01-01

To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system. Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines. There were 1,889 orders for platelets and 152 orders for cryoprecipitate placed in 6 months. Of these, 1,102 (58.3%) platelet and 74 (48.7%) cryoprecipitate orders triggered an alert. The proportion of orders canceled after an alert was generated ranged from 13.5% to 17.9% for platelets and 0% to 50.0% for cryoprecipitate orders. CDSS alerts reduce, but do not eliminate, platelet and cryoprecipitate transfusions that do not meet institutional guidelines.

Documentation of Nursing Practice Using a Computerized Medical Information System

PubMed Central

Romano, Carol

1981-01-01

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

An Assessment of Health Care Information and Management Systems Society and Leapfrog Data on Computerized Provider Order Entry

PubMed Central

Diana, Mark L; Kazley, Abby Swanson; Menachemi, Nir

2011-01-01

Objective To assess the internal consistency and agreement between the Health Care Information and Management Systems Society (HIMSS) and the Leapfrog computerized provider order entry (CPOE) data. Data Sources Secondary hospital data collected by HIMSS Analytics, the Leapfrog Group, and the American Hospital Association from 2005 to 2007. Study Design Dichotomous measures of full CPOE status were created for the HIMSS and Leapfrog datasets in each year. We assessed internal consistency by calculating the percent of full adopters in a given year that report full CPOE status in subsequent years. We assessed the level of agreement between the two datasets by calculating the κ statistic and McNemar's test. We examined responsiveness by assessing the change in full CPOE status rates, over time, reported by HIMSS and Leapfrog data, respectively. Principal Findings Findings indicate minimal agreement between the two datasets regarding positive hospital CPOE status, but adequate agreement within a given dataset from year to year. Relative to each other, the HIMSS data tend to overestimate increases in full CPOE status over time, while the Leapfrog data may underestimate year over year increases in national CPOE status. Conclusions Both Leapfrog and HIMSS data have strengths and weaknesses. Those interested in studying outcomes associated with CPOE use or adoption should be aware of the strengths and limitations of the Leapfrog and HIMSS datasets. Future development of a standard definition of CPOE status in hospitals will allow for a more comprehensive validation of these data. PMID:21449956

Facilitating Stroke Management using Modern Information Technology.

PubMed

Nam, Hyo Suk; Park, Eunjeong; Heo, Ji Hoe

2013-09-01

Information technology and mobile devices may be beneficial and useful in many aspects of stroke management, including recognition of stroke, transport and triage of patients, emergent stroke evaluation at the hospital, and rehabilitation. In this review, we address the contributions of information technology and mobile health to stroke management. Rapid detection and triage are essential for effective thrombolytic treatment. Awareness of stroke warning signs and responses to stroke could be enhanced by using mobile applications. Furthermore, prehospital assessment and notification could be streamlined for use in telemedicine and teleradiology. A mobile telemedicine system for assessing the National Institutes of Health Stroke Scale scores has shown higher correlation and fast assessment comparing with face-to-face method. Because the benefits of thrombolytic treatment are time-dependent, treatment should be initiated as quickly as possible. In-hospital communication between multidisciplinary team members can be enhanced using information technology. A computerized in-hospital alert system using computerized physician-order entry was shown to be effective in reducing the time intervals from hospital arrival to medical evaluations and thrombolytic treatment. Mobile devices can also be used as supplementary tools for neurologic examination and clinical decision-making. In post-stroke rehabilitation, virtual reality and telerehabilitation are helpful. Mobile applications might be useful for public awareness, lifestyle modification, and education/training of healthcare professionals. Information technology and mobile health are useful tools for management of stroke patients from the acute period to rehabilitation. Further improvement of technology will change and enhance stroke prevention and treatment.

Notes from a clinical information system program manager. A solid vision makes all the difference.

PubMed

Staggers, N

1997-01-01

Today's CIS manager will create a vision that connects computerization in ambulatory, home and community-based care with increased responsibility for patients to assume self-care. Patients will be faced with a glut of information and they will need nursing help in determining the validity of information. The new vision in this environment will focus on integration, interoperability, and a new definition for patient-centered information. Creating a well-articulated vision is the first skill in the repertoire of a CIS manager's tool set. A vision provides the firm structure upon which the entire project can be built, and provides for links to life-cycle planning. This first step in project planning begins to bring order to the chaos of dynamic demands in clinical computing.

A Computerized Content Analysis of the Perceived Criterion Categories for the "Speech to Inform" of Inexperienced and Experienced Basic Course Students.

ERIC Educational Resources Information Center

Jones, Tom; Di Salvo, Vince

A computerized content analysis of the "theory input" for a basic speech course was conducted. The questions to be answered were (1) What does the inexperienced basic speech student hold as a conceptual perspective of the "speech to inform" prior to his being subjected to a college speech class? and (2) How does that inexperienced student's…

Computerized Drug Information Services

ERIC Educational Resources Information Center

And Others; Smith, Daniel R.

1972-01-01

To compare computerized services in chemistry, pharmacology, toxicology, and clinical medicine of pharmaceutical interest, equivalent profiles were run on magnetic tape files of CA-Condensates," CBAC," Excerpta Medica," MEDLARS" and Ringdoc." The results are tabulated for overlap of services, relative speed of citing references, and unique…

g--Acceleration of Gravity: Its Measurement from the Shape of Water by Using a Computerized Rotational System

ERIC Educational Resources Information Center

Pintao, Carlos A. F.; de Souza Filho, Moacir P.

2007-01-01

This paper proposes a different experimental setup compared with the traditional ones, in order to determine the acceleration of gravity, which is carried out by using a fluid at a constant rotation. A computerized rotational system--by using a data acquisition system with specific software, a power amplifier and a rotary motion sensor--is…

Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care

PubMed Central

2011-01-01

Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index), were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (κ = 0.990), with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (κ = 0.778), the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who also had diabetes and in those aged 70 years or over. Conclusions Our results substantiate the validity of using diagnoses of diabetes and hypertension found within the computerized clinical records for epidemiologic studies. PMID:22035202

Total Library Computerization for Windows.

ERIC Educational Resources Information Center

Combs, Joseph, Jr.

1999-01-01

Presents a general review of features of version 2.1 of Total Library Computerization (TLC) for Windows from On Point, Inc. Includes information about pricing, hardware and operating systems, modules/functions available, user interface, security, on-line catalog functions, circulation, cataloging, and documentation and online help. A table…

36 CFR 1120.52 - Computerized records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Computerized records. 1120.52 Section 1120.52 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE... additional programming of the computer, thus producing information not previously in being, is not required...

36 CFR 1120.52 - Computerized records.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Computerized records. 1120.52 Section 1120.52 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE... additional programming of the computer, thus producing information not previously in being, is not required...

Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review.

PubMed

Bogdanova, Yelena; Yee, Megan K; Ho, Vivian T; Cicerone, Keith D

Comprehensive review of the use of computerized treatment as a rehabilitation tool for attention and executive function in adults (aged 18 years or older) who suffered an acquired brain injury. Systematic review of empirical research. Two reviewers independently assessed articles using the methodological quality criteria of Cicerone et al. Data extracted included sample size, diagnosis, intervention information, treatment schedule, assessment methods, and outcome measures. A literature review (PubMed, EMBASE, Ovid, Cochrane, PsychINFO, CINAHL) generated a total of 4931 publications. Twenty-eight studies using computerized cognitive interventions targeting attention and executive functions were included in this review. In 23 studies, significant improvements in attention and executive function subsequent to training were reported; in the remaining 5, promising trends were observed. Preliminary evidence suggests improvements in cognitive function following computerized rehabilitation for acquired brain injury populations including traumatic brain injury and stroke. Further studies are needed to address methodological issues (eg, small sample size, inadequate control groups) and to inform development of guidelines and standardized protocols.

Assessment of eHealth capabilities and utilization in residential care settings.

PubMed

Towne, Samuel D; Lee, Shinduk; Li, Yajuan; Smith, Matthew Lee

2016-12-01

The US National Survey of Residential Care Facilities was used to conduct cross-sectional analyses of residential care facilities (n = 2302). Most residential care facilities lacked computerized capabilities for one or more of these capabilities in 2010. Lacking computerized systems supporting electronic health information exchange with pharmacies was associated with non-chain affiliation (p < .05). Lacking electronic health information exchange with physicians was associated with being a small-sized facility (vs large) (p < .05). Lacking computerized capabilities for discharge/transfer summaries was associated with for-profit status (p < .05) and small-sized facilities (p < .05). Lacking computerized capabilities for medical provider information was associated with non-chain affiliation (p < .05), small- or medium-sized facilities (p < .05), and for-profit status (p < .05). Lack of electronic health record was associated with non-chain affiliation (p < .05), small- or medium-sized facilities (p < .05), for-profit status (p < .05), and location in urban areas (p < .05). eHealth disparities exist across residential care facilities. As the older adult population continues to grow, resources must be in place to provide an integrated system of care across multiple settings. © The Author(s) 2015.

Feasibility Study for a Computerized Serials Control System in the Defense Communications Agency Technical and Management Information Center.

DTIC Science & Technology

1984-06-20

AD-A162 ±88 FEASIBILITY STUDY FOR A COMPUTERIZED SERIALS CONTROL 1/1 SYSTEM IN THE DEFENS (U) DEFENSE COMMUNICATIONS AGENCY WASHINGTON DC TECHNICAL...NATIONAL BUREAU OF STANDARDS- 1963-A 0FEASIBILITY STUDY FOR A COMPUTERIZED SERIALS CONTROL SYSTEM IN THE DEFENSE COMMUNICATIONS 0AGENCY TECHNICAL AND...ABSTRACT 21. ABSTRACT SECURITY CLASSIFICATION UNCLASSIFIED/UNLIMITED R1 SAME AS RPT. 0 DTIC USERS 0 UNCLASSIFIED 22&. NAME OF RESPONSIBLE INDIVIDUAL 22b

Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

PubMed

Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

2013-03-06

Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings should be incorporated into the design and implementation of a computerized shared decision aid at an inner-city hospital.

Measuring value for money: a scoping review on economic evaluation of health information systems

PubMed Central

Bassi, Jesdeep; Lau, Francis

2013-01-01

Objective To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. Materials and methods We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Results Forty-two papers were selected and 33 were deemed high quality (scores ≥8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. Conclusions We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified. PMID:23416247

36 CFR 1120.52 - Computerized records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... organizations and upon the particular types of computer and associated equipment and the amounts of time on such... from the computer which permits copying the printout, the material will be made available at the per... information from computerized records frequently involves a minimum computer time cost of approximately $100...

36 CFR 1120.52 - Computerized records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... organizations and upon the particular types of computer and associated equipment and the amounts of time on such... from the computer which permits copying the printout, the material will be made available at the per... information from computerized records frequently involves a minimum computer time cost of approximately $100...

36 CFR § 1120.52 - Computerized records.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Computerized records. § 1120.52 Section § 1120.52 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS... could be produced only by additional programming of the computer, thus producing information not...

Creating Resilient IT: How the Sign-Out Sheet Shows Clinicians Make Healthcare Work

PubMed Central

Nemeth, Christopher; Nunnally, Mark; O’Connor, Michael; Cook, Richard

2006-01-01

Information technology (IT) systems have been described as brittle and prone to automation surprises. Recent report of information system failure, particularly computerized physician order entry (CPOE) systems, shows the result of IT failure in actual practice. Such mismatches with healthcare work requirements necessitate improvement to IT research and development. Efforts to develop successful IT systems for healthcare’s sharp end must incorporate properties that reflect workers’ initiative in respose to domain constraints. Resilience is the feature of some systems that makes it possible for them to respond to sudden, unanticipated demands for performance and return to normal operation quickly, with minimum decrement in performance. Workers create resilience at healthcare’s sharp end by daily confronting constraints and obstacles that need to be surmounted in order to accomplish results. The sign-out sheet is an example of resilience that can be used to guide IT development. PMID:17238408

[Application of regular expression in extracting key information from Chinese medicine literatures about re-evaluation of post-marketing surveillance].

PubMed

Wang, Zhifei; Xie, Yanming; Wang, Yongyan

2011-10-01

Computerizing extracting information from Chinese medicine literature seems more convenient than hand searching, which could simplify searching process and improve the accuracy. However, many computerized auto-extracting methods are increasingly used, regular expression is so special that could be efficient for extracting useful information in research. This article focused on regular expression applying in extracting information from Chinese medicine literature. Two practical examples were reported in this article about regular expression to extract "case number (non-terminology)" and "efficacy rate (subgroups for related information identification)", which explored how to extract information in Chinese medicine literature by means of some special research method.

Computer-supported weight-based drug infusion concentrations in the neonatal intensive care unit.

PubMed

Giannone, Gay

2005-01-01

This article addresses the development of a computerized provider order entry (CPOE)-embedded solution for weight-based neonatal drug infusion developed during the transition from a legacy CPOE system to a customized application of a neonatal CPOE product during a hospital-wide information system transition. The importance of accurate fluid management in the neonate is reviewed. The process of tailoring the system that eventually resulted in the successful development of a computer application enabling weight-based medication infusion calculation for neonates within the CPOE information system is explored. In addition, the article provides guidelines on how to customize a vendor solution for hospitals with neonatal intensive care unit.

Reflecting on the ethical administration of computerized medical records

NASA Astrophysics Data System (ADS)

Collmann, Jeff R.

1995-05-01

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

Evaluating the Relationship of Computer Literacy Training Competence and Nursing Experience to CPIS Resistance

ERIC Educational Resources Information Center

Reese, Dorothy J.

2012-01-01

The purpose of this quantitative, descriptive/correlational project was to examine the relationship between the level of computer literacy, informatics training, nursing experience, and perceived competence in using computerized patient information systems (CPIS) and nursing resistance to using CPIS. The Nurse Computerized Patient Information…

Special Education Curriculum (Computerized IEP Catalog).

ERIC Educational Resources Information Center

Garland Independent School District, TX.

This special education curriculum, developed by the Garland (Texas) Independent School District, outlines the basic tools for preparing an Individual Educational Plan (IEP) for each handicapped student. The curricular information is organized and coded to facilitate computerized printing of the IEP. The document begins with a list of 13…

Unesco Integrated Documentation Network; Computerized Documentation System (CDS).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Paris (France). Dept. of Documentation, Libraries, and Archives.

Intended for use by the Computerized Documentation System (CDS), the Unesco version of ISIS (Integrated Set of Information Systems)--originally developed by the International Labour Organization--was developed in 1975 and named CDS/ISIS. This system has a comprehensive collection of programs for input, management, and output, running in batch or…

Initial clinical experience with computerized tomography of the body.

PubMed

Stephens, D H; Sheedy, P F; Hattery, R R; Hartman, G W

1976-04-01

Computerized tomography of the body, now possible with an instrument that can complete a scan rapidly enough to permit patients to suspend respiration, adds an important new dimension to radiologic diagnosis. Cross-sectional antomy is uniquely reconstructed to provide accurate diagnostic information for various disorders throughout the body.

Computerized technique for recording board defect data

Treesearch

R. Bruce Anderson; R. Edward Thomas; Charles J. Gatchell; Neal D. Bennett; Neal D. Bennett

1993-01-01

A computerized technique for recording board defect data has been developed that is faster and more accurate than manual techniques. The lumber database generated by this technique is a necessary input to computer simulation models that estimate potential cutting yields from various lumber breakdown sequences. The technique allows collection of detailed information...

Interactive computerized learning program exposes veterinary students to challenging international animal-health problems.

PubMed

Conrad, Patricia A; Hird, Dave; Arzt, Jonathan; Hayes, Rick H; Magliano, Dave; Kasper, Janine; Morfin, Saul; Pinney, Stephen

2007-01-01

This article describes a computerized case-based CD-ROM (CD) on international animal health that was developed to give veterinary students an opportunity to "virtually" work alongside veterinarians and other veterinary students as they try to solve challenging disease problems relating to tuberculosis in South African wildlife, bovine abortion in Mexico, and neurologic disease in horses in Rapa Nui, Chile. Each of the three case modules presents, in a highly interactive format, a problem or mystery that must be solved by the learner. As well as acquiring information via video clips and text about the specific health problem, learners obtain information about the different countries, animal-management practices, diagnostic methods, related disease-control issues, economic factors, and the opinions of local experts. After assimilating this information, the learner must define the problem and formulate an action plan or make a recommendation or diagnosis. The computerized program invokes three principles of adult education: active learning, learner-centered education, and experiential learning. A medium that invokes these principles is a potentially efficient learning tool and template for developing other case-based problem-solving computerized programs. The program is accessible on the World Wide Web at . A broadband Internet connection is recommended, since the modules make extensive use of embedded video and audio clips. Information on how to obtain the CD is also provided.

Critical factors influencing physicians' intention to use computerized clinical practice guidelines: an integrative model of activity theory and the technology acceptance model.

PubMed

Hsiao, Ju-Ling; Chen, Rai-Fu

2016-01-16

With the widespread use of information communication technologies, computerized clinical practice guidelines are developed and considered as effective decision supporting tools in assisting the processes of clinical activities. However, the development of computerized clinical practice guidelines in Taiwan is still at the early stage and acceptance level among major users (physicians) of computerized clinical practice guidelines is not satisfactory. This study aims to investigate critical factors influencing physicians' intention to computerized clinical practice guideline use through an integrative model of activity theory and the technology acceptance model. The survey methodology was employed to collect data from physicians of the investigated hospitals that have implemented computerized clinical practice guidelines. A total of 505 questionnaires were sent out, with 238 completed copies returned, indicating a valid response rate of 47.1 %. The collected data was then analyzed by structural equation modeling technique. The results showed that attitudes toward using computerized clinical practice guidelines (γ = 0.451, p < 0.001), organizational support (γ = 0.285, p < 0.001), perceived usefulness of computerized clinical practice guidelines (γ = 0.219, p < 0.05), and social influence (γ = 0.213, p < 0.05) were critical factors influencing physicians' intention to use computerized clinical practice guidelines, and these factors can explain 68.6 % of the variance in intention to use computerized clinical practice guidelines. This study confirmed that some subject (human) factors, environment (organization) factors, tool (technology) factors mentioned in the activity theory should be carefully considered when introducing computerized clinical practice guidelines. Managers should pay much attention on those identified factors and provide adequate resources and incentives to help the promotion and use of computerized clinical practice guidelines. Through the appropriate use of computerized clinical practice guidelines, the clinical benefits, particularly in improving quality of care and facilitating the clinical processes, will be realized.

Computer programming: quality and safety for neonatal parenteral nutrition orders.

PubMed

Huston, Robert K; Markell, Andrea M; McCulley, Elizabeth A; Marcus, Matthew J; Cohen, Howard S

2013-08-01

Computerized software programs reduce errors and increase consistency when ordering parenteral nutrition (PN). The purpose of this study was to evaluate the effectiveness of our computerized neonatal PN calculator ordering program in reducing errors and optimizing nutrient intake. This was a retrospective study of infants requiring PN during the first 2-3 weeks of life. Caloric, protein, calcium, and phosphorus intakes; days above and below amino acid (AA) goals; and PN ordering errors were recorded. Infants were divided into 3 groups by birth weight for analysis: ≤1000 g, 1001-1500 g, and >1500 g. Intakes and outcomes of infants before (2007) vs after (2009) implementation of the calculator for each group were compared. There were no differences in caloric, protein, or phosphorus intakes in 2007 vs 2009 in any group. Mean protein intakes were 97%-99% of goal for ≤1000-g and 1001- to 1500-g infants in 2009 vs 87% of goal for each group in 2007. In 2007, 7.6 per 100 orders were above and 11.5 per 100 were below recommended AA intakes. Calcium intakes were higher in 2009 vs 2007 in ≤1000-g (46.6 ± 6.1 vs 39.5 ± 8.0 mg/kg/d, P < .001) and >1500-g infants (50.6 ± 7.4 vs 39.9 ± 8.3 mg/kg/d, P < .001). Ordering errors were reduced from 4.6 per 100 in 2007 to 0.1 per 100 in 2009. Our study reaffirms that computerized ordering systems can increase the quality and safety of neonatal PN orders. Calcium and AA intakes were optimized and ordering errors were minimized using the computer-based ordering program.

Views on health information sharing and privacy from primary care practices using electronic medical records.

PubMed

Perera, Gihan; Holbrook, Anne; Thabane, Lehana; Foster, Gary; Willison, Donald J

2011-02-01

To determine how patients and physicians balance the perceived benefits and harms of sharing electronic health data for patient care and for secondary purposes. Before-after survey of patients and providers in practices using electronic medical records (EMRs) enrolled in a clinical trial in Ontario, Canada. Outcomes were measured using the Health Information Privacy Questionnaire (HIPQ) at baseline and end of study. Thirteen questions in 4 general domains investigated attitudes towards the privacy of EMRs, outsider's use of patient's health information, the sharing of patient's information within the health care system, and the overall perception of benefits versus harms of computerization in health care. 511 patients (mean age 60.3 years, 49.6% female) and 46 physicians (mean age 47.2 years, 37.0% female) participated. Most (>90%) supported the computerized sharing of the patient's health records among their health care professionals and to provide clinical advice. Fewer agreed that the patient's de-identified information should be shared outside of the health care circle (<70%). Only a minority of either group supported the notion that computerized records can be keep more private than paper records (38-50%). Overall, a majority (58% patients, 70% physicians) believed that the benefits of computerization were greater than the risks of confidentiality loss. This was especially true for patients who were frequent computer users. While these primary care physicians and their patients valued the clinical features of EMRs, a substantial minority have concerns about the secondary use of de-identified information. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effect of a Computerized Provider Order Entry (CPOE) System on Medication Orders at a Community Hospital and University Hospital

PubMed Central

Wess, Mark L.; Embi, Peter J.; Besier, James L.; Lowry, Chad H.; Anderson, Paul F.; Besier, James C.; Thelen, Geriann; Hegner, Catherine

2007-01-01

Computerized Provider Order Entry (CPOE) has been demonstrated to improve the medication ordering process, but most published studies have been performed at academic hospitals. Little is known about the effects of CPOE at community hospitals. With a pre-post study design, we assessed the effects of a CPOE system on the medication ordering process at both a community and university hospital. The time from provider ordering to pharmacist verification decreased by two hours with CPOE at the community hospital (p<0.0001) and by one hour at the university hospital (p<0.0001). The rate of medication clarifications requiring signature was 2.80 percent pre-CPOE and 0.40 percent with CPOE (p<0.0001) at the community hospital. The university hospital was 2.76 percent pre-CPOE and 0.46 percent with CPOE (p<0.0001). CPOE improved medication order processing at both community and university hospitals. These findings add to the limited literature on CPOE in community hospitals. PMID:18693946

City public service learns to speed read. [Computerized routing system for meter reading

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

Aitken, E.L.

1994-02-01

City Public Service (CPS) of San Antonio, TX is a municipally owned utility that serves a densely populated 1,566 square miles in and around San Antonio. CPS's service area is divided into 21 meter reading districts, each of which is broken down into no more than 99 regular routes. Every day, a CPS employee reads one of the districts, following one or more routes. In 1991, CPS began using handheld computers to record reads for regular routes, which are stored on the devices themselves. In contrast, rereads and final reads occur at random throughout the service area. Because they changemore » every day, the process of creating routes that can be loaded onto a handheld device is difficult. Until recently, rereads and final reads were printed on paper orders, and route schedulers would spend close to two hours sorting the paper orders into routes. Meter readers would then hand-sequence the orders on their routes, often using a city map, before taking them into the field in stacks. When the meter readers returned, their completed orders had to be separated by type of reread, and then keyed into the mainframe computer before bill processing could begin. CPS's data processing department developed a computerized routing system of its own that saves time and labor, as well as paper. The system eliminates paper orders entirely, enabling schedulers to create reread and final read routes graphically on a PC. Information no longer needs to be keyed from hard copy, reducing the margin of error and streamlining bill processing by incorporating automated data transfer between systems.« less

A case study on the impacts of computerized provider order entry (CPOE) system on hospital clinical workflow.

PubMed

Mominah, Maher; Yunus, Faisel; Househ, Mowafa S

2013-01-01

Computerized provider order entry (CPOE) is a health informatics system that helps health care providers create and manage orders for medications and other health care services. Through the automation of the ordering process, CPOE has improved the overall efficiency of hospital processes and workflow. In Saudi Arabia, CPOE has been used for years, with only a few studies evaluating the impacts of CPOE on clinical workflow. In this paper, we discuss the experience of a local hospital with the use of CPOE and its impacts on clinical workflow. Results show that there are many issues related to the implementation and use of CPOE within Saudi Arabia that must be addressed, including design, training, medication errors, alert fatigue, and system dep Recommendations for improving CPOE use within Saudi Arabia are also discussed.

17 CFR 201.141 - Orders and decisions: Service of orders instituting proceedings and other orders and decisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... (3) Record of service. The Secretary shall maintain a record of service on parties (in hard copy or computerized format), identifying the party given notice, the method of service, the date of service, the...

Improving adherence to the Epic Beacon ambulatory workflow.

PubMed

Chackunkal, Ellen; Dhanapal Vogel, Vishnuprabha; Grycki, Meredith; Kostoff, Diana

2017-06-01

Computerized physician order entry has been shown to significantly improve chemotherapy safety by reducing the number of prescribing errors. Epic's Beacon Oncology Information System of computerized physician order entry and electronic medication administration was implemented in Henry Ford Health System's ambulatory oncology infusion centers on 9 November 2013. Since that time, compliance to the infusion workflow had not been assessed. The objective of this study was to optimize the current workflow and improve the compliance to this workflow in the ambulatory oncology setting. This study was a retrospective, quasi-experimental study which analyzed the composite workflow compliance rate of patient encounters from 9 to 23 November 2014. Based on this analysis, an intervention was identified and implemented in February 2015 to improve workflow compliance. The primary endpoint was to compare the composite compliance rate to the Beacon workflow before and after a pharmacy-initiated intervention. The intervention, which was education of infusion center staff, was initiated by ambulatory-based, oncology pharmacists and implemented by a multi-disciplinary team of pharmacists and nurses. The composite compliance rate was then reassessed for patient encounters from 2 to 13 March 2015 in order to analyze the effects of the determined intervention on compliance. The initial analysis in November 2014 revealed a composite compliance rate of 38%, and data analysis after the intervention revealed a statistically significant increase in the composite compliance rate to 83% ( p < 0.001). This study supports a pharmacist-initiated educational intervention can improve compliance to an ambulatory, oncology infusion workflow.

An Efficiency Balanced Information Criterion for Item Selection in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Han, Kyung T.

2012-01-01

Successful administration of computerized adaptive testing (CAT) programs in educational settings requires that test security and item exposure control issues be taken seriously. Developing an item selection algorithm that strikes the right balance between test precision and level of item pool utilization is the key to successful implementation…

Reliability and Validity of the Flemish Physical Activity Computerized Questionnaire in Adults

ERIC Educational Resources Information Center

Matton, Lynn; Wijndaele, Katrien; Duvigneaud, Nathalie; Duquet, William; Philippaerts, Renaat; Thomis, Martine; Lefevre, Johan

2007-01-01

The purpose of this study was to investigate the test-retest reliability and concurrent validity of the Flemish Physical Activity Computerized Questionnaire (FPACQ) in employed/unemployed and retired people. The FPACQ was developed to assess detailed information on several dimensions of physical activity and sedentary behavior over a usual week. A…

Deriving Stopping Rules for Multidimensional Computerized Adaptive Testing

ERIC Educational Resources Information Center

Wang, Chun; Chang, Hua-Hua; Boughton, Keith A.

2013-01-01

Multidimensional computerized adaptive testing (MCAT) is able to provide a vector of ability estimates for each examinee, which could be used to provide a more informative profile of an examinee's performance. The current literature on MCAT focuses on the fixed-length tests, which can generate less accurate results for those examinees whose…

Policy Manual for a Computerized Search Service in an Academic Library.

ERIC Educational Resources Information Center

Jackson, William J.

This proposed policy manual for the computerized information retrieval service of the University of Houston System outlines policies for specific elements of its operation: (1) users--who is/is not eligible for service and for equipment use; (2) cost--rates charged; (3) responsibilities of searchers--maintenance of searching skills, scheduling of…

Dual-Objective Item Selection Criteria in Cognitive Diagnostic Computerized Adaptive Testing

ERIC Educational Resources Information Center

Kang, Hyeon-Ah; Zhang, Susu; Chang, Hua-Hua

2017-01-01

The development of cognitive diagnostic-computerized adaptive testing (CD-CAT) has provided a new perspective for gaining information about examinees' mastery on a set of cognitive attributes. This study proposes a new item selection method within the framework of dual-objective CD-CAT that simultaneously addresses examinees' attribute mastery…

Age influence on attitudes of office workers faced with new computerized technologies: a questionnaire analysis.

PubMed

Marquié, J C; Thon, B; Baracat, B

1994-06-01

The study of Bue and Gollac (1988) provided evidence that a significantly lower proportion of workers aged 45 years and over make use of computer technology compared with younger ones. The aim of the present survey was to explain this fact by a more intensive analysis of the older workers' attitude with respect to the computerization of work situations in relation to other individual and organizational factors. Six hundred and twenty office workers from 18 to 70 years old, either users or non-users of computerized devices, were asked to complete a questionnaire. The questions allowed the assessment of various aspects of the workers' current situation, such as the computer training they had received, the degree of consultation they were subjected to during the computerization process, their representation of the effects of these new technologies on working conditions and employment, the rate of use of new technologies outside the work context, and the perceived usefulness of computers for their own work. The analysis of the questionnaire revealed that as long as the step towards using computer tools, even minimally, has not been taken, then attitudes with respect to computerization are on the whole not very positive and are a source of anxiety for many workers. Age, and even more, seniority in the department, increase such negative representations. The effects of age and seniority were also found among users, as well as the effects of other factors such as qualification, education level, type and rate of computer use, and size of the firm. For the older workers, the expectation of less positive consequences for their career, or even the fear that computerization might be accompanied by threats to their own employment and the less clear knowledge of how computers operate, appeared to account for a significant part of the observed age and seniority differences in attitudes. Although the difference in the amount of computer training between age groups was smaller than expected, the study revealed that one third of the users never received any specific training, and that many of those who benefited from it were trained for only a few days. Consultation of the staff during the computerization process also appeared to be poor, to apply mostly to the best trained and qualified workers, and to be more highly developed in small companies. The results are discussed in the light of more qualitative data recorded during the survey. They suggest the need to increase information, training and involvement of all personnel from the very first stages of computerization (or other technical changes) in order to lessen fears and the feeling of disruption, which are particularly obvious among the oldest workers.

Health technology assessment review: Computerized glucose regulation in the intensive care unit - how to create artificial control

PubMed Central

2009-01-01

Current care guidelines recommend glucose control (GC) in critically ill patients. To achieve GC, many ICUs have implemented a (nurse-based) protocol on paper. However, such protocols are often complex, time-consuming, and can cause iatrogenic hypoglycemia. Computerized glucose regulation protocols may improve patient safety, efficiency, and nurse compliance. Such computerized clinical decision support systems (Cuss) use more complex logic to provide an insulin infusion rate based on previous blood glucose levels and other parameters. A computerized CDSS for glucose control has the potential to reduce overall workload, reduce the chance of human cognitive failure, and improve glucose control. Several computer-assisted glucose regulation programs have been published recently. In order of increasing complexity, the three main types of algorithms used are computerized flowcharts, Proportional-Integral-Derivative (PID), and Model Predictive Control (MPC). PID is essentially a closed-loop feedback system, whereas MPC models the behavior of glucose and insulin in ICU patients. Although the best approach has not yet been determined, it should be noted that PID controllers are generally thought to be more robust than MPC systems. The computerized Cuss that are most likely to emerge are those that are fully a part of the routine workflow, use patient-specific characteristics and apply variable sampling intervals. PMID:19849827

C-A4-01: Computerized Clinical Decision Support During Drug Ordering for Long-term Care Residents With Renal Insufficiency

PubMed Central

Field, Terry S; Rochon, Paula; Lee, Monica; Gavendo, Linda; Baril, Joann L; Gurwitz, Jerry H

2010-01-01

Objective: To determine whether a computerized clinical decision support system (CDSS) providing patient specific recommendations in real- time improves the quality of prescribing for long-term care residents with renal insufficiency. Design: A randomized trial within the long-stay units of a large long-term care facility. Randomization was within blocks by unit type. Alerts related to medication prescribing for residents with renal insufficiency were displayed to prescribers in the intervention units and hidden but tracked in control units. Measurement: The proportions of final drug orders that were appropriate were compared between intervention and control units within alert categories: recommended medication doses; recommended administration frequencies; recommendations to avoid the drug; 4) warnings of missing information. Results: The rates of alerts were nearly equal in the intervention and control units: 2.5 per 1000 resident days in the intervention units and 2.4 in the control units. The proportions of dose alerts for which the final drug orders were appropriate were similar between the intervention and control units (relative risk 0.95, 95% confidence interval 0.83, 1.1). For the remaining alert categories significantly higher proportions of final drug orders were appropriate in the intervention units: relative risk 2.4 for maximum frequency (1.4, 4.4); 2.6 for drugs that should be avoided (1.4, 5.0); and 1.8 for alerts to acquire missing information (1.1, 3.4). Overall, final drug orders were appropriate significantly more often than a relative risk 1.2 (1.0, 1.4). By tracking personnel time and expenditures, we estimated the cost of developing the CDSS as $48,668.57. Drug costs saved during the 12 months of the trial are estimated at $2,137. Conclusion: Clinical decision support for physicians prescribing medications for long-term care residents with renal insufficiency can improve the quality of prescribing decisions. However, patient well-being and quality of care rather than the business case related to cost savings are likely to be the key drivers for adoption of this HIT application.

Population information resources.

PubMed

Pasquariella, S K

1984-12-01

This article describes print and computerized services that are dedicated to bibliographic coverage of 1 or more areas of population studies. Major printed bibliographic information resources for population material include: ADOPT, DOCPAL Resumenes sobre Poblacion en America Latina, PIDSA Abstracts, Population Index and Review of Population Reviews. ADOPT is an annotated computer-aided current-awareness bibliographic journal which has been published monthly since January 1975 by the Regional Population Information Center of the Economic and Social Commission for Asia and the Pacific (ESCAP). DOCPAL Resumenes is a computer-produced biannual collection of abstracts containing indexes and between 600 and 700 summaries of both published and unpublished population documents. PIDSA is intended to make available documentary information about population matters in sub-Saharan Africa. Population Index, 1 of the oldest and most definitive bibliographies in the demography field, is international in scope and is arranged as a classified and annotated bibliography of monographs, journal articles and 2ndary source material relevant to all aspects of demography. Review of Population Reviews, published 4 times a year, are annotated bibliographies containing summaries of articles that have been published in 83 periodicals in 37 countries. Cited articles are assigned subject-heading descriptors from the Population Multilingual Thesaurus. Major computerized information resources are: DOCPAL, DOCPOP, EBIS/POPFILE, MANPINS, POPLINE and POPULATION BIBLIOGRAPHY. DOCPAL was established to assist Latin Ameran countries in the collection, storage, processing and retrieval of population documents about Latin America. DOCPAL contains over 19,000 bibliographic citations. DOCPOP was established as the 1st Latin American national computerized population documentation system for Brazilian material. POPLINE is a computerized retrieval service cooperatively produced in the US which covers the worldwide literature on population and family planning. POPULATION BIBLIOGRAPHY consists of bibliographic records of the Carolina Population Center Library at the University of North Carolina. EBIS/PROFILE provides computerized literature search services using improved information processing techniques. The system enables interactive information retrieval using a combination of subject descriptors, free text, author names and words in other fields and can be utilized to generate various lists. MANPINS is a cooperative network of 28 population and other libraries in Peninsular Malaysia. Its data bank includes contributions from member libraries in the form of bibliographic information on monographs and journal articles.

Mutual Information Item Selection Method in Cognitive Diagnostic Computerized Adaptive Testing with Short Test Length

ERIC Educational Resources Information Center

Wang, Chun

2013-01-01

Cognitive diagnostic computerized adaptive testing (CD-CAT) purports to combine the strengths of both CAT and cognitive diagnosis. Cognitive diagnosis models aim at classifying examinees into the correct mastery profile group so as to pinpoint the strengths and weakness of each examinee whereas CAT algorithms choose items to determine those…

Evaluating the Effectiveness of Nurse-Focused Computerized Clinical Decision Support on Urinary Catheter Practice Guidelines

ERIC Educational Resources Information Center

Lang, Robin Lynn Neal

2012-01-01

A growing national emphasis has been placed on health information technology (HIT) with robust computerized clinical decision support (CCDS) integration into health care delivery. Catheter-associated urinary tract infection is the most frequent health care-associated infection in the United States and is associated with high cost, high volumes and…

Computerized Placement Management Software (CPMS): User Manual, Version 3.0.

ERIC Educational Resources Information Center

College Entrance Examination Board, Princeton, NJ.

This guide is designed to enable the beginner, as well as the advanced user, to understand and use the Computerized Placement Management Software (CPMS). The CPMS is a system for evaluating information about students and recommending their placement into courses best suited for them. It also tracks their progress and maintains their records. The…

A Computerized Classroom Language Management and Recording System for Deaf and Hard of Hearing Children.

ERIC Educational Resources Information Center

Bornstein, Harry; Casella, Vicki

This interim report describes the development of a networked computerized classroom language management and recording system to assist teachers of children who are deaf or hard-of-hearing. The system will provide storage and access capability for such information as changes in instruction, language learning progress, modifications in communication…

The Child Well-Being Scales as a Clinical Tool and a Management Information System.

ERIC Educational Resources Information Center

Lyons, Peter; Doueck, Howard J.; Koster, Andrew J.; Witzky, Melissa K.; Kelly, Patricia L.

1999-01-01

Describes implementation of a computerized version of the Child Welfare League of America's Child Well-Being Scales by a family services agency in southern Ontario. Reviews results obtained from 172 families to illustrate the potential for using computerized risk assessment as an aid in clinical, supervisory, and management decision-making…

A New Item Selection Procedure for Mixed Item Type in Computerized Classification Testing.

ERIC Educational Resources Information Center

Lau, C. Allen; Wang, Tianyou

This paper proposes a new Information-Time index as the basis for item selection in computerized classification testing (CCT) and investigates how this new item selection algorithm can help improve test efficiency for item pools with mixed item types. It also investigates how practical constraints such as item exposure rate control, test…

A Semiparametric Model for Jointly Analyzing Response Times and Accuracy in Computerized Testing

ERIC Educational Resources Information Center

Wang, Chun; Fan, Zhewen; Chang, Hua-Hua; Douglas, Jeffrey A.

2013-01-01

The item response times (RTs) collected from computerized testing represent an underutilized type of information about items and examinees. In addition to knowing the examinees' responses to each item, we can investigate the amount of time examinees spend on each item. Current models for RTs mainly focus on parametric models, which have the…

The Design and Evaluation of a Computerized Adaptive Test on Mobile Devices

ERIC Educational Resources Information Center

Triantafillou, Evangelos; Georgiadou, Elissavet; Economides, Anastasios A.

2008-01-01

The use of computerized adaptive testing (CAT) has expanded rapidly over recent years mainly due to the advances in communication and information technology. Availability of advanced mobile technologies provides several benefits to e-learning by creating an additional channel of access with mobile devices such as PDAs and mobile phones. This paper…

The Couzens Machine. A Computerized Learning Exchange. Final Report, 1973-74.

ERIC Educational Resources Information Center

Davis, Ken, Comp.; Libengood, Richard, Comp.

The Couzens Machine is a computerized learning exchange and information service developed for the residents of Couzens Hall, a dormitory at the University of Michigan. Organized as a collective within the framework of a course and supported by an instructional development grant from the Center for Research on Learning and Teaching, the Couzens…

Optimizing the Use of Response Times for Item Selection in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Choe, Edison M.; Kern, Justin L.; Chang, Hua-Hua

2018-01-01

Despite common operationalization, measurement efficiency of computerized adaptive testing should not only be assessed in terms of the number of items administered but also the time it takes to complete the test. To this end, a recent study introduced a novel item selection criterion that maximizes Fisher information per unit of expected response…

A Multiple Objective Test Assembly Approach for Exposure Control Problems in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Veldkamp, Bernard P.; Verschoor, Angela J.; Eggen, Theo J. H. M.

2010-01-01

Overexposure and underexposure of items in the bank are serious problems in operational computerized adaptive testing (CAT) systems. These exposure problems might result in item compromise, or point at a waste of investments. The exposure control problem can be viewed as a test assembly problem with multiple objectives. Information in the test has…

The Reliability and Validity of the Dominic Interactive: A Computerized Child Report Instrument for Mental Health Problems

ERIC Educational Resources Information Center

Kuijpers, Rowella C. W. M.; Otten, Roy; Krol, Nicole P. C. M.; Vermulst, Ad A.; Engels, Rutger C. M. E.

2013-01-01

Background: Children and youths' self-report of mental health problems is considered essential but complicated. Objective: This study examines the psychometric properties of the Dominic Interactive, a computerized DSM-IV based self-report questionnaire and explores informant correspondence. Methods: The Dominic Interactive was administered to 214…

Promoting meaningful use of health information technology in Israel: ministry of health vision.

PubMed

Gerber, Ayala; Topaz, Maxim Max

2014-01-01

The Ministry of Health (MOH) of Israel has overall responsibility for the healthcare system. In recent years the MOH has developed strong capabilities in the areas of technology assessment and prioritization of new technologies. Israel completed the transition to computerized medical records a decade ago in most care settings; however, the processes in Israel was spontaneous, without government control and standards settings, therefore large variations among systems and among organizations were created. Currently, the main challenge is to convert the information scattered in different systems, to organized, visible information and to make it available to various levels in health management. The MOH's solution is of implementing a selected information system from a specific vendor, at all the hospitals and all HMO's clinics, in order to achieve interoperability. The sys-tem will enable access to the patient's medical record history from any location.

Health information technology and the medical school curriculum.

PubMed

Triola, Marc M; Friedman, Erica; Cimino, Christopher; Geyer, Enid M; Wiederhorn, Jo; Mainiero, Crystal

2010-12-01

Medical schools must teach core biomedical informatics competencies that address health information technology (HIT), including explaining electronic medical record systems and computerized provider order entry systems and their role in patient safety; describing the research uses and limitations of a clinical data warehouse; understanding the concepts and importance of information system interoperability; explaining the difference between biomedical informatics and HIT; and explaining the ways clinical information systems can fail. Barriers to including these topics in the curricula include lack of teachers; the perception that informatics competencies are not applicable during preclinical courses and there is no place in the clerkships to teach them; and the legal and policy issues that conflict with students' need to develop skills. However, curricular reform efforts are creating opportunities to teach these topics with new emphasis on patient safety, team-based medical practice, and evidence-based care. Overarching HIT competencies empower our students to be lifelong technology learners.

Hypothesis-confirming information search strategies and computerized information-retrieval systems

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

Jacobs, S.M.

A recent trend in information-retrieval systems technology is the development of on-line information retrieval systems. One objective of these systems has been to attempt to enhance decision effectiveness by allowing users to preferentially seek information, thereby facilitating the reduction or elimination of information overload. These systems do not necessarily lead to more-effective decision making, however. Recent research in information-search strategy suggests that when users are seeking information subsequent to forming initial beliefs, they may preferentially seek information to confirm these beliefs. It seems that effective computer-based decision support requires an information retrieval system capable of: (a) retrieving a subset ofmore » all available information, in order to reduce information overload, and (b) supporting an information search strategy that considers all relevant information, rather than merely hypothesis-confirming information. An information retrieval system with an expert component (i.e., a knowledge-based DSS) should be able to provide these capabilities. Results of this study are non conclusive; there was neither strong confirmatory evidence nor strong disconfirmatory evidence regarding the effectiveness of the KBDSS.« less

Evaluating and selecting an information system, Part 1.

PubMed

Neal, T

1993-01-01

Initial steps in the process of evaluating and selecting a computerized information system for the pharmacy department are described. The first step in the selection process is to establish a steering committee and a project committee. The steering committee oversees the project, providing policy guidance, making major decisions, and allocating budgeted expenditures. The project committee conducts the departmental needs assessment, identifies system requirements, performs day-to-day functions, evaluates vendor proposals, trains personnel, and implements the system chosen. The second step is the assessment of needs in terms of personnel, workload, physical layout, and operating requirements. The needs assessment should be based on the department's mission statement and strategic plan. The third step is the development of a request for information (RFI) and a request for proposal (RFP). The RFI is a document designed for gathering preliminary information from a wide range of vendors; this general information is used in deciding whether to send the RFP to a given vendor. The RFP requests more detailed information and gives the purchaser's exact specifications for a system; the RFP also includes contractual information. To help ensure project success, many institutions turn to computer consultants for guidance. The initial steps in selecting a computerized pharmacy information system are establishing computerization committees, conducting a needs assessment, and writing an RFI and an RFP. A crucial early decision is whether to seek a consultant's expertise.

Practitioners’ Views on Computerized Drug–Drug Interaction Alerts in the VA System

PubMed Central

Ko, Yu; Abarca, Jacob; Malone, Daniel C.; Dare, Donna C.; Geraets, Doug; Houranieh, Antoun; Jones, William N.; Nichol, W. Paul; Schepers, Gregory P.; Wilhardt, Michelle

2007-01-01

Objectives To assess Veterans Affairs (VA) prescribers’ and pharmacists’ opinions about computer-generated drug–drug interaction (DDI) alerts and obtain suggestions for improving DDI alerts. Design A mail survey of 725 prescribers and 142 pharmacists from seven VA medical centers across the United States. Measurements A questionnaire asked respondents about their sources of drug and DDI information, satisfaction with the combined inpatient and outpatient computerized prescriber order entry (CPOE) system, attitude toward DDI alerts, and suggestions for improving DDI alerts. Results The overall response rate was 40% (prescribers: 36%; pharmacists: 59%). Both prescribers and pharmacists indicated that the CPOE system had a neutral to positive impact on their jobs. DDI alerts were not viewed as a waste of time and the majority (61%) of prescribers felt that DDI alerts had increased their potential to prescribe safely. However, only 30% of prescribers felt DDI alerts provided them with what they needed most of the time. Both prescribers and pharmacists agreed that DDI alerts should be accompanied by management alternatives (73% and 82%, respectively) and more detailed information (65% and 89%, respectively). When asked about suggestions for improving DDI alerts, prescribers most preferred including management options whereas pharmacists most preferred making it more difficult to override lethal interactions. Prescribers and pharmacists reported primarily relying on electronic references for general drug information (62% and 55%, respectively) and DDI information (51% and 79%, respectively). Conclusion Respondents reported neutral to positive views regarding the effect of CPOE on their jobs. Their opinions suggest DDI alerts are useful but still require additional work to increase their clinical utility. PMID:17068346

Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

PubMed

Staszewska, Anna; Zaki, Pearl; Lee, Joon

2017-10-06

Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious illness. ©Anna Staszewska, Pearl Zaki, Joon Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 06.10.2017.

Implementation of Hospital Computerized Physician Order Entry Systems in a Rural State: Feasibility and Financial Impact

PubMed Central

Ohsfeldt, Robert L.; Ward, Marcia M.; Schneider, John E.; Jaana, Mirou; Miller, Thomas R.; Lei, Yang; Wakefield, Douglas S.

2005-01-01

Objective The aim of this study was to estimate the costs of implementing computerized physician order entry (CPOE) systems in hospitals in a rural state and to evaluate the financial implications of statewide CPOE implementation. Methods A simulation model was constructed using estimates of initial and ongoing CPOE costs mapped onto all general hospitals in Iowa by bed quantity and current clinical information system (CIS) status. CPOE cost estimates were obtained from a leading CPOE vendor. Current CIS status was determined through mail survey of Iowa hospitals. Patient care revenue and operating cost data published by the Iowa Hospital Association were used to simulate the financial impact of CPOE adoption on hospitals. Results CPOE implementation would dramatically increase operating costs for rural and critical access hospitals in the absence of substantial costs savings associated with improved efficiency or improved patient safety. For urban and rural referral hospitals, the cost impact is less dramatic but still substantial. However, relatively modest benefits in the form of patient care cost savings or revenue enhancement would be sufficient to offset CPOE costs for these larger hospitals. Conclusion Implementation of CPOE in rural or critical access hospitals may depend on net increase in operating costs. Adoption of CPOE may be financially infeasible for these small hospitals in the absence of increases in hospital payments or ongoing subsidies from third parties. PMID:15492033

Managed care penetration and other factors affecting computerized physician order entry in the ambulatory setting.

PubMed

Menachemi, Nir; Ford, Eric W; Chukmaitov, Askar; Brooks, Robert G

2006-12-01

To estimate the current uses level of ambulatory computerized physician order entry (A-CPOE) among physicians and to examine the relationship of managed care penetration as well as other market and practice characteristics to use of A-CPOE by physicians. This study uses both primary and secondary data sources. The primary data source was a large-scale survey of physicians' use of information technologies in Florida. Secondary data on managed care penetration were obtained from the Florida Agency for Health Care Administration, and other market-level data were extracted from the area resource file. A hierarchical logistic regression model was used to examine the correlation of county-level and practice-level characteristics with physicians' self-reported use of A-CPOE systems. Overall, 1360 physicians (32.4%) indicated use of an A-CPOE system. Findings suggest that 1% more managed care penetration was associated with 2.1% lower use of A-CPOE (P = .003). Additionally, practice size, multispecialty affiliation, and primary care practice were significantly and positively correlated with the use of A-CPOE. Physician age was negatively associated with A-CPOE use. Managed care organizations may experience significant financial savings from A-CPOE use by physicians; however, managed care penetration in a community negatively affects A-CPOE use among physicians in their practices. Further study regarding the causal nature of this association is warranted.

Development of ground-water vulnerability database for the U.S. Environmental protection agency's hazard ranking system using a geographic information system

USGS Publications Warehouse

Clarke, John S.; Sorensen, Jerry W.; Strickland, Henry G.; Collins, George

1992-01-01

Geographic information system (GIS) methods were applied to the U.S. Environmental Protection Agency's (EPA) hazard ranking system (HRS) to evaluate the vulnerability of ground water to contamination from actual or potential releases of hazardous materials from waste-disposal sites. Computerized maps of four factors influencing ground-water vulnerability - hydraulic conductivity, sorptive capacity, depth to water, and net precipitation - were derived for the Southeastern United States from digitized copies of published maps and from computerized databases, including the U.S. Geological Survey's (USGS) national water information system. To test the accuracy of the derived data coverages used to assess ground-water vulnerability, GIS-derived values for hydraulic conductivity, depth to water, and net precipitation were compared to corresponding values assigned by EPA's field investigation teams (FIT) at 28 hazardous waste sites. For each factor, site data were divided into three physiographic groupings: (1) Coastal Plain, (2) Valley and Ridge-Interior Low Plateaus, and (3) Piedmont-Blue Ridge. The best correlation between the paired data sets was for the net precipitation factor, where most GIS-derived values were within 0 to 40% of the FIT data, and 79% were within the same HRS scoring range. For the hydraulic conductivity factor, the best correlation between GIS and FIT data was for values derived from a published surficial deposits map, where most of the values were within one order of magnitude of the FIT data, and on the average were within 1.24 orders of magnitude of the FIT data. For this map, the best match between data sets was in the Coastal Plain province, where the difference in order to magnitude averaged 0.92. For the depth-to-water factor, most of the GIS derived values were within 51 to 100% of the FIT data, and only 44 to 50% of the sites were within a common scoring range. The best correlation for depth to water was in the Coastal Plain where GIS derived values were within 8 to 100% of the FIT data.

Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.

PubMed

Patel, Minal R; Vichich, Jennifer; Lang, Ian; Lin, Jessica; Zheng, Kai

2017-04-01

The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill "best" behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Evaluation and Certification of Computerized Provider Order Entry Systems

PubMed Central

Classen, David C.; Avery, Anthony J.; Bates, David W.

2007-01-01

Computerized physician order entry (CPOE) is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. It is used in about 15% of U.S. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care. Most of these studies have been undertaken at CPOE exemplar sites with homegrown clinical information systems. With the increasing implementation of commercial CPOE systems in various settings of care has come evidence that some implementation approaches may not achieve previously published results or may actually cause new errors or even harm. This has lead to new initiatives to evaluate CPOE systems, which have been undertaken by both vendors and other groups who evaluate vendors, focused on CPOE vendor capabilities and effective approaches to implementation that can achieve benefits seen in published studies. In addition, an electronic health record (EHR) vendor certification process is ongoing under the province of the Certification Commission for Health Information Technology (CCHIT) (which includes CPOE) that will affect the purchase and use of these applications by hospitals and clinics and their participation in public and private health insurance programs. Large employers have also joined this focus by developing flight simulation tools to evaluate the capabilities of these CPOE systems once implemented, potentially linking the results of such programs to reimbursement through pay for performance programs. The increasing role of CPOE systems in health care has invited much more scrutiny about the effectiveness of these systems in actual practice which has the potential to improve their ultimate performance. PMID:17077453

Evaluation and certification of computerized provider order entry systems.

PubMed

Classen, David C; Avery, Anthony J; Bates, David W

2007-01-01

Computerized physician order entry (CPOE) is an application that is used to electronically write physician orders either in the hospital or in the outpatient setting. It is used in about 15% of U.S. Hospitals and a smaller percentage of ambulatory clinics. It is linked with clinical decision support, which provides much of the value of implementing it. A number of studies have assessed the impact of CPOE with respect to a variety of parameters, including costs of care, medication safety, use of guidelines or protocols, and other measures of the effectiveness or quality of care. Most of these studies have been undertaken at CPOE exemplar sites with homegrown clinical information systems. With the increasing implementation of commercial CPOE systems in various settings of care has come evidence that some implementation approaches may not achieve previously published results or may actually cause new errors or even harm. This has lead to new initiatives to evaluate CPOE systems, which have been undertaken by both vendors and other groups who evaluate vendors, focused on CPOE vendor capabilities and effective approaches to implementation that can achieve benefits seen in published studies. In addition, an electronic health record (EHR) vendor certification process is ongoing under the province of the Certification Commission for Health Information Technology (CCHIT) (which includes CPOE) that will affect the purchase and use of these applications by hospitals and clinics and their participation in public and private health insurance programs. Large employers have also joined this focus by developing flight simulation tools to evaluate the capabilities of these CPOE systems once implemented, potentially linking the results of such programs to reimbursement through pay for performance programs. The increasing role of CPOE systems in health care has invited much more scrutiny about the effectiveness of these systems in actual practice which has the potential to improve their ultimate performance.

Computerized implementation of higher-order electron-correlation methods and their linear-scaling divide-and-conquer extensions.

PubMed

Nakano, Masahiko; Yoshikawa, Takeshi; Hirata, So; Seino, Junji; Nakai, Hiromi

2017-11-05

We have implemented a linear-scaling divide-and-conquer (DC)-based higher-order coupled-cluster (CC) and Møller-Plesset perturbation theories (MPPT) as well as their combinations automatically by means of the tensor contraction engine, which is a computerized symbolic algebra system. The DC-based energy expressions of the standard CC and MPPT methods and the CC methods augmented with a perturbation correction were proposed for up to high excitation orders [e.g., CCSDTQ, MP4, and CCSD(2) TQ ]. The numerical assessment for hydrogen halide chains, polyene chains, and first coordination sphere (C1) model of photoactive yellow protein has revealed that the DC-based correlation methods provide reliable correlation energies with significantly less computational cost than that of the conventional implementations. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Diagnostic Yield of Transbronchial Biopsy in Comparison to High Resolution Computerized Tomography in Sarcoidosis Cases

PubMed

Akten, H Serpil; Kilic, Hatice; Celik, Bulent; Erbas, Gonca; Isikdogan, Zeynep; Turktas, Haluk; Kokturk, Nurdan

2018-04-25

This study aimed to evaluate the diagnostic yield of fiberoptic bronchoscopic (FOB) transbronchial biopsy and its relation with quantitative findings of high resolution computerized tomography (HRCT). A total of 83 patients, 19 males and 64 females with a mean age of 45.1 years diagnosed with sarcoidosis with complete records of high resolution computerized tomography were retrospectively recruited during the time period from Feb 2005 to Jan 2015. High resolution computerized tomography scans were retrospectively assessed in random order by an experienced observer without knowledge of the bronchoscopic results or lung function tests. According to the radiological staging with HRCT, 2.4% of the patients (n=2) were stage 0, 19.3% (n=16) were stage 1, 72.3% (n=60) were stage 2 and 6.0% (n=5) were stage 3. This study showed that transbronchial lung biopsy showed positive results in 39.7% of the stage I or II sarcoidosis patients who were diagnosed by bronchoscopy. Different high resolution computerized tomography patterns and different scores of involvement did make a difference in the diagnostic accuracy of transbronchial biopsy (p=0.007). Creative Commons Attribution License

DARE: Unesco Computerized Data Retrieval System for Documentation in the Social and Human Sciences (Including an Analysis of the Present System).

ERIC Educational Resources Information Center

Vasarhelyi, Paul

The new data retrieval system for the social sciences which has recently been installed in the UNESCO Secretariat in Paris is described in this comprehensive report. The computerized system is designed to facilitate the existing storage systems in the circulation of information, data retrieval, and indexing services. Basically, this report…

Campground users... a computerized method for summarizing where they come from and how long they stay

Treesearch

Gary H. Elsner

1971-01-01

A computerized method for gathering market area information from campground permits has been developed. Point-of-origin and length-of-stay of campground users can be estimated and summarized quickly and inexpensively. The method should be equally useful for public as well as private campgrounds-provided basic registration data are available and can be processed...

An Analysis of a Computerized System for Managing Curriculum Decisions and Tracking Student Progress in a Home-Based Pre-School Education Project.

ERIC Educational Resources Information Center

Lutz, John E.; And Others

The degree of success of the computerized Child-Based Information System (CBIS) was analyzed in two areas--presenting, delivering, and managing a developmental curriculum; and recording, filing, and monitoring child tracking data, including requirements for Individualized Education Plans (IEP's). Preschool handicapped and high-risk children and…

Demonstration and Evaluation of the Effects of Incentives on Resource Sharing Using a Computerized Interlibrary Communications System.

ERIC Educational Resources Information Center

New England Board of Higher Education, Wellesley, MA. New England Library Information Network.

The potential for using a computerized communication system to facilitate resource sharing in New England has been investigated by the staff of the New England Information Network (NELINET). The central purpose of their research was to determine whether a strategy for load leveling of interlibrary loan (ILL) requests could be implemented online as…

Multidimensional Computerized Adaptive Scholastic Aptitude Test Program Used for Grade 9 Students under Different Reviewing Test Conditions

ERIC Educational Resources Information Center

Khunkrai, Naruemon; Sawangboon, Tatsirin; Ketchatturat, Jatuphum

2015-01-01

The aim of this research is to study the accurate prediction of comparing test information and evaluation result by multidimensional computerized adaptive scholastic aptitude test program used for grade 9 students under different reviewing test conditions. Grade 9 students of the Secondary Educational Service Area Office in the North-east of…

Information management and informatics: need for a modern pathology service.

PubMed

Jones, Rick; O'Connor, John

2004-05-01

Requirements for information technology in pathology now extend well beyond the provision of purely analytical data. With the aim of achieving seamless integration of laboratory data into the total clinical pathway, "informatics"--the art and science of turning data into useful information--is becoming increasingly important in laboratory medicine. Informatics is a powerful tool in pathology--whether in implementing processes for pathology modernization, introducing new diagnostic modalities (e.g. proteomics, genomics), providing timely and evidence-based disease management, or enabling best use of limited and often costly resources. Providing appropriate information to empowered and interested patients--which requires critical assessment of the ever-increasing volume of information available--can also benefit greatly from appropriate use of informatics. General trends in medical informatics are reflected in current priorities for laboratory medicine, including the need for unified electronic records, computerized order entry, data security and recovery, and audit. The increasing demands placed on pathology information systems in the context of wider developmental change in healthcare delivery are explored in this paper.

Test results management and distributed cognition in electronic health record-enabled primary care.

PubMed

Smith, Michael W; Hughes, Ashley M; Brown, Charnetta; Russo And, Elise; Giardina, Traber D; Mehta, Praveen; Singh, Hardeep

2018-06-01

Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses. We performed content analysis using a distributed cognition approach, identifying patterns of information transmission across people and artifacts (e.g. electronic health records). Results illustrate challenges (e.g. information overload) as well as strategies used to overcome challenges. Various communication paths were used. Some team members served as intermediaries, processing information before relaying it. Artifacts were used as memory aids. Health information technology should address the risks of distributed work by supporting awareness of team and task status for reliable management of results.

Leveraging Health Information Technology to Improve Quality in Federal Healthcare.

PubMed

Weigel, Fred K; Switaj, Timothy L; Hamilton, Jessica

2015-01-01

Healthcare delivery in America is extremely complex because it is comprised of a fragmented and nonsystematic mix of stakeholders, components, and processes. Within the US healthcare structure, the federal healthcare system is poised to lead American medicine in leveraging health information technology to improve the quality of healthcare. We posit that through developing, adopting, and refining health information technology, the federal healthcare system has the potential to transform federal healthcare quality by managing the complexities associated with healthcare delivery. Although federal mandates have spurred the widespread use of electronic health records, other beneficial technologies have yet to be adopted in federal healthcare settings. The use of health information technology is fundamental in providing the highest quality, safest healthcare possible. In addition, health information technology is valuable in achieving the Agency for Healthcare Research and Quality's implementation goals. We conducted a comprehensive literature search using the Google Scholar, PubMed, and Cochrane databases to identify an initial list of articles. Through a thorough review of the titles and abstracts, we identified 42 articles as having relevance to health information technology and quality. Through our exclusion criteria of currency of the article, citation frequency, applicability to the federal health system, and quality of research supporting conclusions, we refined the list to 11 references from which we performed our analysis. The literature shows that the use of computerized physician order entry has significantly increased accurate medication dosage and decreased medication errors. The use of clinical decision support systems have significantly increased physician adherence to guidelines, although there is little evidence that indicates any significant correlation to patient outcomes. Research shows that interoperability and usability are continuing challenges for implementation. The Veterans Administration is the only entity within the federal health system that has published research on the use of health information technology to improve quality. The federal healthcare system has existing systems in place with computerized physician order entry systems and clinical decision support systems, but these should be advanced. Particular focus and attention should be placed on data mining capabilities, integrating the electronic health record across all aspects of care, using the electronic health record to improve quality at the point of care, and developing interoperable and usable health information technology.

Multitasking capacities in persons diagnosed with schizophrenia: a preliminary examination of their neurocognitive underpinnings and ability to predict real world functioning.

PubMed

Laloyaux, Julien; Van der Linden, Martial; Levaux, Marie-Noëlle; Mourad, Haitham; Pirri, Anthony; Bertrand, Hervé; Domken, Marc-André; Adam, Stéphane; Larøi, Frank

2014-07-30

Difficulties in everyday life activities are core features of persons diagnosed with schizophrenia and in particular during multitasking activities. However, at present, patients׳ multitasking capacities have not been adequately examined in the literature due to the absence of suitable assessment strategies. We thus recently developed a computerized real-life activity task designed to take into account the complex and multitasking nature of certain everyday life activities where participants are required to prepare a room for a meeting. Twenty-one individuals diagnosed with schizophrenia and 20 matched healthy controls completed the computerized task. Patients were also evaluated with a cognitive battery, measures of symptomatology and real world functioning. To examine the ecological validity, 14 other patients were recruited and were given the computerized version and a real version of the meeting preparation task. Results showed that performance on the computerized task was significantly correlated with executive functioning, pointing to the major implication of these cognitive processes in multitasking situations. Performance on the computerized task also significantly predicted up to 50% of real world functioning. Moreover, the computerized task demonstrated good ecological validity. These findings suggest the importance of evaluating multitasking capacities in patients diagnosed with schizophrenia in order to predict real world functioning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Incentives and Barriers That Influence Clinical Computerization in Hong Kong: A Population-based Physician Survey

PubMed Central

Leung, Gabriel M.; Yu, Philip L. H.; Wong, Irene O. L.; Johnston, Janice M.; Tin, Keith Y. K.

2003-01-01

Objective: Given the slow adoption of medical informatics in Hong Kong and Asia, we sought to understand the contributory barriers and potential incentives associated with information technology implementation. Design and Measurements: A representative sample of 949 doctors (response rate = 77.0%) was asked through a postal survey to rank a list of nine barriers associated with clinical computerization according to self-perceived importance. They ranked seven incentives or catalysts that may influence computerization. We generated mean rank scores and used multidimensional preference analysis to explore key explanatory dimensions of these variables. A hierarchical cluster analysis was performed to identify homogenous subgroups of respondents. We further determined the relationships between the sets of barriers and incentives/catalysts collectively using canonical correlation. Results: Time costs, lack of technical support and large capital investments were the biggest barriers to computerization, whereas improved office efficiency and better-quality care were ranked highest as potential incentives to computerize. Cost vs. noncost, physician-related vs. patient-related, and monetary vs. nonmonetary factors were the key dimensions explaining the barrier variables. Similarly, within-practice vs external and “push” vs “pull” factors accounted for the incentive variables. Four clusters were identified for barriers and three for incentives/catalysts. Canonical correlation revealed that respondents who were concerned with the costs of computerization also perceived financial incentives and government regulation to be important incentives/catalysts toward computerization. Those who found the potential interference with communication important also believed that the promise of improved care from computerization to be a significant incentive. Conclusion: This study provided evidence regarding common barriers associated with clinical computerization. Our findings also identified possible incentive strategies that may be employed to accelerate uptake of computer systems. PMID:12595409

Decreased rates of hypoglycemia following implementation of a comprehensive computerized insulin order set and titration algorithm in the inpatient setting.

PubMed

Sinha Gregory, Naina; Seley, Jane Jeffrie; Gerber, Linda M; Tang, Chin; Brillon, David

2016-12-01

More than one-third of hospitalized patients have hyperglycemia. Despite evidence that improving glycemic control leads to better outcomes, achieving recognized targets remains a challenge. The objective of this study was to evaluate the implementation of a computerized insulin order set and titration algorithm on rates of hypoglycemia and overall inpatient glycemic control. A prospective observational study evaluating the impact of a glycemic order set and titration algorithm in an academic medical center in non-critical care medical and surgical inpatients. The initial intervention was hospital-wide implementation of a comprehensive insulin order set. The secondary intervention was initiation of an insulin titration algorithm in two pilot medicine inpatient units. Point of care testing blood glucose reports were analyzed. These reports included rates of hypoglycemia (BG < 70 mg/dL) and hyperglycemia (BG >200 mg/dL in phase 1, BG > 180 mg/dL in phase 2). In the first phase of the study, implementation of the insulin order set was associated with decreased rates of hypoglycemia (1.92% vs 1.61%; p < 0.001) and increased rates of hyperglycemia (24.02% vs 27.27%; p < 0.001) from 2010 to 2011. In the second phase, addition of a titration algorithm was associated with decreased rates of hypoglycemia (2.57% vs 1.82%; p = 0.039) and increased rates of hyperglycemia (31.76% vs 41.33%; p < 0.001) from 2012 to 2013. A comprehensive computerized insulin order set and titration algorithm significantly decreased rates of hypoglycemia. This significant reduction in hypoglycemia was associated with increased rates of hyperglycemia. Hardwiring the algorithm into the electronic medical record may foster adoption.

A Comparison of Item Selection Procedures Using Different Ability Estimation Methods in Computerized Adaptive Testing Based on the Generalized Partial Credit Model

ERIC Educational Resources Information Center

Ho, Tsung-Han

2010-01-01

Computerized adaptive testing (CAT) provides a highly efficient alternative to the paper-and-pencil test. By selecting items that match examinees' ability levels, CAT not only can shorten test length and administration time but it can also increase measurement precision and reduce measurement error. In CAT, maximum information (MI) is the most…

Skills Required by Agricultural Education Students of Colleges of Education for Employment in Compterized Office of Agribusiness Organizations

ERIC Educational Resources Information Center

Ugwuoke, Cajethan Uche; Onah, Benardine Ifeoma

2015-01-01

One of the major concerns of employers of labour in this information age is the recruitment of employees with requisite computerized office skills to fit into the various organization's jobs and positions. In Agricultural education, acquisition of these computerized office skills do not only depends on whether one is able to fulfill the paper…

Surface mapping of spike potential fields: experienced EEGers vs. computerized analysis.

PubMed

Koszer, S; Moshé, S L; Legatt, A D; Shinnar, S; Goldensohn, E S

1996-03-01

An EEG epileptiform spike focus recorded with scalp electrodes is clinically localized by visual estimation of the point of maximal voltage and the distribution of its surrounding voltages. We compared such estimated voltage maps, drawn by experienced electroencephalographers (EEGers), with a computerized spline interpolation technique employed in the commercially available software package FOCUS. Twenty-two spikes were recorded from 15 patients during long-term continuous EEG monitoring. Maps of voltage distribution from the 28 electrodes surrounding the points of maximum change in slope (the spike maximum) were constructed by the EEGer. The same points of maximum spike and voltage distributions at the 29 electrodes were mapped by computerized spline interpolation and a comparison between the two methods was made. The findings indicate that the computerized spline mapping techniques employed in FOCUS construct voltage maps with similar maxima and distributions as the maps created by experienced EEGers. The dynamics of spike activity, including correlations, are better visualized using the computerized technique than by manual interpretation alone. Its use as a technique for spike localization is accurate and adds information of potential clinical value.

Reduction in chemotherapy order errors with computerized physician order entry.

PubMed

Meisenberg, Barry R; Wright, Robert R; Brady-Copertino, Catherine J

2014-01-01

To measure the number and type of errors associated with chemotherapy order composition associated with three sequential methods of ordering: handwritten orders, preprinted orders, and computerized physician order entry (CPOE) embedded in the electronic health record. From 2008 to 2012, a sample of completed chemotherapy orders were reviewed by a pharmacist for the number and type of errors as part of routine performance improvement monitoring. Error frequencies for each of the three distinct methods of composing chemotherapy orders were compared using statistical methods. The rate of problematic order sets-those requiring significant rework for clarification-was reduced from 30.6% with handwritten orders to 12.6% with preprinted orders (preprinted v handwritten, P < .001) to 2.2% with CPOE (preprinted v CPOE, P < .001). The incidence of errors capable of causing harm was reduced from 4.2% with handwritten orders to 1.5% with preprinted orders (preprinted v handwritten, P < .001) to 0.1% with CPOE (CPOE v preprinted, P < .001). The number of problem- and error-containing chemotherapy orders was reduced sequentially by preprinted order sets and then by CPOE. CPOE is associated with low error rates, but it did not eliminate all errors, and the technology can introduce novel types of errors not seen with traditional handwritten or preprinted orders. Vigilance even with CPOE is still required to avoid patient harm.

Land Use Planning

NASA Technical Reports Server (NTRS)

1978-01-01

Computer technology, aerial photography and space imagery are being combined in a NASA community services program designed to help solve land use and natural resource planning problems. As urban areas grow, so grows the need for comprehensive, up-to-date information on which to base intelligent decisions regarding land use. State and local planners need information such as the nature of urban change, where the changes are occurring, how they affect public safety, transportation, the economy, tax assessment, sewer systems, water quality, flood hazard, noise impact and a great variety of other considerations. Most importantly they need continually updated maps. Preparing timely maps, gathering the essential data and maintaining it in orderly fashion are becoming matters of increasing difficulty. The NASA project, which has nationwide potential for improving efficiency in the planning process, is a pilot program focused on Tacoma, Washington and surrounding Pierce County. Its key element, developed by Jet Propulsion Laboratory (JPL), is a computerized Land Use Management Information System (LUMIS).

Research on nursing handoffs for medical and surgical settings: an integrative review.

PubMed

Staggers, Nancy; Blaz, Jacquelyn W

2013-02-01

To synthesize outcomes from research on handoffs to guide future computerization of the process on medical and surgical units. Handoffs can create important information gaps, omissions and errors in patient care. Authors call for the computerization of handoffs; however, a synthesis of the literature is not yet available that might guide computerization. PubMed, CINAHL, Cochrane, PsycINFO, Scopus and a handoff database from Cohen and Hilligoss. Integrative literature review. This integrative review included studies from 1980-March 2011 in peer-reviewed journals. Exclusions were studies outside medical and surgical units, handoff education and nurses' perceptions. The search strategy yielded a total of 247 references; 81 were retrieved, read and rated for relevance and research quality. A set of 30 articles met relevance criteria. Studies about handoff functions and rituals are saturated topics. Verbal handoffs serve important functions beyond information transfer and should be retained. Greater consideration is needed on analysing handoffs from a patient-centred perspective. Handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs is not supported by available evidence. The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames. © 2012 Blackwell Publishing Ltd.

The Computer and Personal Privacy, Part I: The Individual under Assault.

ERIC Educational Resources Information Center

Rubin, Michael Rogers

1987-01-01

Describes the development and current uses of computerized databases of information about individuals by the government and private agencies, especially credit bureaus, and discusses three major categories of abusive information practices that threaten personal privacy: information collection, information dissemination, and information management…

Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

PubMed

Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

2017-08-01

We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

Title list of documents made publicly available, November 1-30, 1995

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

NONE

1996-01-01

The Title List of Documents Made Publicly Available is a monthly publication. It contains descriptions of the information received and generated by the U.S. Nuclear Regulatory Commission (NRC). This information includes (1) docketed material associated with civilian nuclear power plants and other uses of radioactive materials and (2) nondocketed material received and generated by NRC pertinent to its role as a regulatory agency. As used here, docketed does not refer to Court dockets; it refers to the system by which NRC maintains its regulatory records. This series of documents is indexed by a Personal Author Index, a Corporate Source Indexmore » and a Report Number Index. The docketed information contained in the Title List includes the information formerly issued through the Department of Energy publication Power Reactor Docker Information, last published in January 1979. NRC documents that are publicly available may be examined without charge at the NRC Public Document Room (PDR). Duplicate copies may be obtained for a fee. Standing orders for certain categories of documents are also available. Clients may search for and order desired titles through the PDR computerized Bibliographic Retrieval System, which is accessible both at the PDR and remotely. The PDR is staffed by professional technical librarians, who provide reference assistance to users.« less

Use of RSS feeds for the implementation of clinical reminder.

PubMed

Chi, Wen-Chou; Wen, Chia-Hsien; Lin, Chih-Yu; Poon, Sek-Kwong; Huang, Shih-Che

2012-06-01

A computer-based reminder system can help physicians get right information and make right decisions in daily clinical work in time. This study presents a RSS-based Clinical Reminding System (RCRS) designed for reminding clinicians to deal with their varied unfinished clinical works. The RCRS was implemented in a hospital to automatically generate messages for every clinician on the basis of clinical information gathered from the hospital information system (HIS) and send them by RSS feed. In order to allow all physicians to participate in the project, the RCRS was integrated with the Computerized Physician Order Entry (COPE) system to provide messages whenever a clinician logs in the HIS; the connection on screen lets the clinician easily make some response. The system can help clinicians focus on patient care without keeping track of the schedule of clinical chores stored in various systems. Two physicians, also directors from Clinical Informatics Research & Development Center (CIRD) who were appointed as project leaders of the RCRS project who went through the entire development process were chosen as interviewees to obtain a preliminary evaluation of the system. The results show the "Information Content" of this system was suggested to be modified, and "Information Accuracy", "Formats", "Ease of use" and "Timeliness" of the system were appropriate to meet the system design purposes.

RxTerms - a drug interface terminology derived from RxNorm.

PubMed

Fung, Kin Wah; McDonald, Clement; Bray, Bruce E

2008-11-06

A good interface terminology is an essential component of any Computerized Provider Order Entry system. RxTerms is a drug interface terminology derived from RxNorm. By reorganizing the drug information into two dimensions as prescribers do when writing prescriptions and by eliminating drug names that are less likely to be needed in a prescribing environment, RxTerms helps the user to efficiently enter complete prescription orders. Preliminary evaluation of RxTerms using a list of most commonly prescribed drugs showed that its coverage was very good (99% for both generic and branded drug names). There was significant efficiency gain compared to using the unprocessed RxNorm names. RxTerms fills the gap for a free, up-to-date drug interface terminology that is linked to RxNorm, the U.S. designated standard for clinical drugs.

Sources of Information for Evaluating Rural Development: An Overview.

ERIC Educational Resources Information Center

Grayburn, Laura; And Others

Designed to help rural development evaluators and other social scientists use their bibliographic search time more efficiently, this information guide presents the following: (1) detailed information on computerized information retrieval systems, including name, location, subject matter, turnaround time, cost, availability, and utility…

Evaluation of Psychology Clinicians' Attitudes towards Computerized Cognitive Behavior Therapy, for Use in Their Future Clinical Practice, with Regard to Treating Those Suffering from Anxiety and Depression

ERIC Educational Resources Information Center

Dunne, Nivek

2017-01-01

Computerized Cognitive Behavioural Therapy (CCBT) is an empirically supported therapeutic modality used in the treatment of anxiety and depression. It is an important area of research considering there is much research lacking in this area, especially regarding trainee and qualified psychology clinicians' attitudes which are informative in terms…

A randomized controlled trial of the Cool Teens CD-ROM computerized program for adolescent anxiety.

PubMed

Wuthrich, Viviana M; Rapee, Ronald M; Cunningham, Michael J; Lyneham, Heidi J; Hudson, Jennifer L; Schniering, Carolyn A

2012-03-01

Computerized cognitive behavioral interventions for anxiety disorders in adults have been shown to be efficacious, but limited data are available on the use of computerized interventions with young persons. Adolescents in particular are difficult to engage in treatment and may be especially suited to computerized technologies. This paper describes the results of a small randomized controlled trial of the Cool Teens program for adolescent anxiety, and examines potential barriers to treatment and user preferences of computerized technology in this population. Forty-three adolescents with a primary diagnosis of anxiety were randomly allocated to the Cool Teens program, a 12-week computerized cognitive-behavioral therapy program for anxiety management, or a 12-week wait list. Effects on symptoms, negative thoughts, and life interference were assessed at post-treatment and 3-month follow-up, based on diagnosis as well as self and maternal report. Using mixed-model analyses, at post-treatment and follow-up assessments, adolescents in the Cool Teens condition, compared with those on the wait list, were found to have significant reductions in the total number of anxiety disorders, the severity of the primary anxiety disorder, and the average severity for all disorders. These results were matched by significant reductions in mother and child questionnaire reports of anxiety, internalizing symptoms, automatic thoughts, and life interference. Further few barriers to treatment were found, and user preferences indicated that the computerized treatment was well suited to adolescents with anxiety. The Cool Teens program is efficacious for treatment of adolescent anxiety. Clinical trial registration information-A randomized controlled trial of the Cool Teens computerized program for anxious adolescents compared with waist list; http://www.anzctr.org.au; ACTRN12611000508976. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

Computerized Management Information and Reporting Systems for Sponsored Projects.

ERIC Educational Resources Information Center

Rodman, John A.; Peters, Carl M.

1980-01-01

The effective management of the university depends on the research office providing usable, accurate, timely, and accessible information regarding sponsored programs. The utilization of automated systems to store, access, and manage information is seen as essential. (MLW)

Information Technology and Literacy Assessment.

ERIC Educational Resources Information Center

Balajthy, Ernest

2002-01-01

Compares technology predictions from around 1989 with the technology of 2002. Discusses the place of computer-based assessment today, computer-scored testing, computer-administered formal assessment, Internet-based formal assessment, computerized adaptive tests, placement tests, informal assessment, electronic portfolios, information management,…

Using intranet-based order sets to standardize clinical care and prepare for computerized physician order entry.

PubMed

Heffner, John E; Brower, Kathleen; Ellis, Rosemary; Brown, Shirley

2004-07-01

The high cost of computerized physician order entry (CPOE) and physician resistance to standardized care have delayed implementation. An intranet-based order set system can provide some of CPOE's benefits and offer opportunities to acculturate physicians toward standardized care. INTRANET CLINICIAN ORDER FORMS (COF): The COF system at the Medical University of South Carolina (MUSC) allows caregivers to enter and print orders through the intranet at points of care and to access decision support resources. Work on COF began in March 2000 with transfer of 25 MUSC paper-based order set forms to an intranet site. Physician groups developed additional order sets, which number more than 200. Web traffic increased progressively during a 24-month period, peaking at more than 6,400 hits per month to COF. Decision support tools improved compliance with Centers for Medicare & Medicaid Services core indicators. Clinicians demonstrated a willingness to develop and use order sets and decision support tools posted on the COF site. COF provides a low-cost method for preparing caregivers and institutions to adopt CPOE and standardization of care. The educational resources, relevant links to external resources, and communication alerts will all link to CPOE, thereby providing a head start in CPOE implementation.

Development and validation of a survey instrument for assessing prescribers' perception of computerized drug-drug interaction alerts.

PubMed

Zheng, Kai; Fear, Kathleen; Chaffee, Bruce W; Zimmerman, Christopher R; Karls, Edward M; Gatwood, Justin D; Stevenson, James G; Pearlman, Mark D

2011-12-01

To develop a theoretically informed and empirically validated survey instrument for assessing prescribers' perception of computerized drug-drug interaction (DDI) alerts. The survey is grounded in the unified theory of acceptance and use of technology and an adapted accident causation model. Development of the instrument was also informed by a review of the extant literature on prescribers' attitude toward computerized medication safety alerts and common prescriber-provided reasons for overriding. To refine and validate the survey, we conducted a two-stage empirical validation study consisting of a pretest with a panel of domain experts followed by a field test among all eligible prescribers at our institution. The resulting survey instrument contains 28 questionnaire items assessing six theoretical dimensions: performance expectancy, effort expectancy, social influence, facilitating conditions, perceived fatigue, and perceived use behavior. Satisfactory results were obtained from the field validation; however, a few potential issues were also identified. We analyzed these issues accordingly and the results led to the final survey instrument as well as usage recommendations. High override rates of computerized medication safety alerts have been a prevalent problem. They are usually caused by, or manifested in, issues of poor end user acceptance. However, standardized research tools for assessing and understanding end users' perception are currently lacking, which inhibits knowledge accumulation and consequently forgoes improvement opportunities. The survey instrument presented in this paper may help fill this methodological gap. We developed and empirically validated a survey instrument that may be useful for future research on DDI alerts and other types of computerized medication safety alerts more generally.

Utilization of information technology in eastern North Carolina physician practices: determining the existence of a digital divide.

PubMed

Rosenthal, David A; Layman, Elizabeth J

2008-02-13

The United States Department of Health and Human Services (DHHS) has emphasized the importance of utilizing health information technologies, thus making the availability of electronic resources critical for physicians across the country. However, few empirical assessments exist regarding the current status of computerization and utilization of electronic resources in physician offices and physicians' perceptions of the advantages and disadvantages of computerization. Through a survey of physicians' utilization and perceptions of health information technology, this study found that a "digital divide" existed for eastern North Carolina physicians in smaller physician practices. The physicians in smaller practices were less likely to utilize or be interested in utilizing electronic health records, word processing applications, and the Internet.

A Cross-site Qualitative Study of Physician Order Entry

PubMed Central

Ash, Joan S.; Gorman, Paul N.; Lavelle, Mary; Payne, Thomas H.; Massaro, Thomas A.; Frantz, Gerri L.; Lyman, Jason A.

2003-01-01

Objective: To describe the perceptions of diverse professionals involved in computerized physician order entry (POE) at sites where POE has been successfully implemented and to identify differences between teaching and nonteaching hospitals. Design: A multidisciplinary team used observation, focus groups, and interviews with clinical, administrative, and information technology staff to gather data at three sites. Field notes and transcripts were coded using an inductive approach to identify patterns and themes in the data. Measurements: Patterns and themes concerning perceptions of POE were identified. Results: Four high-level themes were identified: (1) organizational issues such as collaboration, pride, culture, power, politics, and control; (2) clinical and professional issues involving adaptation to local practices, preferences, and policies; (3) technical/implementation issues, including usability, time, training and support; and (4) issues related to the organization of information and knowledge, such as system rigidity and integration. Relevant differences between teaching and nonteaching hospitals include extent of collaboration, staff longevity, and organizational missions. Conclusion: An organizational culture characterized by collaboration and trust and an ongoing process that includes active clinician engagement in adaptation of the technology were important elements in successful implementation of physician order entry at the institutions that we studied. PMID:12595408

Computerization of guidelines: a knowledge specification method to convert text to detailed decision tree for electronic implementation.

PubMed

Aguirre-Junco, Angel-Ricardo; Colombet, Isabelle; Zunino, Sylvain; Jaulent, Marie-Christine; Leneveut, Laurence; Chatellier, Gilles

2004-01-01

The initial step for the computerization of guidelines is the knowledge specification from the prose text of guidelines. We describe a method of knowledge specification based on a structured and systematic analysis of text allowing detailed specification of a decision tree. We use decision tables to validate the decision algorithm and decision trees to specify and represent this algorithm, along with elementary messages of recommendation. Edition tools are also necessary to facilitate the process of validation and workflow between expert physicians who will validate the specified knowledge and computer scientist who will encode the specified knowledge in a guide-line model. Applied to eleven different guidelines issued by an official agency, the method allows a quick and valid computerization and integration in a larger decision support system called EsPeR (Personalized Estimate of Risks). The quality of the text guidelines is however still to be developed further. The method used for computerization could help to define a framework usable at the initial step of guideline development in order to produce guidelines ready for electronic implementation.

Exploring the possibility of modeling a genetic counseling guideline using agile methodology.

PubMed

Choi, Jeeyae

2013-01-01

Increased demand of genetic counseling services heightened the necessity of a computerized genetic counseling decision support system. In order to develop an effective and efficient computerized system, modeling of genetic counseling guideline is an essential step. Throughout this pilot study, Agile methodology with United Modeling Language (UML) was utilized to model a guideline. 13 tasks and 14 associated elements were extracted. Successfully constructed conceptual class and activity diagrams revealed that Agile methodology with UML was a suitable tool to modeling a genetic counseling guideline.

Bone Scan

MedlinePlus

... your doctor might order additional imaging called single-photon emission computerized tomography (SPECT). This imaging can help ... radioactivity from the tracers is usually completely eliminated two days after the scan. Results A doctor who ...

Effects of computerized prescriber order entry on pharmacy order-processing time.

PubMed

Wietholter, Jon; Sitterson, Susan; Allison, Steven

2009-08-01

The effect of computerized prescriber order entry (CPOE) on the efficiency of medication-order-processing time was evaluated. This study was conducted at a 761-bed, tertiary care hospital. A total of 2988 medication orders were collected and analyzed before (n = 1488) and after CPOE implementation (n = 1500). Data analyzed included the time the prescriber ordered the medication, the time the pharmacy received the order, and the time the order was completed by a pharmacist. The mean order-processing time before CPOE implementation was 115 minutes from prescriber composition to pharmacist verification. After CPOE implementation, the mean order-processing time was reduced to 3 minutes (p < 0.0001). The time that an order was received by the pharmacy to the time it was verified by a pharmacist was reduced from 31 minutes before CPOE implementation to 3 minutes after CPOE implementation (p < 0.0001). The implementation of CPOE reduced the order-processing time (from order composition to verification) by 97%. Additionally, pharmacy-specific order-processing time (from order receipt in the pharmacy to pharmacist verification) was reduced by 90%. This reduction in order-processing time improves patient care by shortening the interval between physician prescribing and medication availability and may allow pharmacists to explore opportunities for enhanced clinical activities that will further positively impact patient care. CPOE implementation reduced the mean pharmacy order-processing time from composition to verification by 97%. After CPOE implementation, a new medication order was verified as appropriate by a pharmacist in three minutes, on average.

Impact of Stewardship Interventions on Antiretroviral Medication Errors in an Urban Medical Center: A 3-Year, Multiphase Study.

PubMed

Zucker, Jason; Mittal, Jaimie; Jen, Shin-Pung; Cheng, Lucy; Cennimo, David

2016-03-01

There is a high prevalence of HIV infection in Newark, New Jersey, with University Hospital admitting approximately 600 HIV-infected patients per year. Medication errors involving antiretroviral therapy (ART) could significantly affect treatment outcomes. The goal of this study was to evaluate the effectiveness of various stewardship interventions in reducing the prevalence of prescribing errors involving ART. This was a retrospective review of all inpatients receiving ART for HIV treatment during three distinct 6-month intervals over a 3-year period. During the first year, the baseline prevalence of medication errors was determined. During the second year, physician and pharmacist education was provided, and a computerized order entry system with drug information resources and prescribing recommendations was implemented. Prospective audit of ART orders with feedback was conducted in the third year. Analyses and comparisons were made across the three phases of this study. Of the 334 patients with HIV admitted in the first year, 45% had at least one antiretroviral medication error and 38% had uncorrected errors at the time of discharge. After education and computerized order entry, significant reductions in medication error rates were observed compared to baseline rates; 36% of 315 admissions had at least one error and 31% had uncorrected errors at discharge. While the prevalence of antiretroviral errors in year 3 was similar to that of year 2 (37% of 276 admissions), there was a significant decrease in the prevalence of uncorrected errors at discharge (12%) with the use of prospective review and intervention. Interventions, such as education and guideline development, can aid in reducing ART medication errors, but a committed stewardship program is necessary to elicit the greatest impact. © 2016 Pharmacotherapy Publications, Inc.

An Information Service for the Maritime Industry.

ERIC Educational Resources Information Center

Mellor, Davis G.

1979-01-01

The Maritime Research Information Service (MRIS), sponsored by the Maritime Administration and operated by the Transportation Research Board, distributes information to the maritime industry through monthly and semiannual publications, special bibliographies, computerized retrievals, and online retrieval directly through the Lockheed Dialog…

39 CFR 262.5 - Systems (Privacy).

Code of Federal Regulations, 2014 CFR

2014-07-01

... Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... information about individuals, including mailing lists, from which information is retrieved by the name of an... Management and Budget, and these regulations. The term “matching program” includes any computerized...

39 CFR 262.5 - Systems (Privacy).

Code of Federal Regulations, 2013 CFR

2013-07-01

... Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... information about individuals, including mailing lists, from which information is retrieved by the name of an... Management and Budget, and these regulations. The term “matching program” includes any computerized...

39 CFR 262.5 - Systems (Privacy).

Code of Federal Regulations, 2012 CFR

2012-07-01

... Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... information about individuals, including mailing lists, from which information is retrieved by the name of an... Management and Budget, and these regulations. The term “matching program” includes any computerized...

39 CFR 262.5 - Systems (Privacy).

Code of Federal Regulations, 2011 CFR

2011-07-01

... Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION RECORDS AND INFORMATION MANAGEMENT... information about individuals, including mailing lists, from which information is retrieved by the name of an... Management and Budget, and these regulations. The term “matching program” includes any computerized...

Control systems for heating, ventilating, and air conditioning

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

Haines, R.W.

1977-01-01

Hundreds of ideas for designing and controlling sophisticated heating, ventilating and air conditioning (HVAC) systems are presented. Information is included on enthalpy control, energy conservation in HVAC systems, on solar heating, cooling and refrigeration systems, and on a self-draining water collector and heater. Computerized control systems and the economics of supervisory systems are discussed. Information is presented on computer system components, software, relevant terminology, and computerized security and fire reporting systems. Benefits of computer systems are explained, along with optimization techniques, data management, maintenance schedules, and energy consumption. A bibliography, glossaries of HVAC terminology, abbreviations, symbols, and a subject indexmore » are provided. (LCL)« less

Methodology for vocational psychodiagnostics of senior schoolchildren using information technologies

NASA Astrophysics Data System (ADS)

Bogdanovskaya, I. M.; Kosheleva, A. N.; Kiselev, P. B.; Davydova, Yu. A.

2017-01-01

The article identifies the role and main problems of vocational psychodiagnostics in modern socio-cultural conditions. It analyzes the potentials of information technologies in vocational psychodiagnostics of senior schoolchildren. The article describes the theoretical and methodological grounds, content and diagnostic potentials of the computerized method in vocational psychodiagnostics. The computerized method includes three blocks of sub-tests to identify intellectual potential, personal qualities, professional interests and values, career orientations, as well as subtests to analyze the specific life experience of senior schoolchildren. The results of diagnostics allow developing an integrated psychodiagnostic conclusion with recommendations. The article contains options of software architecture for the given method.

Economics of infection control surveillance technology: cost-effective or just cost?

PubMed

Furuno, Jon P; Schweizer, Marin L; McGregor, Jessina C; Perencevich, Eli N

2008-04-01

Previous studies have suggested that informatics tools, such as automated alert and decision support systems, may increase the efficiency and quality of infection control surveillance. However, little is known about the cost-effectiveness of these tools. We focus on 2 types of economic analyses that have utility in assessing infection control interventions (cost-effectiveness analysis and business-case analysis) and review the available literature on the economics of computerized infection control surveillance systems. Previous studies on the effectiveness of computerized infection control surveillance have been limited to assessments of whether these tools increase the sensitivity and specificity of surveillance over traditional methods. Furthermore, we identified only 2 studies that assessed the costs associated with computerized infection control surveillance. Thus, it remains unknown whether computerized infection control surveillance systems are cost-effective and whether use of these systems improves patient outcomes. The existing data are insufficient to allow for a summary conclusion on the cost-effectiveness of infection control surveillance technology. All future studies of computerized infection control surveillance systems should aim to collect outcomes and economic data to inform decision making and assist hospitals with completing business-cases analyses.

ONLINE Interviews Delores Meglio of Information Access Company.

ERIC Educational Resources Information Center

Pemberton, Jeffery K.

1987-01-01

The vice president of a computerized information center discusses her career history, the development of information services and the database industry, current information technologies and the role of artificial intelligence, characteristics of indexers and abstractors employed, the kind of training needed by abstractors and indexers, and…

76 FR 4703 - Proposed Information Collection Activity; Comment Request Proposed Projects:

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... Information Collection Activity; Comment Request Proposed Projects: Title: Computerized Support Enforcement Systems. OMB No. 0980-0271. Description: The information being collected is mandated by Section 454(16) of...) approved under section 452(d) of the title, of a statewide automated data processing and information...

24 CFR 92.502 - Program disbursement and information system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... information system. 92.502 Section 92.502 Housing and Urban Development Office of the Secretary, Department of... disbursement and information system. (a) General. The Home Investment Trust Fund account established in the United States Treasury is managed through a computerized disbursement and information system established...

Occupational Information Systems and Their Use in Rehabilitation. Revised.

ERIC Educational Resources Information Center

Kruger, Reuven

As our industrial-based economy changes into an information-based economy, information activities will continue to permeate rehabilitation. New technology in this area includes computerized occupational information systems used to aid vocational planning. Such systems include the federal government's Job Service Matching System, the Michigan…

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.

Novel Representation of Clinical Information in the ICU

PubMed Central

Pickering, B.W.; Herasevich, V.; Ahmed, A.; Gajic, O.

2010-01-01

The introduction of electronic medical records (EMR) and computerized physician order entry (CPOE) into the intensive care unit (ICU) is transforming the way health care providers currently work. The challenge facing developers of EMR’s is to create products which add value to systems of health care delivery. As EMR’s become more prevalent, the potential impact they have on the quality and safety, both negative and positive, will be amplified. In this paper we outline the key barriers to effective use of EMR and describe the methodology, using a worked example of the output. AWARE (Ambient Warning and Response Evaluation), is a physician led, electronic-environment enhancement program in an academic, tertiary care institution’s ICU. The development process is focused on reducing information overload, improving efficiency and eliminating medical error in the ICU. PMID:23616831

HOW GOOD ARE MY DATA? INFORMATION QUALITY ASSESSMENT METHODOLOGY

EPA Science Inventory

Quality assurance techniques used in software development and hardware maintenance/reliability help to ensure that data in a computerized information management system are maintained well. However, information workers may not know the quality of the data resident in their inf...

Impact of computerized order entry and pre-mixed dialysis solutions for continuous veno-venous hemodiafiltration on selection of therapy for acute renal failure.

PubMed

Saadulla, Lawand; Reeves, W Brian; Irey, Brittany; Ghahramani, Nasrollah

2012-02-01

To investigate the impacts of availability of pre-mixed solutions and computerized order entry on nephrologists' choice of the initial mode of renal replacement therapy in acute renal failure. We studied 898 patients with acute renal failure in 3 consecutive eras: era 1 (custom-mixed solution; n = 309), era 2 (pre-mixed commercial solution; n = 324), and era 3 (post-computerized order entry; n = 265). The proportion of patients treated with renal replacement therapy and the time from consult to initiation of continuous renal replacement therapy was similar in the 3 eras. Following introduction of the pre-mixed solution, the proportion of patients treated with continuous renal replacement therapy increased (20% vs. 33%; p < 0.05), it was initiated at a lower serum creatinine (353 ± 123 μmol/L vs. 300 ± 80 μmol/L; p < 0.05) and in older patients (53 ± 12 vs. 61 ± 14 years; p < 0.05). There was a progressive increase in the use of continuous veno-venous hemodialysis (18% vs. 79% vs. 100%; p < 0.05) and in the total prescribed flow rate (1,382 ± 546 vs. 2,324 ± 737 vs. 2,900 ± 305 mL/hr 3; p < 0.05). There was no significant impact on mortality. The availability of a pre-mixed solution increases the likelihood of initiating continuous renal replacement therapy in acute renal failure, initiating it at a lower creatinine and for older patients, use of continuous veno-venous hemodialysis and higher prescribed continuous renal replacement therapy dose. Computerized order entry implementation is associated with an additional increase in the use of continuous veno-venous hemodialysis, higher total prescribed dialysis dose, and use of CRRT among an increasing number of patients not on mechanical ventilation. The effect of these changes on patient survival is not significant.

Electronic information and clinical decision support for prescribing: state of play in Australian general practice

PubMed Central

Robertson, Jane; Moxey, Annette J; Newby, David A; Gillies, Malcolm B; Williamson, Margaret; Pearson, Sallie-Anne

2011-01-01

Background. Investments in eHealth worldwide have been mirrored in Australia, with >90% of general practices computerized. Recent eHealth incentives promote the use of up to date electronic information sources relevant to general practice with flexibility in mode of access. Objective. To determine GPs’ access to and use of electronic information sources and computerized clinical decision support systems (CDSSs) for prescribing. Methods. Semi-structured interviews were conducted with 18 experienced GPs and nine GP trainees in New South Wales, Australia in 2008. A thematic analysis of interview transcripts was undertaken. Results. Information needs varied with clinical experience, and people resources (specialists, GP peers and supervisors for trainees) were often preferred over written formats. Experienced GPs used a small number of electronic resources and accessed them infrequently. Familiarity from training and early clinical practice and easy access were dominant influences on resource use. Practice time constraints meant relevant information needed to be readily accessible during consultations, requiring integration or direct access from prescribing software. Quality of electronic resource content was assumed and cost a barrier for some GPs. Conclusions. The current Australian practice incentives do not prescribe which information resources GPs should use. Without integration into practice computing systems, uptake and routine use seem unlikely. CDSS developments must recognize the time pressures of practice, preference for integration and cost concerns. Minimum standards are required to ensure that high-quality information resources are integrated and regularly updated. Without standards, the anticipated benefits of computerization on patient safety and health outcomes will be uncertain. PMID:21109619

Guide to the Use of Information. Question Negotiation, Search Delivery, Search Evaluation.

ERIC Educational Resources Information Center

Kansas State Dept. of Education, Topeka.

This guide to the use of information reviews the development of Kansas Project Communicate from 1972-1976, and the Kansas State Department of Education (KSDE) computerized information service (KEDDS), which serves as the resource component of the information dissemination system. KEDDS (Kansas Educational Dissemination Diffusion system) is…

Sylvatic rabies epidemic in Italy: implementation of a data management system to assess the level of application of preventive dog vaccination.

PubMed

Bortolotti, Laura; Cobianchi, Mario; Breda, Tatiana; Favero, Laura; Ruocco, Luigi; Marangon, Stefano

2013-10-01

After 20 years of absence, rabies re-emerged in wild animals in north-eastern Italy in October 2008. Besides measures undertaken to fight the spread of infection in wildlife, vaccination against rabies was made compulsory for dogs living in the risk area. In the last 15 years, the veterinary authorities have focused on implementing computerized data collection systems in animal health, to serve as working tools for epidemiological surveillance activities and emergencies management. The prerequisite for implementing any data collection system is knowledge of the animal population. This also applies to the Canine Registry Data Bank, in which data on dogs and their movements, together with personal data on each owner and keeper, have been stored since 2003. The management information system has been updated and specific functions have been integrated in order to support the activity of both the veterinary services and the veterinary practitioners involved in the dog vaccination program. Vaccination became voluntary in February 2013. This paper describes implementation of the software and organization of data gathering, highlighting the benefits of computerized data compared to previously used paper-based data collection systems. The new functions, designed to centralize collection of uniform, updated vaccination data, have led to more efficient organization and better control of the vaccination plan. Automated information processing allowed vaccination operations to be supervised, incurred costs to be calculated, and vaccination coverage of the dog population to be monitored during the 3 years of compulsory vaccination.

Regulation, Privacy and Security: Chairman's Opening Remarks

PubMed Central

Gabrieli, E.R.

1979-01-01

Medical privacy is a keystone of a free democratic society. To conserve the right of the patient to medical privacy, computerization of the medical data must be regulated. This paper enumerates some steps to be taken urgently for the protection of computerized sensitive medical data. A computer-oriented medical lexicon is urgently needed for accurate coding. Health industry standards should be drafted. The goals of various data centers must be sharply defined to avoid conflicts of interest. Medical privacy should be studied further, and medical data centers should consider cost-effectiveness. State boards for medical privacy should be created to monitor data security procedures. There is a need for purposeful decentralization. A national medical information policy should be drafted, and a national clinical information board should implement the nation's medical information policy.

Current and emerging business models in the health care information technology industry: a view from wall street.

PubMed

Frank, Seth

2003-01-01

When we think about health care IT, we don't just think about clinical automation with the movement to computerized physician order entry (CPOE), but also the need to upgrade legacy financial and administrative systems to interact with clinical systems. Technology acceptance by physicians remains low, and computer use by physicians for data entry and analysis remains minimal. We expect this trend to change, and expect increased automation to represent gradual change. The HCIT space is dynamic, with many opportunities, but also many challenges. The unique nature of the end market buyers, existing business models, and nature of the technology makes this a challenging but dynamic area for equity investment.

Focus of attention in systems for visual monitoring of experiments

NASA Technical Reports Server (NTRS)

Blank, G. E.; Martin, W. N.

1987-01-01

The problem of designing a computerized experiment monitoring system for use in a space station or elsewhere is examined. It is shown that the essential challenge of such a system - attaining a reasonable expected running time - can be attacked using the concept of focus of attention and by exploiting parallelism. The use of the Contract Net Protocol for the latter purpose is discussed. The use of ideas from information science to help focus a programs's efforts on those computations likely to bring results is addressed, and the incorporation of those ideas into a design in order to aid the system in deciding upon the best course of action is considered.

Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow.

PubMed

Hartman, Douglas J

2015-06-01

Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2015 Elsevier Inc. All rights reserved.

Enhancing and Customizing Laboratory Information Systems to Improve/Enhance Pathologist Workflow.

PubMed

Hartman, Douglas J

2016-03-01

Optimizing pathologist workflow can be difficult because it is affected by many variables. Surgical pathologists must complete many tasks that culminate in a final pathology report. Several software systems can be used to enhance/improve pathologist workflow. These include voice recognition software, pre-sign-out quality assurance, image utilization, and computerized provider order entry. Recent changes in the diagnostic coding and the more prominent role of centralized electronic health records represent potential areas for increased ways to enhance/improve the workflow for surgical pathologists. Additional unforeseen changes to the pathologist workflow may accompany the introduction of whole-slide imaging technology to the routine diagnostic work. Copyright © 2016 Elsevier Inc. All rights reserved.

Identification codes for organizations listed in computerized data systems of the U.S. Geological Survey

USGS Publications Warehouse

Blackwell, C.D.

1988-01-01

Codes for the unique identification of public and private organizations listed in computerized data systems are presented. These codes are used by the U.S. Geological Survey 's National Water Data Exchange (NAWDEX), National Water Data Storage and Retrieval System (WATSTORE), National Cartographic Information Center (NCIC), and Office of Water Data Coordination (OWDC). The format structure of the codes is discussed and instructions are given for requesting new books. (Author 's abstract)

Primary care guidelines on consultation practices: the effectiveness of computerized versus paper-based versions. A cluster randomized controlled trial among newly qualified primary care physicians.

PubMed

Jousimaa, Jukkapekka; Mäkelä, Marjukka; Kunnamo, Ilkka; MacLennan, Graeme; Grimshaw, Jeremy M

2002-01-01

To compare the effects of computerized and paper-based versions of guidelines on recently qualified physicians' consultation practices. Two arm cluster randomized controlled trial. Physicians were randomized to receive computerized or textbook-based versions of the same guidelines for a 4-week study period. Physicians' compliance with guideline recommendations about laboratory, radiological, physical and other examinations, procedures, nonpharmacologic and pharmacologic treatments, physiotherapy, and referrals were measured by case note review. There were 139 recently qualified physicians working in 96 primary healthcare centers in Finland who participated in the study. Data on 4,633 patient encounters were abstracted, of which 3,484 were suitable for further analysis. Physicians' compliance with guidelines was high (over 80% for use of laboratory, radiology, physical examinations, and referrals). There were no significant differences in physicians' consultation practices in any of the measured outcomes between the computerized and textbook group. Guidelines are a useful source of information for recently qualified physicians working in primary care. However, the method of presentation of the guidelines (electronic or paper) does not have an effect on guideline use or their impact on decisions. Other factors should be considered when choosing the method of presentation of guidelines, such as information-seeking time, ease of use during the consultation, ability to update, production costs, and the physician's own preferences.

Quality Assessment of Process Measures in Antimicrobial Stewardship: Concordance of Valacyclovir Indication and Automatic Prospective Approval in Computerized Provider Order Entry

PubMed Central

Lee, Tiffany; McCoy, Christopher; Mahoney, Monica V

2017-01-01

Abstract Background The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) recommend computerized decision support at the time of prescribing as an antimicrobial stewardship (AST) tool. Providing antimicrobial indications during prescribing can optimize infection-specific therapy through appropriate antimicrobial selection, dosing, and frequency. The Leapfrog group identifies this as a quality measure for their report card system. At Beth Israel Deaconess Medical Center (BIDMC), indication-based dosing has been incorporated in the computerized provider order entry (CPOE) system since 2006. At BIDMC, valacyclovir is only approved for the treatment of varicella zoster (VZV) infection or prophylaxis of solid organ transplant (SOT) patients at low risk for cytomegalovirus. These indications bypass the need for AST approval. Accuracy validation of the selected indications has not been formally performed. Methods A retrospective chart review was performed in patients prescribed valacyclovir during an 8-month period in 2016. Electronic medical records, laboratory reports, and pharmacy records were reviewed to identify the suspected/confirmed infection. The primary outcome was the concordance rate of selected CPOE valacyclovir indication compared with suspected/confirmed infection at the time of ordering. The secondary outcome was the proportion of valacyclovir use per institutional protocol. Results Overall, 117 patients were included, with a median age of 57.9 years, 51 (43.6%) were male, and 4 (3.4%) were located in an intensive care unit. Fifty-nine orders (50.4%) selected VZV as the indication, followed by 21 orders (17.9%) for SOT prophylaxis. Of orders with any CPOE indication, only 59/101 (58.4%) were concordant with suspected/confirmed infection. Of the valacyclovir orders with a VZV indication, 37 (62.7%) were concordant. Of the orders with SOT prophylaxis indications, 5 (23.8%) were concordant. Furthermore, only 46 orders (39.3%) were per BIDMC-protocol. Conclusion Concordance of CPOE indication selection and suspected/confirmed infection for valacyclovir was low. Using CPOE to grant automatic prospective approval must be monitored and audited for accuracy if employed as an AST tool. Disclosures All authors: No reported disclosures.

Assessing research productivity in an oncology research institute: the role of the documentation center.

PubMed Central

Ugolini, D; Bogliolo, A; Parodi, S; Casilli, C; Santi, L

1997-01-01

An evaluation method used to assess the quality of research productivity and to provide priorities for budget allocation purposes is presented. This method, developed by a working group of the National Institute for Research on Cancer (IST), Genoa, Italy, is based on the partitioning of categories of the Science Citation Index and Journal Citation Reports (SCI-JCR) into deciles, which normalizes journal impact factors in order to gauge the quality of the productivity. A second parameter related to the number of staff of each institute department co-authoring a given paper has been introduced in order to guide departmental budget allocations. The information scientists of the IST Documentation Center who participated in the working group played a pivotal role in developing the computerized database of publications, providing and analyzing data, supplying and evaluating literature on the topic, and placing international bibliographic databases at the working group's disposal. PMID:9028569

Abdominal Tumor Characterization and Recognition Using Superior-Order Cooccurrence Matrices, Based on Ultrasound Images

PubMed Central

Mitrea, Delia; Mitrea, Paulina; Nedevschi, Sergiu; Badea, Radu; Lupsor, Monica; Socaciu, Mihai; Golea, Adela; Hagiu, Claudia; Ciobanu, Lidia

2012-01-01

The noninvasive diagnosis of the malignant tumors is an important issue in research nowadays. Our purpose is to elaborate computerized, texture-based methods for performing computer-aided characterization and automatic diagnosis of these tumors, using only the information from ultrasound images. In this paper, we considered some of the most frequent abdominal malignant tumors: the hepatocellular carcinoma and the colonic tumors. We compared these structures with the benign tumors and with other visually similar diseases. Besides the textural features that proved in our previous research to be useful in the characterization and recognition of the malignant tumors, we improved our method by using the grey level cooccurrence matrix and the edge orientation cooccurrence matrix of superior order. As resulted from our experiments, the new textural features increased the malignant tumor classification performance, also revealing visual and physical properties of these structures that emphasized the complex, chaotic structure of the corresponding tissue. PMID:22312411

E-waste Management and Refurbishment Prediction (EMARP) Model for Refurbishment Industries.

PubMed

Resmi, N G; Fasila, K A

2017-10-01

This paper proposes a novel algorithm for establishing a standard methodology to manage and refurbish e-waste called E-waste Management And Refurbishment Prediction (EMARP), which can be adapted by refurbishing industries in order to improve their performance. Waste management, particularly, e-waste management is a serious issue nowadays. Computerization has been into waste management in different ways. Much of the computerization has happened in planning the waste collection, recycling and disposal process and also managing documents and reports related to waste management. This paper proposes a computerized model to make predictions for e-waste refurbishment. All possibilities for reusing the common components among the collected e-waste samples are predicted, thus minimizing the wastage. Simulation of the model has been done to analyse the accuracy in the predictions made by the system. The model can be scaled to accommodate the real-world scenario. Copyright © 2017 Elsevier Ltd. All rights reserved.

Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events?

PubMed

Charles, Krista; Cannon, Margaret; Hall, Robert; Coustasse, Alberto

2014-01-01

Computerized provider order entry (CPOE) systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology. This study followed a methodology using the basic principles of a systematic review and referenced 50 sources. CPOE systems in hospitals were found to be capable of reducing medical errors and ADEs, especially when CPOE systems are bundled with clinical decision support systems designed to alert physicians and other healthcare providers of pending lab or medical errors. However, CPOE systems face major barriers associated with adoption in a hospital system, mainly high implementation costs and physicians' resistance to change.

49 CFR 1244.5 - Date of filing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... waybill sample information shall be the audit (accounting) month except as specified below: (1) Subject railroads using the computerized system may submit waybill sample information quarterly as specified in Statement 81-1. (2) Subject railroad using the manual system may submit waybill sample information quarterly...

Four "E"pochs: The Story of Informatization.

ERIC Educational Resources Information Center

Duff, Alistair S.

2003-01-01

Informatization is a term of Japanese provenance denoting major systemic change from the application of information technology. Proposes a theory of post-war informatization focusing on information services in libraries, specifically computerized information retrieval. Describes four electronic epochs: offline, online, CD-ROM, and Internet, and…

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.

Evaluation and implementation of chemotherapy regimen validation in an electronic health record.

PubMed

Diaz, Amber H; Bubalo, Joseph S

2014-12-01

Computerized provider order entry of chemotherapy regimens is quickly becoming the standard for prescribing chemotherapy in both inpatient and ambulatory settings. One of the difficulties with implementation of chemotherapy regimen computerized provider order entry lies in verifying the accuracy and completeness of all regimens built in the system library. Our goal was to develop, implement, and evaluate a process for validating chemotherapy regimens in an electronic health record. We describe our experience developing and implementing a process for validating chemotherapy regimens in the setting of a standard, commercially available computerized provider order entry system. The pilot project focused on validating chemotherapy regimens in the adult inpatient oncology setting and adult ambulatory hematologic malignancy setting. A chemotherapy regimen validation process was defined as a result of the pilot project. Over a 27-week pilot period, 32 chemotherapy regimens were validated using the process we developed. Results of the study suggest that by validating chemotherapy regimens, the amount of time spent by pharmacists in daily chemotherapy review was decreased. In addition, the number of pharmacist modifications required to make regimens complete and accurate were decreased. Both physician and pharmacy disciplines showed improved satisfaction and confidence levels with chemotherapy regimens after implementation of the validation system. Chemotherapy regimen validation required a considerable amount of planning and time but resulted in increased pharmacist efficiency and improved provider confidence and satisfaction. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

A Computer Program for Displaying Forest Survey Type Information

Treesearch

B. Bruce Bare; Robert N. Stone

1968-01-01

Presents a computerized procedure for displaying forest type information from inventory plots. Although the development of general forest type maps in emphasized, the program can be used to display any locational data having rectangular coordinates

Telemedicine: Toward Better Health Care for the Elderly.

ERIC Educational Resources Information Center

Greenberger, Martin; Puffer, James C.

1989-01-01

Describes the results of projects exploring the potential of information technology for delivering health care. Describes a proposed project coupling the telephone with computerized audiotext responses, which would provide elderly patients with information, contact, and reassurance. (SR)

Computerized training management system

DOEpatents

Rice, H.B.; McNair, R.C.; White, K.; Maugeri, T.

1998-08-04

A Computerized Training Management System (CTMS) is disclosed for providing a procedurally defined process that is employed to develop accreditable performance based training programs for job classifications that are sensitive to documented regulations and technical information. CTMS is a database that links information needed to maintain a five-phase approach to training-analysis, design, development, implementation, and evaluation independent of training program design. CTMS is designed using R-Base{trademark}, an-SQL compliant software platform. Information is logically entered and linked in CTMS. Each task is linked directly to a performance objective, which, in turn, is linked directly to a learning objective; then, each enabling objective is linked to its respective test items. In addition, tasks, performance objectives, enabling objectives, and test items are linked to their associated reference documents. CTMS keeps all information up to date since it automatically sorts, files and links all data; CTMS includes key word and reference document searches. 18 figs.

Computerized training management system

DOEpatents

Rice, Harold B.; McNair, Robert C.; White, Kenneth; Maugeri, Terry

1998-08-04

A Computerized Training Management System (CTMS) for providing a procedurally defined process that is employed to develop accreditable performance based training programs for job classifications that are sensitive to documented regulations and technical information. CTMS is a database that links information needed to maintain a five-phase approach to training-analysis, design, development, implementation, and evaluation independent of training program design. CTMS is designed using R-Base.RTM., an-SQL compliant software platform. Information is logically entered and linked in CTMS. Each task is linked directly to a performance objective, which, in turn, is linked directly to a learning objective; then, each enabling objective is linked to its respective test items. In addition, tasks, performance objectives, enabling objectives, and test items are linked to their associated reference documents. CTMS keeps all information up to date since it automatically sorts, files and links all data; CTMS includes key word and reference document searches.

Emergency physicians' attitudes and preferences regarding computed tomography, radiation exposure, and imaging decision support.

PubMed

Griffey, Richard T; Jeffe, Donna B; Bailey, Thomas

2014-07-01

Although computerized decision support for imaging is often recommended for optimizing computed tomography (CT) use, no studies have evaluated emergency physicians' (EPs') preferences regarding computerized decision support in the emergency department (ED). In this needs assessment, the authors sought to determine if EPs view overutilization as a problem, if they want decision support, and if so, the kinds of support they prefer. A 42-item, Web-based survey of EPs was developed and used to measure EPs' attitudes, preferences, and knowledge. Key contacts at local EDs sent letters describing the study to their physicians. Exploratory principal components analysis (PCA) was used to determine the underlying factor structure of multi-item scales, Cronbach's alpha was used to measure internal consistency of items on a scale, Spearman correlations were used to describe bivariate associations, and multivariable linear regression analysis was used to identify variables independently associated with physician interest in decision support. Of 235 surveys sent, 155 (66%) EPs responded. Five factors emerged from the PCA. EPs felt that: 1) CT overutilization is a problem in the ED (α = 0.75); 2) a patient's cumulative CT study count affects decisions of whether and what type of imaging study to order only some of the time (α = 0.75); 3) knowledge that a patient has had prior CT imaging for the same indication makes EPs less likely to order a CT (α = 0.42); 4) concerns about malpractice, patient satisfaction, or insistence on CTs affect CT ordering decisions (α = 0.62); and 5) EPs want decision support before ordering CTs (α = 0.85). Performance on knowledge questions was poor, with only 18% to 39% correctly responding to each of the three multiple-choice items about effective radiation doses of chest radiograph and single-pass abdominopelvic CT, as well as estimated increased risk of cancer from a 10-mSv exposure. Although EPs wanted information on patients' cumulative exposures, they feel inadequately familiar with this information to make use of it clinically. If provided with patients' cumulative radiation exposures from CT, 87% of EPs said that they would use this information to discuss imaging options with their patients. In the multiple regression model, which included all variables associated with interest in decision support at p < 0.10 in bivariate tests, items independently associated with EPs' greater interest in all types of decision support proposed included lower total knowledge scores, greater frequency that cumulative CT study count affects EP's decision to order CTs, and greater agreement that overutilization of CT is a problem and that awareness of multiple prior CTs for a given indication affects CT ordering decisions. Emergency physicians view overutilization of CT scans as a problem with potential for improvement in the ED and would like to have more information to discuss risks with their patients. EPs are interested in all types of imaging decision support proposed to help optimize imaging ordering in the ED and to reduce radiation to their patients. Findings reveal several opportunities that could potentially affect CT utilization. © 2014 by the Society for Academic Emergency Medicine.

Emergency Physicians’ Attitudes and Preferences Regarding Computed Tomography, Radiation Exposure, and Imaging Decision Support

PubMed Central

Griffey, Richard T.; Jeffe, Donna B.; Bailey, Thomas

2014-01-01

Objectives Although computerized decision support for imaging is often recommended for optimizing computed tomography (CT) use, no studies have evaluated emergency physicians’ (EPs’) preferences regarding computerized decision support in the emergency department (ED). In this needs assessment, the authors sought to determine if EPs view overutilization as a problem, if they want decision support, and if so, the kinds of support they prefer. Methods A 42-item, Web-based survey of EPs was developed and used to measure EPs’ attitudes, preferences, and knowledge. Key contacts at local EDs sent letters describing the study to their physicians. Exploratory principal components analysis (PCA) was used to determine the underlying factor structure of multi-item scales, Cronbach’s alpha was used to measure internal consistency of items on a scale, Spearman correlations were used to describe bivariate associations, and multivariable linear regression analysis was used to identify variables independently associated with physician interest in decision support. Results Of 235 surveys sent, 155 (66%) EPs responded. Five factors emerged from the PCA. EPs felt that: 1) CT overutilization is a problem in the ED (α = 0.75); 2) a patient’s cumulative CT study count affects decisions of whether and what type of imaging study to order only some of the time (α = 0.75); 3) knowledge that a patient has had prior CT imaging for the same indication makes EPs less likely to order a CT (α = 0.42); 4) concerns about malpractice, patient satisfaction, or insistence on CTs affect CT ordering decisions (α = 0.62); and 5) EPs want decision support before ordering CTs (α = 0.85). Performance on knowledge questions was poor, with only 18% to 39% correctly responding to each of the three multiple-choice items about effective radiation doses of chest radiograph and single-pass abdominopelvic CT, as well as estimated increased risk of cancer from a 10-mSv exposure. Although EPs wanted information on patients’ cumulative exposures, they feel inadequately familiar with this information to make use of it clinically. If provided with patients’ cumulative radiation exposures from CT, 87% of EPs said that they would use this information to discuss imaging options with their patients. In the multiple regression model, which included all variables associated with interest in decision support at p < 0.10 in bivariate tests, items independently associated with EPs’ greater interest in all types of decision support proposed included lower total knowledge scores, greater frequency that cumulative CT study count affects EP’s decision to order CTs, and greater agreement that overutilization of CT is a problem and that awareness of multiple prior CTs for a given indication affects CT ordering decisions. Conclusions Emergency physicians view overutilization of CT scans as a problem with potential for improvement in the ED and would like to have more information to discuss risks with their patients. EPs are interested in all types of imaging decision support proposed to help optimize imaging ordering in the ED and to reduce radiation to their patients. Findings reveal several opportunities that could potentially affect CT utilization. PMID:25125272

Preliminary evaluation of a micro-based repeated measures testing system

NASA Technical Reports Server (NTRS)

Kennedy, Robert S.; Wilkes, Robert L.; Lane, Norman E.

1985-01-01

A need exists for an automated performance test system to study the effects of various treatments which are of interest to the aerospace medical community, i.e., the effects of drugs and environmental stress. The ethics and pragmatics of such assessment demand that repeated measures in small groups of subjects be the customary research paradigm. Test stability, reliability-efficiency and factor structure take on extreme significance; in a program of study by the U.S. Navy, 80 percent of 150 tests failed to meet minimum metric requirements. The best is being programmed on a portable microprocessor and administered along with tests in their original formats in order to examine their metric properties in the computerized mode. Twenty subjects have been tested over four replications on a 6.0 minute computerized battery (six tests) and which compared with five paper and pencil marker tests. All tests achieved stability within the four test sessions, reliability-efficiencies were high (r greater than .707 for three minutes testing), and the computerized tests were largely comparable to the paper and pencil version from which they were derived. This computerized performance test system is portable, inexpensive and rugged.

National Crime Information Center (NCIC) Training Videos.

ERIC Educational Resources Information Center

Federal Bureau of Investigation, Washington, DC. National Crime Information Center.

The Federal Bureau of Investigation's National Crime Information Center (NCIC) maintains a set of computerized files of documented criminal justice information reported by a network of over 60,000 participating national, regional, state, and local agencies. The files, dealing with wanted persons, missing persons, unidentified persons, and stolen…

Document Indexing for Image-Based Optical Information Systems.

ERIC Educational Resources Information Center

Thiel, Thomas J.; And Others

1991-01-01

Discussion of image-based information retrieval systems focuses on indexing. Highlights include computerized information retrieval; multimedia optical systems; optical mass storage and personal computers; and a case study that describes an optical disk system which was developed to preserve, access, and disseminate military documents. (19…

Ergonomic nursing workstation design to prevent cumulative trauma disorders.

PubMed

McHugh, M L; Schaller, P

1997-01-01

The introduction of computerized nursing information systems offers health care institutions an opportunity to take a new look at safety issues related to nursing workstation design. Industrial studies have investigated the injuries sustained by clerical workers who spend long periods of time at their computers. Cumulative trauma disorders (CTDs) are the most common injuries associated with computerized workstation use. They account for nearly 90,000 injuries each year in the United States. Typical CTDs include back pain, strain of the neck, shoulders and eyes, and carpal tunnel syndrome. As the information handling work of nurses is increasingly computerized, the incidence of computer-related injury is expected to increase. Injury rates can be reduced by ergonomic workstation design. An assessment of potential risks associated with the equipment installed should be done as part of workstation design. Risk identification is a prerequisite for avoiding injuries by designing workstations that protect human health. The ergonomic principles learned and tested on office workers are addressed and extrapolated to nursing workstation design. Specific suggestions for design of sitting and standing workstations are presented.

Evaluation and Information in the Field of Technical Aids for Disabled Persons: An European Perspective. Monograph Number Thirty-Five.

ERIC Educational Resources Information Center

Pedotti, Antonio, Ed.; Andrich, Renzo, Ed.

The monograph provides information on evaluation of technical aids, wheelchairs, and computerized information systems for disabled persons. The first chapter provides a general overview of actions of the European Community concerning technical aids evaluation, information on the "Concerted Action" program called "Evaluation of…

The Fire Effects Information System

Treesearch

William C. Fischer

1987-01-01

Lack of information regarding fire effects is perceived by many fire and resource managers as a barrier to the effective application of prescribed fire. This lack of information, in many instances, is the result of poor diffusion of existing knowledge rather than lack of knowledge. A computerized Fire Effects Information System can make existing fire effects knowledge...

PGIS (Project Grant Information System) Taxonomy [Rough Draft].

ERIC Educational Resources Information Center

North American Rockwell Information Systems Co., Arlington, VA.

The Project Grant Information System (PGIS) is a computerized information indexing and retrieval system which supports the U.S. Office of Education. Its purpose is to provide OE officials with up-to-date information about the Office's discretionary grant programs and projects. The purpose of the Taxonomy is to provide: (1) those individuals who…

Normobaric Hypoxia Effects on Balance Measured by Computerized Dynamic Posturography.

PubMed

Wagner, Dale R; Saunders, Skyler; Robertson, Brady; Davis, John E

2016-09-01

Wagner, Dale R., Skyler Saunders, Brady Robertson, and John E. Davis. Normobaric hypoxia effects on balance measured by computerized dynamic posturography. High Alt Med Biol. 17:222-227, 2016.-Background/Aim: Equilibrium was measured by computerized dynamic posturography at varying levels of normobaric hypoxia before and after exercise. Following a familiarization trial, 12 males (27.3 ± 7.1 years) completed three sessions in random order on a NeuroCom SMART Balance Master: a sham trial at the ambient altitude of 1500 m and simulated altitudes of 3000 and 5000 m created by a hypoxic generator. The NeuroCom provided composite scores for a sensory organization test of equilibrium and a motor control test to assess the appropriate motor response. Additional information on somatosensory, visual, and vestibular responses was obtained. Each session consisted of 20 minutes of rest followed by the NeuroCom test, then 10 minutes of exercise, and 10 minutes of recovery followed by a second NeuroCom test, all while connected to the hypoxic generator. Mean differences were identified with a two-way (pre/postexercise and altitude condition), repeated-measures analysis of variance. The composite sensory score was significantly lower (p < 0.001) during the 5000 m trial (73.4 ± 12.0) compared to the 1500 m (80.8 ± 7.0) and 3000 m (84.1 ± 5.0) altitudes. The inability to ignore inaccurate visual cues in a situation of visual conflict was the most common sensory error. Motor control was not affected by altitude or exercise. These results suggest that moderate hypoxia does not affect balance, but severe hypoxia significantly reduces equilibrium. Furthermore, it appears that the alterations in equilibrium are primarily from impairments in visual function.

Definition of Tire Properties Required for Landing System Analysis

NASA Technical Reports Server (NTRS)

Clark, S. K.; Dodge, R. N.; Luchini, J. R.

1978-01-01

The data bank constructed provided two basic advantages for the user of aircraft tire information. First, computerization of the data bank allowed mechanical property data to be stored, corrected, updated, and revised quickly and easily as more reliable tests and measurements were carried out. Secondly, the format of the book which can be printed from the computerized data bank can be easily adjusted to suit the needs of the users without the great expense normally associated with reprinting and editing books set by ordinary typography.

Freight Transportation Information Systems and Their Implications for R&D Policy

DOT National Transportation Integrated Search

1974-03-01

The current use of computerized management information and control systems in intercity freight transportation are examined. Each of the four modes (railroad, motor carrier, maritime and air cargo industries) is investigated. In each case, computer i...

Real-time subway information for improving transit ridership.

DOT National Transportation Integrated Search

2016-08-01

In recent years, the standardization of transit schedule information has yielded a dramatic increase in the accessibility of computerized transit schedules and given rise to real-time service schedules. Two such real-time service schedules are the Ge...

Reliability, validity and sensitivity of a computerized visual analog scale measuring state anxiety.

PubMed

Abend, Rany; Dan, Orrie; Maoz, Keren; Raz, Sivan; Bar-Haim, Yair

2014-12-01

Assessment of state anxiety is frequently required in clinical and research settings, but its measurement using standard multi-item inventories entails practical challenges. Such inventories are increasingly complemented by paper-and-pencil, single-item visual analog scales measuring state anxiety (VAS-A), which allow rapid assessment of current anxiety states. Computerized versions of VAS-A offer additional advantages, including facilitated and accurate data collection and analysis, and applicability to computer-based protocols. Here, we establish the psychometric properties of a computerized VAS-A. Experiment 1 assessed the reliability, convergent validity, and discriminant validity of the computerized VAS-A in a non-selected sample. Experiment 2 assessed its sensitivity to increase in state anxiety following social stress induction, in participants with high levels of social anxiety. Experiment 1 demonstrated the computerized VAS-A's test-retest reliability (r = .44, p < .001); convergent validity with the State-Trait Anxiety Inventory's state subscale (STAI-State; r = .60, p < .001); and discriminant validity as indicated by significantly lower correlations between VAS-A and different psychological measures relative to the correlation between VAS-A and STAI-State. Experiment 2 demonstrated the VAS-A's sensitivity to changes in state anxiety via a significant pre- to during-stressor rise in VAS-A scores (F(1,48) = 25.13, p < .001). Set-order administration of measures, absence of clinically-anxious population, and gender-unbalanced samples. The adequate psychometric characteristics, combined with simple and rapid administration, make the computerized VAS-A a valuable self-rating tool for state anxiety. It may prove particularly useful for clinical and research settings where multi-item inventories are less applicable, including computer-based treatment and assessment protocols. The VAS-A is freely available: http://people.socsci.tau.ac.il/mu/anxietytrauma/visual-analog-scale/. Copyright © 2014 Elsevier Ltd. All rights reserved.

Introducing Physician Order Entry at a Major Academic Medical Center: I. Impact on Organizational Culture and Behavior.

ERIC Educational Resources Information Center

Massaro, Thomas A.

1993-01-01

Implementation of the University of Virginia Medical Center's computerized system for mandatory recordkeeping of physician orders is discussed, focusing on administrative issues: delays, costs, disruption of work routine and behavior, and the need to bring in a senior management team. Recommendations are made for institutions with similar…

Adapting Nielsen’s Design Heuristics to Dual Processing for Clinical Decision Support

PubMed Central

Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

2016-01-01

The study objective was to improve the applicability of Nielson’s standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access. PMID:28269915

On categorizing gestational, birth, and neonatal complications following late pregnancy exposure to antidepressants: the prenatal antidepressant exposure syndrome.

PubMed

Gentile, Salvatore

2010-03-01

Late in utero exposure to antidepressants has been suspected of adversely impacting pregnancy outcome and compromising neonatal adaptation. Hence, the necessity exists to analyze published information on antidepressant use during late pregnancy to individuate potential recurrent patterns of iatrogenic complications. Computerized searches on MEDLINE, PsycINFO, ENBASE, and Cochrane Library through February 10, 2010 were performed for selecting literature information and investigating the safety of antidepressants when used during late pregnancy. Antidepressant treatment during late pregnancy may increase the rates of poor pregnancy outcome and neonatal withdrawal/toxic reactions. Because both gestational complications and neonatal adverse events acknowledge the same etiology, the author suggests including such iatrogenic events under the definition of prenatal antidepressant exposure syndrome, in order to increase clinicians' awareness about the spectrum of risks which may concern the mother-infant pair when antidepressant treatment is deemed indispensable during late pregnancy.

Adapting Nielsen's Design Heuristics to Dual Processing for Clinical Decision Support.

PubMed

Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

2016-01-01

The study objective was to improve the applicability of Nielson's standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access.

[Digital signature: new prospects for the information of the cardiologic clinical card].

PubMed

Cervesato, E; Antonini-Canterin, F; Nicolosi, G L

2001-02-01

In the last few years, remarkable improvements have been made in computerized database systems used in cardiology. However, they will not easily lead to further relevant improvements unless the weaknesses and the gaps deriving from the obligation of forming and storing case sheets, according to law, are faced and resolved in an original way. This article covers the topic of the digital signature and how it could form the basis for a new powerful impulse to the process of informatization of cardiology records. The proposal of elaborating a totally computerized case sheet involves the need of rationalizing the flow of clinical information and of implementing a management system integrated with the hospital information system. The elimination of paper support will probably lead to an advantageous cycle that will involve the entire hospital, both clinically as well as administratively.

The Naval Enlisted Professional Development Information System (NEPDIS): Front End Analysis (FEA) Process. Technical Report 159.

ERIC Educational Resources Information Center

Aagard, James A.; Ansbro, Thomas M.

The Naval Enlisted Professional Development Information System (NEPDIS) was designed to function as a fully computerized information assembly and analysis system to support labor force, personnel, and training management. The NEPDIS comprises separate training development, instructional, training record and evaluation, career development, and…

A Plan For a Publication Network For Rapid Dissemination of Technical Information.

ERIC Educational Resources Information Center

MacLachlan, James

This paper describes an alternative to current information dissemination systems (letter journals), computerized information systems, and clearinghouse operations) that would establish a network of depositories at universities and research organizations. The essence of the approach is to provide convenient access to working papers and technical…

Computerized Information Service--SDI. Annual Report 1974-75.

ERIC Educational Resources Information Center

Hjerppe, Roland

The Information and Documentation Centre of the Royal Institute of Technology Library performs research and development in information science. The two main areas of this continuing research and development programme are (1) development of a comprehensive SDI service and (2) investigations in interactive retrieval services. This annual report…

DIALOG for Electrical Engineers. CTHB Publikation Nr 29 (1982).

ERIC Educational Resources Information Center

Fjallbrant, Nancy

This manual provides electrical and electronic engineers with an introduction to online information retrieval as implemented on the DIALOG information retrieval system. Sections cover: (1) the development of computerized information retrieval; (2) its advantages; (3) the equipment needed, DIALOG hours of availability, methods of access, and cost…

Transborder Flow of Computerized Information: Controls and Restrictions.

ERIC Educational Resources Information Center

Shrader, Erwin

Of major concern to United States position and policy in the telecommunications and information areas is "transborder data flow," the transferring of computer stored data between nations. Many European nations, including France, Austria, and West Germany, have enacted laws regulating the flow of information leaving the country where it…

Solid Waste Information Management System (SWIMS). Data summary, fiscal year 1980

NASA Astrophysics Data System (ADS)

Batchelder, H. M.

1981-05-01

The solid waste information management system (SWIMS) maintains computerized records on a master data base. It provides a comprehensive system for cataloging and assembling data into output reports. The SWIMS data base contains information on the transuranic (TRU) and low level waste (LLW) generated, buried, or stored.

Socio-Economic Impact Assessment of the Computerized Customer Information System (CCIS) at the Southern California Rapid Transit District (SCRTD)

DOT National Transportation Integrated Search

1983-06-01

This document is a product of an ongoing program to assess the impacts of automated transit information system (ATIS) technology on the transit industry's efforts to improve the productivity and quality of telephone information/marketing services to ...

Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients.

PubMed

Vermeulen, K M; van Doormaal, J E; Zaal, R J; Mol, P G M; Lenderink, A W; Haaijer-Ruskamp, F M; Kosterink, J G W; van den Bemt, P M L A

2014-08-01

Prescribing medication is an important aspect of almost all in-hospital treatment regimes. Besides their obviously beneficial effects, medicines can also cause adverse drug events (ADE), which increase morbidity, mortality and health care costs. Partially, these ADEs arise from medication errors, e.g. at the prescribing stage. ADEs caused by medication errors are preventable ADEs. Until now, medication ordering was primarily a paper-based process and consequently, it was error prone. Computerized Physician Order Entry, combined with basic Clinical Decision Support System (CPOE/CDSS) is considered to enhance patient safety. Limited information is available on the balance between the health gains and the costs that need to be invested in order to achieve these positive effects. Aim of this study was to study the balance between the effects and costs of CPOE/CDSS compared to the traditional paper-based medication ordering. The economic evaluation was performed alongside a clinical study (interrupted time series design) on the effectiveness of CPOE/CDSS, including a cost minimization and a cost-effectiveness analysis. Data collection took place between 2005 and 2008. Analyses were performed from a hospital perspective. The study was performed in a general teaching hospital and a University Medical Centre on general internal medicine, gastroenterology and geriatric wards. Computerized Physician Order Entry, combined with basic Clinical Decision Support System (CPOE/CDSS) was compared to a traditional paper based system. All costs of both medication ordering systems are based on resources used and time invested. Prices were expressed in Euros (price level 2009). Effectiveness outcomes were medication errors and preventable adverse drug events. During the paper-based prescribing period 592 patients were included, and during the CPOE/CDSS period 603. Total costs of the paper-based system and CPOE/CDSS amounted to €12.37 and €14.91 per patient/day respectively. The Incremental Cost-Effectiveness Ratio (ICER) for medication errors was 3.54 and for preventable adverse drug events 322.70, indicating the extra amount (€) that has to be invested in order to prevent one medication error or one pADE. CPOE with basic CDSS contributes to a decreased risk of preventable harm. Overall, the extra costs of CPOE/CDSS needed to prevent one ME or one pADE seem to be acceptable. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

FINE PARTICLE EMISSIONS INFORMATION SYSTEM: SUMMARY REPORT (SUMMER 1976)

EPA Science Inventory

The report summarizes the initial loading of data into the Fine Particle Emissions Information System (FPEIS), a computerized database on primary fine particle emissions to the atmosphere from stationary sources, designed to assist engineers and scientists engaged in fine particl...

49 CFR 1244.5 - Date of filing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... railroads using the computerized system may submit waybill sample information quarterly as specified in Statement 81-1. (2) Subject railroad using the manual system may submit waybill sample information quarterly... OF TRANSPORTATION (CONTINUED) ACCOUNTS, RECORDS AND REPORTS WAYBILL ANALYSIS OF TRANSPORTATION OF...

Information Systems and Management Training.

ERIC Educational Resources Information Center

Curry, B.; Smith, D. G.

1991-01-01

A case study of a South Wales manufacturer illustrates the need for companies to adopt an integrated strategy for computerization and information systems. Lack of management training blending computing and business skills can have a crippling effect on system development and organizational health. (SK)

Clinician preferences for verbal communication compared to EHR documentation in the ICU

PubMed Central

Collins, S.A.; Bakken, S.; Vawdrey, D.K.; Coiera, E.; Currie, L

2011-01-01

Background Effective communication is essential to safe and efficient patient care. Additionally, many health information technology (HIT) developments, innovations, and standards aim to implement processes to improve data quality and integrity of electronic health records (EHR) for the purpose of clinical information exchange and communication. Objective We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. Methods We conducted a focus group and 5 interviews with ICU clinicians and observed 59.5 hours of interdisciplinary ICU morning rounds. Results Clinicians used an EHR system, which included electronic documentation and computerized provider order entry (CPOE), and paper artifacts for documentation; yet, preferred the verbal communication space as a method of information exchange because they perceived that the documentation was often not updated or efficient for information retrieval. These perceptions that the EHR is a “shift behind” may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Conclusions Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication. PMID:23616870

Weigh-in-Motion systems evaluation : final report.

DOT National Transportation Integrated Search

1976-04-01

This relatively short-term project was initiated in order to perfect installation, operation, and maintenance practices necessary for continued accurate and reliable operation of a computerized Weigh-in-Motion system which will be used to gather truc...

Comparison of micro-computerized tomography and cone-beam computerized tomography in the detection of accessory canals in primary molars.

PubMed

Acar, Buket; Kamburoğlu, Kıvanç; Tatar, İlkan; Arıkan, Volkan; Çelik, Hakan Hamdi; Yüksel, Selcen; Özen, Tuncer

2015-12-01

This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

Towards a Framework for Developing Semantic Relatedness Reference Standards

PubMed Central

Pakhomov, Serguei V.S.; Pedersen, Ted; McInnes, Bridget; Melton, Genevieve B.; Ruggieri, Alexander; Chute, Christopher G.

2010-01-01

Our objective is to develop a framework for creating reference standards for functional testing of computerized measures of semantic relatedness. Currently, research on computerized approaches to semantic relatedness between biomedical concepts relies on reference standards created for specific purposes using a variety of methods for their analysis. In most cases, these reference standards are not publicly available and the published information provided in manuscripts that evaluate computerized semantic relatedness measurement approaches is not sufficient to reproduce the results. Our proposed framework is based on the experiences of medical informatics and computational linguistics communities and addresses practical and theoretical issues with creating reference standards for semantic relatedness. We demonstrate the use of the framework on a pilot set of 101 medical term pairs rated for semantic relatedness by 13 medical coding experts. While the reliability of this particular reference standard is in the “moderate” range; we show that using clustering and factor analyses offers a data-driven approach to finding systematic differences among raters and identifying groups of potential outliers. We test two ontology-based measures of relatedness and provide both the reference standard containing individual ratings and the R program used to analyze the ratings as open-source. Currently, these resources are intended to be used to reproduce and compare results of studies involving computerized measures of semantic relatedness. Our framework may be extended to the development of reference standards in other research areas in medical informatics including automatic classification, information retrieval from medical records and vocabulary/ontology development. PMID:21044697

32 CFR 21.510 - Why does the DoD report information to the CFDA?

Code of Federal Regulations, 2011 CFR

2011-07-01

... maintaining the Federal Assistance Programs Retrieval System, a computerized data base of the information. 4... 32 National Defense 1 2011-07-01 2011-07-01 false Why does the DoD report information to the CFDA... GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Information Reporting on...

32 CFR 21.510 - Why does the DoD report information to the CFDA?

Code of Federal Regulations, 2010 CFR

2010-07-01

... maintaining the Federal Assistance Programs Retrieval System, a computerized data base of the information. 4... 32 National Defense 1 2010-07-01 2010-07-01 false Why does the DoD report information to the CFDA... GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Information Reporting on...

32 CFR 21.510 - Why does the DoD report information to the CFDA?

Code of Federal Regulations, 2013 CFR

2013-07-01

... maintaining the Federal Assistance Programs Retrieval System, a computerized data base of the information. 4... 32 National Defense 1 2013-07-01 2013-07-01 false Why does the DoD report information to the CFDA... GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Information Reporting on...

32 CFR 21.510 - Why does the DoD report information to the CFDA?

Code of Federal Regulations, 2014 CFR

2014-07-01

... maintaining the Federal Assistance Programs Retrieval System, a computerized data base of the information. 4... 32 National Defense 1 2014-07-01 2014-07-01 false Why does the DoD report information to the CFDA... GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Information Reporting on...

32 CFR 21.510 - Why does the DoD report information to the CFDA?

Code of Federal Regulations, 2012 CFR

2012-07-01

... maintaining the Federal Assistance Programs Retrieval System, a computerized data base of the information. 4... 32 National Defense 1 2012-07-01 2012-07-01 false Why does the DoD report information to the CFDA... GRANT AND AGREEMENT REGULATIONS DoD GRANTS AND AGREEMENTS-GENERAL MATTERS Information Reporting on...

Computerized Vocational Information and Decision-Making in Secured Environments in New York State.

ERIC Educational Resources Information Center

Heller, Barbara R.; Gross, Linda Chitayat

A study was conducted on the use of the Guidance Information System (GIS), an on-line computer information retrieval system for occupational, two-year college, four-year college, and scholarship and financial aid information, in four detention/correctional facilities in New York. These were the Queens House of Detention for Men (QHDM), Brooklyn…

User's Guide to OASIS, Oceanic and Atmospheric Scientific Information System. Key to Oceanic and Atmospheric Information Sources No. 1.

ERIC Educational Resources Information Center

National Oceanic and Atmospheric Administration (DOC), Washington, DC. Environmental Data Service.

OASIS (Oceanic and Atmospheric Scientific Information System) is an information retrieval service that furnishes ready reference to the technical literature and research efforts concerning the environmental sciences and marine and coastal resources. It provides computerized searches of both NOAA (National Oceanic and Atmospheric Administration)…

Computerized provider order entry systems.

PubMed

2001-01-01

Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

A study of the relative effectiveness and cost of computerized information retrieval in the interactive mode

NASA Technical Reports Server (NTRS)

Smetana, F. O.; Furniss, M. A.; Potter, T. R.

1974-01-01

Results of a number of experiments to illuminate the relative effectiveness and costs of computerized information retrieval in the interactive mode are reported. It was found that for equal time spent in preparing the search strategy, the batch and interactive modes gave approximately equal recall and relevance. The interactive mode however encourages the searcher to devote more time to the task and therefore usually yields improved output. Engineering costs as a result are higher in this mode. Estimates of associated hardware costs also indicate that operation in this mode is more expensive. Skilled RECON users like the rapid feedback and additional features offered by this mode if they are not constrained by considerations of cost.

How to implement information technology in the operating room and the intensive care unit.

PubMed

Meyfroidt, Geert

2009-03-01

The number of operating rooms and intensive care units looking for a data management system to perform their increasingly complex tasks is rising. Although at this time only a minority is computerized, within the next few years many centres will start implementing information technology. The transition towards a computerized system is a major venture, which will have a major impact on workflow. This chapter reviews the present literature. Published papers on this subject are predominantly single- or multi-centre implementation reports. The general principles that should guide such a process are described. For healthcare institutions or individual practitioners that plan to undertake this venture, the implementation process is described in a practical, nine-step overview.

Planning: supporting and optimizing clinical guidelines execution.

PubMed

Anselma, Luca; Montani, Stefania

2008-01-01

A crucial feature of computerized clinical guidelines (CGs) lies in the fact that they may be used not only as conventional documents (as if they were just free text) describing general procedures that users have to follow. In fact, thanks to a description of their actions and control flow in some semiformal representation language, CGs can also take advantage of Computer Science methods and Information Technology infrastructures and techniques, to become executable documents, in the sense that they may support clinical decision making and clinical procedures execution. In order to reach this goal, some advanced planning techniques, originally developed within the Artificial Intelligence (AI) community, may be (at least partially) resorted too, after a proper adaptation to the specific CG needs has been carried out.

A framework for considering business models.

PubMed

Anderson, James G

2003-01-01

Information technology (IT) such as computerized physician order entry, computer-based decision support and alerting systems, and electronic prescribing can reduce medical errors and improve the quality of health care. However, the business value of these systems is frequently questioned. At present a number of barriers exist to realizing the potential of IT to improve quality of care. Some of these barriers are: the ineffectiveness of existing error reporting systems, low investment in IT infrastructure, legal impediments to reforms, and the difficulty in demonstrating a sufficient return on investment to justify expenditures for quality improvement. This paper provides an overview of these issues, a framework for considering business models, and examples of successful implementations of IT to improve quality of patient care.

Time studies in A&E departments--a useful tool for management.

PubMed

Aharonson-Daniel, L; Fung, H; Hedley, A J

1996-01-01

A time and motion study was conducted in an accident and emergency (A&E) department in a Hong Kong Government hospital in order to suggest solutions for severe queuing problems found in A&E. The study provided useful information about the patterns of arrival and service; the throughput; and the factors that influence the length of the queue at the A&E department. Plans for building a computerized simulation model were dropped as new intelligence generated by the study enabled problem solving using simple statistical analysis and common sense. Demonstrates some potential benefits for management in applying operations research methods in busy clinical working environments. The implementation of the recommendations made by this study successfully eliminated queues in A&E.

Implementation of a Computerized Order Entry Tool to Reduce the Inappropriate and Unnecessary Use of Cardiac Stress Tests With Imaging in Hospitalized Patients.

PubMed

Gertz, Zachary M; O'Donnell, William; Raina, Amresh; Balderston, Jessica R; Litwack, Andrew J; Goldberg, Lee R

2016-10-15

The rising use of imaging cardiac stress tests has led to potentially unnecessary testing. Interventions designed to reduce inappropriate stress testing have focused on the ambulatory setting. We developed a computerized order entry tool intended to reduce the use of imaging cardiac stress tests and improve appropriate use in hospitalized patients. The tool was evaluated using preimplementation and postimplementation cohorts at a single urban academic teaching hospital. All hospitalized patients referred for testing were included. The co-primary outcomes were the use of imaging stress tests as a percentage of all stress tests and the percentage of inappropriate tests, compared between the 2 cohorts. There were 478 patients in the precohort and 463 in the postcohort. The indication was chest pain in 66% and preoperative in 18% and was not significantly different between groups. The use of nonimaging stress tests increased from 4% in the pregroup to 15% in the postgroup (p <0.001). Among very low-risk chest pain patients, the use of nonimaging stress tests increased from 7% to 25% (p <0.001). Inappropriate testing did not change significantly between groups (12% vs 11%). Inappropriate tests were most often preoperative evaluations (83%). In conclusion, our computerized ordering tool significantly increased the use of nonimaging cardiac stress tests and reduced the use of imaging tests yet was not able to reduce inappropriate use. Our study highlights the differences in cardiac stress testing between hospitalized and ambulatory patients. Copyright © 2016 Elsevier Inc. All rights reserved.

A Versatile, User-Oriented, Computerized Library System.

ERIC Educational Resources Information Center

Neuron, Eric

This paper deals with the problem of the referencing or storing methods in information systems which must be designed to allow for rapid retrieval of the key data leading to the desired information or the recovery of the information directly. Considered as a secondary, but frequently desirable, feature for the system is the ability to determine…

Skills and Competencies for Digital Information Management in Africa.

ERIC Educational Resources Information Center

Shibanda, George Gundu

Given the global computerization environment, this paper aspires for the kind of information manager in Africa that is versatile globally, deals with all sorts of technical and resource management issues, and relates at all levels of interaction. The emphasis is on the information professional and manager with a vision of good leadership and…

Guide for the Establishment and Evaluation of Services for Selective Dissemination of Information.

ERIC Educational Resources Information Center

Poncelet, J.

This guide describes the components of a selective dissemination of information (SDI) service which is designed to give developing countries access to international sources of bibliographic information and provides guidelines for the establishment and evaluation of this type of service. It defines the main features of a computerized documentation…

Comparison of Computer-Based Versus Counselor-Based Occupational Information Systems with Disadvantaged Vocational Students

ERIC Educational Resources Information Center

Maola, Joseph; Kane, Gary

1976-01-01

Subjects, who were Occupational Work Experience students, were randomly assigned to individual guidance from either a computerized occupational information system, to a counselor-based information system or to a control group. Results demonstrate a hierarchical learning effect: The computer group learned more than the counseled group, which…

The Development of an Occupational Information System (OIS), Volume II.

ERIC Educational Resources Information Center

Louisiana State Univ., Baton Rouge. Div. of Continuing Education.

Suppliers of postsecondary trained manpower data in Louisiana were surveyed during a project to obtain labor market information and occupational supply/demand information. All supply data were computerized and assigned to the appropriate training file. The data compiled fell into four major categories with regard to the method(s) of capture and…

Title list of documents made publicly available, March 1--31, 1995: Volume 17, No. 3

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

NONE

The Title List of Documents Made Publicly Available is a monthly publication. It contains descriptions of the information received and generated by the US Nuclear Regulatory Commission (NRC). This information includes (1) docketed material associated with civilian nuclear power plants and other uses of radioactive materials and (2) nondocketed material received and generated by NRC pertinent to its role as a regulatory agency. As used here, docketed does not refer to Court dockets; it refers to the system by which NRC maintains its regulatory records. This series of documents is indexed by a Personal Author Index, a Corporate Source Index,more » and a Report Number Index. The docketed information contained in the Title List includes the information formerly issued through the Department of Energy publication Power Reactor Docket Information, last published in January 1979. NRC documents that are publicly available may be examined without charge at the NRC Public Document Room (PDR). Duplicate copies may be obtained for a fee. Standing orders for certain categories of documents are also available. Clients may search for and order desired titles through the PDR computerized Bibliographic Retrieval System, which is accessible both at the PDR and remotely. The PDR is staffed by professional technical librarians, who provide reference assistance to users. See NOTES at the end of the preface for information about reaching the PDR. Microfiche of the docketed information listed in the Title List is available for sale on a subscription basis from the National Technical Information Service (NTIS).« less

Computerized measurement and analysis of scoliosis: a more accurate representation of the shape of the curve.

PubMed

Jeffries, B F; Tarlton, M; De Smet, A A; Dwyer, S J; Brower, A C

1980-02-01

A computer program was created to identify and accept spatial data regarding the location of the thoracic and lumbar vertebral bodies on scoliosis films. With this information, the spine can be mathematically reconstructed and a scoliotic angle calculated. There was a 0.968 positive correlation between the computer and manual methods of measuring scoliosis. The computer method was more reproducible with a standard deviation of only 1.3 degrees. Computerized measurement of scoliosis also provides better evaluation of the true shape of the curve.

Effective Heart Disease Detection Based on Quantitative Computerized Traditional Chinese Medicine Using Representation Based Classifiers.

PubMed

Shu, Ting; Zhang, Bob; Tang, Yuan Yan

2017-01-01

At present, heart disease is the number one cause of death worldwide. Traditionally, heart disease is commonly detected using blood tests, electrocardiogram, cardiac computerized tomography scan, cardiac magnetic resonance imaging, and so on. However, these traditional diagnostic methods are time consuming and/or invasive. In this paper, we propose an effective noninvasive computerized method based on facial images to quantitatively detect heart disease. Specifically, facial key block color features are extracted from facial images and analyzed using the Probabilistic Collaborative Representation Based Classifier. The idea of facial key block color analysis is founded in Traditional Chinese Medicine. A new dataset consisting of 581 heart disease and 581 healthy samples was experimented by the proposed method. In order to optimize the Probabilistic Collaborative Representation Based Classifier, an analysis of its parameters was performed. According to the experimental results, the proposed method obtains the highest accuracy compared with other classifiers and is proven to be effective at heart disease detection.

Transfusion audit of fresh-frozen plasma in southern Taiwan.

PubMed

Yeh, C-J; Wu, C-F; Hsu, W-T; Hsieh, L-L; Lin, S-F; Liu, T-C

2006-10-01

The demand for transfusions has increased rapidly in southern Taiwan. Between 1993 and 2003, requests for fresh-frozen plasma (FFP) in particular rose dramatically at Kaohsiung Medical University Hospital (KMUH). Transfusion orders were not tightly regulated, and inappropriate use of blood products was common. We carried out a prospective analysis of transfusion requests from October 2003 to January 2004 at KMUH, and then repeated the audit for another 3-month period after the clinical faculty had undergone five sessions of education on transfusion guidelines. Later, our consultant haematologist applied computerized guidelines to periodic audits. A 5.2% decrease in inappropriate FFP usage followed the educational programme and a further 30% reduction took place after the application of computerized transfusion guidelines. With the guidelines and periodic audits, FFP transfusions decreased by 74.6% and inappropriate requests from 65.2% to 30%. Hospital policy, computerized transfusion guidelines and periodic audits greatly reduced inappropriate FFP transfusions. An educational campaign had a more limited effect.

[Security of the medicinal therapy: Cartography of risks a priori within service of orthopaedic surgery].

PubMed

Razurel, A; Bertrand, É; Deranlot, J; Benhamou, F; Tritz, T; Le Mercier, F; Hardy, P

2015-11-01

Security and quality of the Medicinal Therapy are one of the most important objectives of the April 6th, 2011 order. The objective is to realize this study of the risks incurred by patients related to management and security of medicinal therapy in order to establish a plan to reduce the risks of drug's dispensation. The method of the Preliminary Risk Analysis (PRA) has been implemented by a multidisciplinary group in a hospital service of orthopaedic surgery. The study focused on the dispensation phase of medicinal circuit. This analysis revealed 148 scenarii, 35 were criticality unacceptable. Fifty-four initial risk control actions were proposed and their stress levels to put them in place were evaluated. The main measures of risk management are: training, information, communication, computerization, automation, dual control, updating the documentation system, drug reconciliation and respect for Best Practices Hospitallers (BPH). Risk management requires a significant human and financial investment as well as, material resources and multidisciplinary expertise in order to offer the best solutions. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Managing Information for Development in the 21st Century: Prospects for African Libraries, Challenges to the World.

ERIC Educational Resources Information Center

Nwalo, Kenneth Ivo Ngozi

This paper discusses the role information can play in the development of African countries in the 21st century. It stresses that development information can only be guaranteed when libraries in Africa computerize their systems, form networks for resource sharing, and take advantage of the benefits of information technology (IT), especially CD-ROM…

Information Security and Data Breach Notification Safeguards

DTIC Science & Technology

2007-07-31

for unauthorized purposes. Data breach notification requirements obligate covered entities to provide notice to affected persons (e.g., cardholders...customers) about the occurrence of a data security breach involving personally identifiable information. The first data breach notification law was...computerized personal information to disclose any breach of a resident’s personal information. S.B. 1386 was the model for subsequent data breach notification

Coupling computer-interpretable guidelines with a drug-database through a web-based system – The PRESGUID project

PubMed Central

Dufour, Jean-Charles; Fieschi, Dominique; Fieschi, Marius

2004-01-01

Background Clinical Practice Guidelines (CPGs) available today are not extensively used due to lack of proper integration into clinical settings, knowledge-related information resources, and lack of decision support at the point of care in a particular clinical context. Objective The PRESGUID project (PREScription and GUIDelines) aims to improve the assistance provided by guidelines. The project proposes an online service enabling physicians to consult computerized CPGs linked to drug databases for easier integration into the healthcare process. Methods Computable CPGs are structured as decision trees and coded in XML format. Recommendations related to drug classes are tagged with ATC codes. We use a mapping module to enhance computerized guidelines coupling with a drug database, which contains detailed information about each usable specific medication. In this way, therapeutic recommendations are backed up with current and up-to-date information from the database. Results Two authoritative CPGs, originally diffused as static textual documents, have been implemented to validate the computerization process and to illustrate the usefulness of the resulting automated CPGs and their coupling with a drug database. We discuss the advantages of this approach for practitioners and the implications for both guideline developers and drug database providers. Other CPGs will be implemented and evaluated in real conditions by clinicians working in different health institutions. PMID:15053828

Development of medical data information systems

NASA Technical Reports Server (NTRS)

Anderson, J.

1971-01-01

Computerized storage and retrieval of medical information is discussed. Tasks which were performed in support of the project are: (1) flight crew health stabilization computer system, (2) medical data input system, (3) graphic software development, (4) lunar receiving laboratory support, and (5) Statos V printer/plotter software development.

Facilities Management via Computer: Information at Your Fingertips.

ERIC Educational Resources Information Center

Hensey, Susan

1996-01-01

Computer-aided facilities management is a software program consisting of a relational database of facility information--such as occupancy, usage, student counts, etc.--attached to or merged with computerized floor plans. This program can integrate data with drawings, thereby allowing the development of "what if" scenarios. (MLF)

Shuttle Program Information Management System (SPIMS) data base

NASA Technical Reports Server (NTRS)

1983-01-01

The Shuttle Program Information Management System (SPIMS) is a computerized data base operations system. The central computer is the CDC 170-730 located at Johnson Space Center (JSC), Houston, Texas. There are several applications which have been developed and supported by SPIMS. A brief description is given.

Coping with Computing Success.

ERIC Educational Resources Information Center

Breslin, Richard D.

Elements of computing success of Iona College, the challenges it currently faces, and the strategies conceived to cope with future computing needs are discussed. The college has mandated computer literacy for students and offers nine degrees in the computerized information system/management information system areas. Since planning is needed in…

How to Search the ERIC File.

ERIC Educational Resources Information Center

Mathies, Lorraine

1972-01-01

The ERIC information system is designed for computerized information storage and retrieval. While the computer can play an increasingly more vital role in facilitating reference searches of large literature collections, experience shows that manual searching gives the user skills and expertise that are essential to effectively use the computerized…

Visual information transfer. 1: Assessment of specific information needs. 2: The effects of degraded motion feedback. 3: Parameters of appropriate instrument scanning behavior

NASA Technical Reports Server (NTRS)

Comstock, J. R., Jr.; Kirby, R. H.; Coates, G. D.

1984-01-01

Pilot and flight crew assessment of visually displayed information is examined as well as the effects of degraded and uncorrected motion feedback, and instrument scanning efficiency by the pilot. Computerized flight simulation and appropriate physiological measurements are used to collect data for standardization.

Service Evaluation in a Special Library: Supporting Development Research at the Institute of Social Sciences Library, New Delhi.

ERIC Educational Resources Information Center

Ghosh, Sharmila

2003-01-01

Discusses the development of special libraries to meet demands of interdisciplinary information and describes the library at The Institute of Social Sciences, New Delhi (India) which establishes a synergy between research and information derived from research through a computerized information management system. Considers evaluation of special…

The Design and Implementation of a Management Information System to Facilitate the Functioning of a CBTE Program.

ERIC Educational Resources Information Center

Neuhauser, Charlotte

The Vocational and Applied Arts (VAE) Management Information System (MIS) is designed to select, store, process, and transmit information needed in a competency-based teacher education (CBTE) program. The system is computerized and is composed of six subsystems which deal with admissions, class scheduling, faculty loads, instruction, field…

Guidelines for Reviewers and the Editor at the Nuclear Safety Information Center.

ERIC Educational Resources Information Center

Whetsel, H. B.

The main purpose of this report is to help novice reviewers accelerate their apprenticeship at the Nuclear Safety Information Center, a computerized information service sponsored by the U.S. Atomic Energy Commission. Guidelines for reviewers are presented in Part 1; Part 2 contains guidelines for the novice editor. The goal of the reviewers and…

Requirements for SPIRES II. An External Specification for the Stanford Public Information Retrieval System.

ERIC Educational Resources Information Center

Parker, Edwin B.

SPIRES (Stanford Public Information Retrieval System) is a computerized information storage and retrieval system intended for use by students and faculty members who have little knowledge of computers but who need rapid and sophisticated retrieval and analysis. The functions and capabilities of the system from the user's point of view are…

An Overview of the Naval Enlisted Professional Development Information System (NEPDIS). Focus on the Trained Person.

ERIC Educational Resources Information Center

Ansbro, Thomas M.

This is the first in a series of reports describing the origin, development, and applications of the Naval Enlisted Professional Development Information System (NEPDIS). The NEPDIS was designed to be a fully computerized information assembly and analysis system that would eventually support manpower, personnel, and training management. This report…

Towards a framework for developing semantic relatedness reference standards.

PubMed

Pakhomov, Serguei V S; Pedersen, Ted; McInnes, Bridget; Melton, Genevieve B; Ruggieri, Alexander; Chute, Christopher G

2011-04-01

Our objective is to develop a framework for creating reference standards for functional testing of computerized measures of semantic relatedness. Currently, research on computerized approaches to semantic relatedness between biomedical concepts relies on reference standards created for specific purposes using a variety of methods for their analysis. In most cases, these reference standards are not publicly available and the published information provided in manuscripts that evaluate computerized semantic relatedness measurement approaches is not sufficient to reproduce the results. Our proposed framework is based on the experiences of medical informatics and computational linguistics communities and addresses practical and theoretical issues with creating reference standards for semantic relatedness. We demonstrate the use of the framework on a pilot set of 101 medical term pairs rated for semantic relatedness by 13 medical coding experts. While the reliability of this particular reference standard is in the "moderate" range; we show that using clustering and factor analyses offers a data-driven approach to finding systematic differences among raters and identifying groups of potential outliers. We test two ontology-based measures of relatedness and provide both the reference standard containing individual ratings and the R program used to analyze the ratings as open-source. Currently, these resources are intended to be used to reproduce and compare results of studies involving computerized measures of semantic relatedness. Our framework may be extended to the development of reference standards in other research areas in medical informatics including automatic classification, information retrieval from medical records and vocabulary/ontology development. Copyright © 2010 Elsevier Inc. All rights reserved.

Guide to radioactive waste management literature

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

Houser, B.L.; Holoway, C.F.; Madewell, D.G.

Increased public concern about radioactive waste management has called attention to this aspect of the nuclear fuel cycle. Socio-economic planning and technical development are being undertaken to assure that such wastes will be managed safely. This Guide to Radioactive Waste Management Literature has been compiled to serve scientists, engineers, administrators, legislators, and private citizens by directing them to sources of information on various aspects of the subject. References were selected from about 6000 documents on waste management in the computerized information centers in Oak Ridge. The documents were selected, examined, indexed, and abstracted between 1966-1976 by several knowledgeable indexers, principallymore » at the Nuclear Safety Information Center. The selected references were further indexed and classified into 12 categories. Each category is discussed in enough detail to give some understandng of present technology in various phases of waste management and some appreciation of the attendant issues and problems. The bibliographic part of this guide exists in computerized form in the Health Physics Information System and is available through the Oak Ridge Information Center Complex for searching from remote terminals.« less

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

The effectiveness of computerized drug-lab alerts: a systematic review and meta-analysis.

PubMed

Bayoumi, Imaan; Al Balas, Mosab; Handler, Steven M; Dolovich, Lisa; Hutchison, Brian; Holbrook, Anne

2014-06-01

Inadequate lab monitoring of drugs is a potential cause of ADEs (adverse drug events) which is remediable. To determine the effectiveness of computerized drug-lab alerts to improve medication-related outcomes. Citations from the Computerized Clinical Decision Support System Systematic Review (CCDSSR) and MMIT (Medications Management through Health Information Technology) databases, which had searched MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts from 1974 to March 27, 2013. Randomized controlled trials (RCTs) of clinician-targeted computerized drug lab alerts conducted in any healthcare setting. Two reviewers performed full text review to determine study eligibility. A single reviewer abstracted data and evaluated validity of included studies using Cochrane handbook domains. Thirty-six studies met the inclusion criteria (25 single drug studies with 22,504 participants, 14 targeting anticoagulation; 11 multi-drug studies with 56,769 participants). ADEs were reported as an outcome in only four trials, all targeting anticoagulants. Computerized drug-lab alerts did not reduce ADEs (OR 0.89, 95% CI 0.79-1.00, p=0.05), length of hospital stay (SMD 0.00, 95%CI -0.93 to 0.93, p=0.055, 1 study), likelihood of hypoglycemia (OR 1.29, 95% CI 0.31-5.37) or likelihood of bleeding, but were associated with increased likelihood of prescribing changes (OR 1.73, 95% CI 1.21-2.47) or lab monitoring (OR 1.47, 95% confidence interval 1.12-1.94) in accordance with the alert. There is no evidence that computerized drug-lab alerts are associated with important clinical benefits, but there is evidence of improvement in selected clinical surrogate outcomes (time in therapeutic range for vitamin K antagonists), and changes in process outcomes (lab monitoring and prescribing decisions). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

CT scan (image)

MedlinePlus

CT stands for computerized tomography. In this procedure, a thin X-ray beam is rotated around the ... D image of a section through the body. CT scans are very detailed and provide excellent information ...

Head CT (image)

MedlinePlus

CT stands for computerized tomography. In this procedure, a thin X-ray beam is rotated around the ... D image of a section through the body. CT scans are very detailed and provide excellent information ...

Will Decision Support in Medications Order Entry Save Money? A Return On Investment Analysis of the Case of the Hong Kong Hospital Authority

PubMed Central

Fung, Kin Wah; Vogel, Lynn Harold

2003-01-01

The computerized medications order entry system currently used in the public hospitals of Hong Kong does not have decision support features. Plans are underway to add decision support to this system to alert physicians on drug-allergy conflicts, drug-lab result conflicts, drug-drug interactions and atypical dosages. A return on investment analysis is done on this enhancement, both as an examination of whether there is a positive return on the investment and as a contribution to the ongoing discussion of the use of return on investment models in health care information technology investments. It is estimated that the addition of decision support will reduce adverse drug events by 4.2 – 8.4%. Based on this estimate, a total net saving of $44,000 – $586,000 is expected over five years. The breakeven period is estimated to be between two to four years. PMID:14728171

Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System

PubMed Central

Beccaro, M. A. Del; Villanueva, R.; Knudson, K. M.; Harvey, E. M.; Langle, J. M.; Paul, W.

2010-01-01

Objective We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. Design Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy alerts from our electronic medical record. During seven sampling periods (each two weeks long) between April 2006 and October 2008 all alerts in these categories were analyzed. Another audit was performed of all DRC alerts by ordering provider role from November 2008 through January 2009. Medication ordering error counts were obtained from a voluntary error reporting system. Measurement/Results Between April 2006 and October 2008 the percent of medication orders that triggered a dose range alert decreased from 23.9% to 7.4%. The relative risk (RR) for getting an alert was higher at the start of the interventions versus later (RR= 2.40, 95% CI 2.28-2.52; p< 0.0001). The percentage of medication orders that triggered alerts for drug-drug interactions also decreased from 13.5% to 4.8%. The RR for getting a drug interaction alert at the start was 1.63, 95% CI 1.60-1.66; p< 0.0001. Alerts decreased in all clinical areas without an increase in reported medication errors. Conclusion We reduced the quantity of decision support alerts in CPOE using a systematic approach without an increase in reported medication errors PMID:23616845

The Development and Validation of a Special Education Intelligent Administration Support Program. Final Report.

ERIC Educational Resources Information Center

Utah State Univ., Logan. Center for Persons with Disabilities.

This project studied the effects of implementing a computerized management information system developed for special education administrators. The Intelligent Administration Support Program (IASP), an expert system and database program, assisted in information acquisition and analysis pertaining to the district's quality of decisions and procedures…

SURBAL: computerized metes and bounds surveying

Treesearch

Roger N. Baughman; James H. Patric

1970-01-01

A computer program has been developed at West Virginia University for use in metes and bounds surveying. Stations, slope distances, slope angles, and bearings are primary information needed for this program. Other information needed may include magnetic deviation, acceptable closure error, desired map scale, and title designation. SURBAL prints out latitudes and...

Geographic Information Systems as Applied to the Manipulation of Environmental Data.

ERIC Educational Resources Information Center

Hill, J. M.; And Others

1983-01-01

Discusses two aspects of a Geographic Information System (GIS), a computerized system for processing geographic and/or mapped data and components/implementation of a GIS and GIS demonstration in natural resources management. Demonstrations related to lignite mining permit requirements in coastal zone, and location of potential landfills/hazardous…

Northeast economic data and retrieval system

Treesearch

Henry Spelter; Sujata Ghosh

1993-01-01

To help foster rural economic development in 18 Northeastern states, an economic information system developed at the USDA Forest Service, Forest Products Laboratory was used to facilitate access to reference data on forest products industry activities. The Census and Survey of Manufactures were used as sources for information. This report explains the computerized...

Item Selection in Multidimensional Computerized Adaptive Testing--Gaining Information from Different Angles

ERIC Educational Resources Information Center

Wang, Chun; Chang, Hua-Hua

2011-01-01

Over the past thirty years, obtaining diagnostic information from examinees' item responses has become an increasingly important feature of educational and psychological testing. The objective can be achieved by sequentially selecting multidimensional items to fit the class of latent traits being assessed, and therefore Multidimensional…

Computerization of Library and Information Services in Mainland China.

ERIC Educational Resources Information Center

Lin, Sharon Chien

1994-01-01

Describes two phases of the automation of library and information services in mainland China. From 1974-86, much effort was concentrated on developing computer systems, databases, online retrieval, and networking. From 1986 to the present, practical progress became possible largely because of CD-ROM technology; and large scale networking for…

Computerization of School Administration: Impact on the Principal's Role--A Case Study.

ERIC Educational Resources Information Center

Telem, Moshe

2001-01-01

Describes a study at an Israeli high school that investigated changes in the principal's role as the result of the introduction of a school management information system (SMIS). Discusses information handling and flow, interrelations with teachers, accountability, instruction evaluation, supervision, feedback, frequency of meetings, and shared…

A Prudent Access Control Behavioral Intention Model for the Healthcare Domain

ERIC Educational Resources Information Center

Mussa, Constance C.

2011-01-01

In recent years, many health care organizations have begun to take advantage of computerized information systems to facilitate more effective and efficient management and processing of information. However, commensurate with the vastly innovative enhancements that computer technology has contributed to traditional paper-based health care…

The Computer "Discredit Bureau": An Extension of a Community Information Utility.

ERIC Educational Resources Information Center

Carroll, John M.

The "Discredit" Bureau borrows some of the computerized information-processing techniques adopted by credit-reporting agencies and uses them in the interest of consumers to help them press complaints against suppliers and prospective employers. This is an additional service currently being incorporated into those already afforded by a…

Toward a National Computerized Database for Moving Image Materials.

ERIC Educational Resources Information Center

Gartenberg, Jon

This report summarizes a project conducted by a group of catalogers from film archives devoted to nitrate preservation, which explored ways of developing a database to provide a complete film and television information service that would be available nationwide and could contain filmographic data, information on holdings in archives and…

Policy Information System Computer Program.

ERIC Educational Resources Information Center

Hamlin, Roger E.; And Others

The concepts and methodologies outlined in "A Policy Information System for Vocational Education" are presented in a simple computer format in this booklet. It also contains a sample output representing 5-year projections of various planning needs for vocational education. Computerized figures in the eight areas corresponding to those in the…

A Comparison of Item Selection Techniques for Testlets

ERIC Educational Resources Information Center

Murphy, Daniel L.; Dodd, Barbara G.; Vaughn, Brandon K.

2010-01-01

This study examined the performance of the maximum Fisher's information, the maximum posterior weighted information, and the minimum expected posterior variance methods for selecting items in a computerized adaptive testing system when the items were grouped in testlets. A simulation study compared the efficiency of ability estimation among the…

An information retrieval system for computerized patient records in the context of a daily hospital practice: the example of the Léon Bérard Cancer Center (France).

PubMed

Biron, P; Metzger, M H; Pezet, C; Sebban, C; Barthuet, E; Durand, T

2014-01-01

A full-text search tool was introduced into the daily practice of Léon Bérard Center (France), a health care facility devoted to treatment of cancer. This tool was integrated into the hospital information system by the IT department having been granted full autonomy to improve the system. To describe the development and various uses of a tool for full-text search of computerized patient records. The technology is based on Solr, an open-source search engine. It is a web-based application that processes HTTP requests and returns HTTP responses. A data processing pipeline that retrieves data from different repositories, normalizes, cleans and publishes it to Solr, was integrated in the information system of the Leon Bérard center. The IT department developed also user interfaces to allow users to access the search engine within the computerized medical record of the patient. From January to May 2013, 500 queries were launched per month by an average of 140 different users. Several usages of the tool were described, as follows: medical management of patients, medical research, and improving the traceability of medical care in medical records. The sensitivity of the tool for detecting the medical records of patients diagnosed with both breast cancer and diabetes was 83.0%, and its positive predictive value was 48.7% (gold standard: manual screening by a clinical research assistant). The project demonstrates that the introduction of full-text-search tools allowed practitioners to use unstructured medical information for various purposes.

Evaluation of a Computerized Clinical Information System (Micromedex).

PubMed Central

Lundsgaarde, H. P.; Moreshead, G. E.

1991-01-01

This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database. PMID:1807583

Evaluation of a Computerized Clinical Information System (Micromedex).

PubMed

Lundsgaarde, H P; Moreshead, G E

1991-01-01

This paper summarizes data collected as part of a project designed to identify and assess the technical and organizational problems associated with the implementation and evaluation of a Computerized Clinical Information System (CCIS), Micromedex, in three U.S. Department of Veterans Affairs Medical Centers (VAMCs). The study began in 1987 as a national effort to implement decision support technologies in the Veterans Administration Decentralized Hospital Computer Program (DHCP). The specific objectives of this project were to (1) examine one particular decision support technology, (2) identify the technical and organizational barriers to the implementation of a CCIS in the VA host environment, (3) assess the possible benefits of this system to VA clinicians in terms of therapeutic decision making, and (4) develop new methods for identifying the clinical utility of a computer program designed to provide clinicians with a new information tool. The project was conducted intermittently over a three-year period at three VA medical centers chosen as implementation and evaluation test sites for Micromedex. Findings from the Kansas City Medical Center in Missouri are presented to illustrate some of the technical problems associated with the implementation of a commercial database program in the DHCP host environment, the organizational factors influencing clinical use of the system, and the methods used to evaluate its use. Data from 4581 provider encounters with the CCIS are summarized. Usage statistics are presented to illustrate the methodological possibilities for assessing the "benefits and burdens" of a computerized information system by using an automated collection of user demographics and program audit trails that allow evaluators to monitor user interactions with different segments of the database.

Computerized visual feedback: an adjunct to robotic-assisted gait training.

PubMed

Banz, Raphael; Bolliger, Marc; Colombo, Gery; Dietz, Volker; Lünenburger, Lars

2008-10-01

Robotic devices for walking rehabilitation allow new possibilities for providing performance-related information to patients during gait training. Based on motor learning principles, augmented feedback during robotic-assisted gait training might improve the rehabilitation process used to regain walking function. This report presents a method to provide visual feedback implemented in a driven gait orthosis (DGO). The purpose of the study was to compare the immediate effect on motor output in subjects during robotic-assisted gait training when they used computerized visual feedback and when they followed verbal instructions of a physical therapist. Twelve people with neurological gait disorders due to incomplete spinal cord injury participated. Subjects were instructed to walk within the DGO in 2 different conditions. They were asked to increase their motor output by following the instructions of a therapist and by observing visual feedback. In addition, the subjects' opinions about using visual feedback were investigated by a questionnaire. Computerized visual feedback and verbal instructions by the therapist were observed to result in a similar change in motor output in subjects when walking within the DGO. Subjects reported that they were more motivated and concentrated on their movements when using computerized visual feedback compared with when no form of feedback was provided. Computerized visual feedback is a valuable adjunct to robotic-assisted gait training. It represents a relevant tool to increase patients' motor output, involvement, and motivation during gait training, similar to verbal instructions by a therapist.

Comprehensive Digital Imaging Network Project At Georgetown University Hospital

NASA Astrophysics Data System (ADS)

Mun, Seong K.; Stauffer, Douglas; Zeman, Robert; Benson, Harold; Wang, Paul; Allman, Robert

1987-10-01

The radiology practice is going through rapid changes due to the introduction of state-of-the-art computed based technologies. For the last twenty years we have witnessed the introduction of many new medical diagnostic imaging systems such as x-ray computed tomo-graphy, digital subtraction angiography (DSA), computerized nuclear medicine, single pho-ton emission computed tomography (SPECT), positron emission tomography (PET) and more re-cently, computerized digital radiography and nuclear magnetic resonance imaging (MRI). Other than the imaging systems, there has been a steady introduction of computed based information systems for radiology departments and hospitals.

Computerized Management Information System in a Community Health Nursing Agency

PubMed Central

Simmons, DeLanne A.

1981-01-01

The Visiting Nurse Association of Omaha is a nonprofit, voluntary agency providing home health care, preventive care, clinical services, and school health services in an urban-rural setting. It has developed a computerized system which provides for: (1) centralized dictation by service delivery staff; (2) the printing of a uniform clinical, family problem-oriented record; (3) an integrated data base, statistical system, and financial system; and (4) the communication capability to remote stations. (The hardware utilized is an IBM System 34.) Cost effectiveness has been demonstrated by a reduction in cost of visit from $47.02 to $43.79.

Duke Data Bank

NASA Technical Reports Server (NTRS)

1979-01-01

NASA computerized image processing techniques are an integral part of a cardiovascular data bank at Duke University Medical Center. Developed by Dr. C. F. Starmer and colleagues at Duke, the data bank documents the Center's clinical experience with more than 4,000 heart patients as an aid to diagnosis and treatment of heart disease. Data is stored in a computerized system that allows a physician to summon detailed records of former patients whose medical profiles are similar to those of a new patient. A video display (photo) and printed report shows prognostic information for the new patient based on similar past experience.

Journal of Chemical Education on CD-ROM, 1999

NASA Astrophysics Data System (ADS)

1999-12-01

The Journal of Chemical Education on CD-ROM contains the text and graphics for all the articles, features, and reviews published in the Journal of Chemical Education. This 1999 issue of the JCE CD series includes all twelve issues of 1999, as well as all twelve issues from 1998 and from 1997, and the September-December issues from 1996. Journal of Chemical Education on CD-ROM is formatted so that all articles on the CD retain as much as possible of their original appearance. Each article file begins with an abstract/keyword page followed by the article pages. All pages of the Journal that contain editorial content, including the front covers, table of contents, letters, and reviews, are included. Also included are abstracts (when available), keywords for all articles, and supplementary materials. The Journal of Chemical Education on CD-ROM has proven to be a useful tool for chemical educators. Like the Computerized Index to the Journal of Chemical Education (1) it will help you to locate articles on a particular topic or written by a particular author. In addition, having the complete article on the CD-ROM provides added convenience. It is no longer necessary to go to the library, locate the Journal issue, and read it while sitting in an uncomfortable chair. With a few clicks of the mouse, you can scan an article on your computer monitor, print it if it proves interesting, and read it in any setting you choose. Searching and Linking JCE CD is fully searchable for any word, partial word, or phrase. Successful searches produce a listing of articles that contain the requested text. Individual articles can be quickly accessed from this list. The Table of Contents of each issue is linked to individual articles listed. There are also links from the articles to any supplementary materials. References in the Chemical Education Today section (found in the front of each issue) to articles elsewhere in the issue are also linked to the article, as are WWW addresses and email addresses. If you have Internet access and a WWW browser and email utility, you can go directly to the Web site or prepare to send a message with a single mouse click. Full-text searching of the entire CD enables you to find the articles you want. Price and Ordering An order form is inserted in this issue that provides prices and other ordering information. If this insert is not available or if you need additional information, contact: JCE Software, University of Wisconsin-Madison, 1101 University Avenue, Madison, WI 53706-1396; phone: 608/262-5153 or 800/991-5534; fax: 608/265-8094; email: jcesoft@chem.wisc.edu. Information about all our publications (including abstracts, descriptions, updates) is available from our World Wide Web site at: http://jchemed.chem.wisc.edu/JCESoft/. Hardware and Software Requirements Hardware and software requirements for JCE CD 1999 are listed in the table below: Literature Cited 1. Schatz, P. F. Computerized Index, Journal of Chemical Education; J. Chem. Educ. Software 1993, SP 5-M. Schatz, P. F.; Jacobsen, J. J. Computerized Index, Journal of Chemical Education; J. Chem. Educ. Software 1993, SP 5-W.

Optimizing radiologist e-prescribing of CT oral contrast agent using a protocoling portal.

PubMed

Wasser, Elliot J; Galante, Nicholas J; Andriole, Katherine P; Farkas, Cameron; Khorasani, Ramin

2013-12-01

The purpose of this study is to quantify the time expenditure associated with radiologist ordering of CT oral contrast media when using an integrated protocoling portal and to determine radiologists' perceptions of the ordering process. This prospective study was performed at a large academic tertiary care facility. Detailed timing information for CT inpatient oral contrast orders placed via the computerized physician order entry (CPOE) system was gathered over a 14-day period. Analyses evaluated the amount of physician time required for each component of the ordering process. Radiologists' perceptions of the ordering process were assessed by survey. Descriptive statistics and chi-square analysis were performed. A total of 96 oral contrast agent orders were placed by 13 radiologists during the study period. The average time necessary to create a protocol for each case was 40.4 seconds (average range by subject, 20.0-130.0 seconds; SD, 37.1 seconds), and the average total time to create and sign each contrast agent order was 27.2 seconds (range, 10.0-50.0 seconds; SD, 22.4 seconds). Overall, 52.5% (21/40) of survey respondents indicated that radiologist entry of oral contrast agent orders improved patient safety. A minority of respondents (15% [6/40]) indicated that contrast agent order entry was either very or extremely disruptive to workflow. Radiologist e-prescribing of CT oral contrast agents using CPOE can be embedded in a protocol workflow. Integration of health IT tools can help to optimize user acceptance and adoption.

A Blood Bank Information Management System

PubMed Central

Farmer, James J.

1982-01-01

A computerized Blood Bank Management system is described. Features include product oriented data input, inventory control reports, product utilization reports, rapid retrieval of individual patient reports. Relative benefits of the system are discussed.

Architecture and the Information Revolution.

ERIC Educational Resources Information Center

Driscoll, Porter; And Others

1982-01-01

Traces how technological changes affect the architecture of the workplace. Traces these effects from the industrial revolution up through the computer revolution. Offers suggested designs for the computerized office of today and tomorrow. (JM)

An Evaluation of a Computer-Based Videotext Information Delivery System for Farmers: The Green Thumb Project.

ERIC Educational Resources Information Center

Warner, Paul D.; Clearfield, Frank

The Green Thumb Project was designed to test the feasibility of operating a computerized system for disseminating weather, market, and other agricultural production and management information on a day-to-day basis; to develop a prototype software support system for the test; and to provide essential project information on conduct of the test to…

Drug knowledge expressed as computable semantic triples.

PubMed

Elkin, Peter L; Carter, John S; Nabar, Manasi; Tuttle, Mark; Lincoln, Michael; Brown, Steven H

2011-01-01

The majority of questions that arise in the practice of medicine relate to drug information. Additionally, adverse reactions account for as many as 98,000 deaths per year in the United States. Adverse drug reactions account for a significant portion of those errors. Many authors believe that clinical decision support associated with computerized physician order entry has the potential to decrease this adverse drug event rate. This decision support requires knowledge to drive the process. One important and rich source of drug knowledge is the DailyMed product labels. In this project we used computationally extracted SNOMED CT™ codified data associated with each section of each product label as input to a rules engine that created computable assertional knowledge in the form of semantic triples. These are expressed in the form of "Drug" HasIndication "SNOMED CT™". The information density of drug labels is deep, broad and quite substantial. By providing a computable form of this information content from drug labels we make these important axioms (facts) more accessible to computer programs designed to support improved care.

Custodial Management in the Information Age.

ERIC Educational Resources Information Center

Harris, Jim, Sr.

1999-01-01

Explains how computerizing the custodial department can be achieved through bar coding, hand-held readers, and the appropriate software packages. Software programs that aid cleaning management, track assets, and manage stock are discussed. (GR)

Drainage identification analysis and mapping, phase 2.

DOT National Transportation Integrated Search

2017-01-01

Drainage Identification, Analysis and Mapping System (DIAMS) is a computerized database that captures and : stores relevant information associated with all aboveground and underground hydraulic structures belonging to : the New Jersey Department of T...

Canadian adaptation of the Newest Vital Sign©, a health literacy assessment tool.

PubMed

Mansfield, Elizabeth D; Wahba, Rana; Gillis, Doris E; Weiss, Barry D; L'Abbé, Mary

2018-04-25

The Newest Vital Sign© (NVS) was developed in the USA to measure patient health literacy in clinical settings. We adapted the NVS for use in Canada, in English and French, and created a computerized version. Our objective was to evaluate the reliability of the Canadian NVS as a self-administered computerized tool. We used a randomized crossover design with a washout period of 3-4 weeks to compare health literacy scores obtained using the computerized version with scores obtained using the standard interviewer-administered NVS. ANOVA models and McNemar's tests assessed differences in outcomes assessed with each version of the NVS and order effects of the testing. Participants were recruited from multicultural catchment areas in Ontario and Nova Scotia. English- and French-speaking adults aged 18 years or older. A total of 180 (81 %) of the 222 adults (112 English/110 French) initially recruited completed both the interviewer-NVS and computer-NVS. Scores for those who completed both assessments ranged from 0 to 6 with a mean of 3·63 (sd 2·11) for the computerized NVS and 3·41 (sd 2·21) for the interview-administered NVS. Few (n 18; seven English, eleven French) participants' health literacy assessments differed between the two versions. Overall, the computerized Canadian NVS performed as well as the interviewer-administered version for assessing health literacy levels of English- and French-speaking participants. This Canadian adaptation of the NVS provides Canadian researchers and public health practitioners with an easily administered health literacy assessment tool that can be used to address the needs of Canadians across health literacy levels and ultimately improve health outcomes.

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.

Patient difficulty using tablet computers to screen in primary care.

PubMed

Hess, Rachel; Santucci, Aimee; McTigue, Kathleen; Fischer, Gary; Kapoor, Wishwa

2008-04-01

Patient-administered computerized questionnaires represent a novel tool to assist primary care physicians in the delivery of preventive health care. The aim of this study was to assess patient-reported ease of use with a self-administered tablet computer-based questionnaire in routine clinical care. All patients seen in a university-based primary care practice were asked to provide routine screening information using a touch-screen tablet computer-based questionnaire. Patients reported difficulty using the tablet computer after completion of their first questionnaire. Ten thousand nine hundred ninety-nine patients completed the questionnaire between January 2004 and January 2006. We calculated rates of reporting difficulty (no difficulty, some difficulty, or a lot of difficulty) using the tablet computers based on patient age, sex, race, educational attainment, marital status, and number of comorbid medical conditions. We constructed multivariable ordered logistic models to identify predictors of increased self-reported difficulty using the computer. The majority of patients (84%) reported no difficulty using the tablet computers to complete the questionnaire, with only 3% reporting a lot of difficulty. Significant predictors of reporting more difficulty included increasing age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.05-1.05)]; Asian race (OR 2.3, 95% CI 1.8-2.9); African American race (OR 1.4, 95% CI 1.2-1.6); less than a high school education (OR 3.0, 95% CI 2.6-3.4); and the presence of comorbid medical conditions (1-2: OR 1.3, 95% CI 1.2-1.5; > or =3: OR 1.7 95% CI 1.5-2.1). The majority of primary care patients reported no difficulty using a self-administered tablet computer-based questionnaire. While computerized questionnaires present opportunities to collect routine screening information from patients, attention must be paid to vulnerable groups.

The impact of computerized physician order entry on prescription orders: A quasi-experimental study in Iran

PubMed Central

Khammarnia, Mohammad; Sharifian, Roxana; Zand, Farid; Barati, Omid; Keshtkaran, Ali; Sabetian, Golnar; Shahrokh, , Nasim; Setoodezadeh, Fatemeh

2017-01-01

Background: One way to reduce medical errors associated with physician orders is computerized physician order entry (CPOE) software. This study was conducted to compare prescription orders between 2 groups before and after CPOE implementation in a hospital. Methods: We conducted a before-after prospective study in 2 intensive care unit (ICU) wards (as intervention and control wards) in the largest tertiary public hospital in South of Iran during 2014 and 2016. All prescription orders were validated by a clinical pharmacist and an ICU physician. The rates of ordering the errors in medical orders were compared before (manual ordering) and after implementation of the CPOE. A standard checklist was used for data collection. For the data analysis, SPSS Version 21, descriptive statistics, and analytical tests such as McNemar, chi-square, and logistic regression were used. Results: The CPOE significantly decreased 2 types of errors, illegible orders and lack of writing the drug form, in the intervention ward compared to the control ward (p< 0.05); however, the 2 errors increased due to the defect in the CPOE (p< 0.001). The use of CPOE decreased the prescription errors from 19% to 3% (p= 0.001), However, no differences were observed in the control ward (p<0.05). In addition, more errors occurred in the morning shift (p< 0.001). Conclusion: In general, the use of CPOE significantly reduced the prescription errors. Nonetheless, more caution should be exercised in the use of this system, and its deficiencies should be resolved. Furthermore, it is recommended that CPOE be used to improve the quality of delivered services in hospitals. PMID:29445698

The impact of computerized physician order entry on prescription orders: A quasi-experimental study in Iran.

PubMed

Khammarnia, Mohammad; Sharifian, Roxana; Zand, Farid; Barati, Omid; Keshtkaran, Ali; Sabetian, Golnar; Shahrokh, Nasim; Setoodezadeh, Fatemeh

2017-01-01

Background: One way to reduce medical errors associated with physician orders is computerized physician order entry (CPOE) software. This study was conducted to compare prescription orders between 2 groups before and after CPOE implementation in a hospital. Methods: We conducted a before-after prospective study in 2 intensive care unit (ICU) wards (as intervention and control wards) in the largest tertiary public hospital in South of Iran during 2014 and 2016. All prescription orders were validated by a clinical pharmacist and an ICU physician. The rates of ordering the errors in medical orders were compared before (manual ordering) and after implementation of the CPOE. A standard checklist was used for data collection. For the data analysis, SPSS Version 21, descriptive statistics, and analytical tests such as McNemar, chi-square, and logistic regression were used. Results: The CPOE significantly decreased 2 types of errors, illegible orders and lack of writing the drug form, in the intervention ward compared to the control ward (p< 0.05); however, the 2 errors increased due to the defect in the CPOE (p< 0.001). The use of CPOE decreased the prescription errors from 19% to 3% (p= 0.001), However, no differences were observed in the control ward (p<0.05). In addition, more errors occurred in the morning shift (p< 0.001). Conclusion: In general, the use of CPOE significantly reduced the prescription errors. Nonetheless, more caution should be exercised in the use of this system, and its deficiencies should be resolved. Furthermore, it is recommended that CPOE be used to improve the quality of delivered services in hospitals.

Indication-Based Ordering: A New Paradigm for Glycemic Control in Hospitalized Inpatients

PubMed Central

Lee, Joshua; Clay, Brian; Zelazny, Ziband; Maynard, Gregory

2008-01-01

Background Inpatient glycemic control is a constant challenge. Institutional insulin management protocols and structured order sets are commonly advocated but poorly studied. Effective and validated methods to integrate algorithmic protocol guidance into the insulin ordering process are needed. Methods We introduced a basic structured set of computerized insulin orders (Version 1), and later introduced a paper insulin management protocol, to assist users with the order set. Metrics were devised to assess the impact of the protocol on insulin use, glycemic control, and hypoglycemia using pharmacy data and point of care glucose tests. When incremental improvement was seen (as described in the results), Version 2 of the insulin orders was created to further streamline the process. Results The percentage of regimens containing basal insulin improved with Version 1. The percentage of patient days with hypoglycemia improved from 3.68% at baseline to 2.59% with Version 1 plus the paper insulin management protocol, representing a relative risk for hypoglycemic day of 0.70 [confidence interval (CI) 0.62, 0.80]. The relative risk of an uncontrolled (mean glucose over 180 mg/dl) patient stay was reduced to 0.84 (CI 0.77, 0.91) with Version 1 and was reduced further to 0.73 (CI 0.66, 0.81) with the paper protocol. Version 2 used clinician-entered patient parameters to guide protocol-based insulin ordering and simultaneously improved the flexibility and ease of ordering over Version 1. Conclusion Patient parameter and protocol-based clinical decision support, added to computerized provider order entry, has a track record of improving glycemic control indices. This justifies the incorporation of these algorithms into online order management. PMID:19885198

The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes.

PubMed

Petrides, Athena K; Bixho, Ida; Goonan, Ellen M; Bates, David W; Shaykevich, Shimon; Lipsitz, Stuart R; Landman, Adam B; Tanasijevic, Milenko J; Melanson, Stacy E F

2017-03-01

- A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR with their laboratory information system (LIS). - To determine the impact of an interfaced EHR-LIS on laboratory processes. - We analyzed several different processes before and after implementation of an interfaced EHR-LIS: the turnaround time, the number of stat specimens received, venipunctures per patient per day, preanalytic errors in phlebotomy, the number of add-on tests using a new electronic process, and the number of wrong test codes ordered. Data were gathered through the LIS and/or EHR. - The turnaround time for potassium and hematocrit decreased significantly (P = .047 and P = .004, respectively). The number of stat orders also decreased significantly, from 40% to 7% for potassium and hematocrit, respectively (P < .001 for both). Even though the average number of inpatient venipunctures per day increased from 1.38 to 1.62 (P < .001), the average number of preanalytic errors per month decreased from 2.24 to 0.16 per 1000 specimens (P < .001). Overall there was a 16% increase in add-on tests. The number of wrong test codes ordered was high and it was challenging for providers to correctly order some common tests. - An interfaced EHR-LIS significantly improved within-laboratory turnaround time and decreased stat requests and preanalytic phlebotomy errors. Despite increasing the number of add-on requests, an electronic add-on process increased efficiency and improved provider satisfaction. Laboratories implementing an interfaced EHR-LIS should be cautious of its effects on test ordering and patient venipunctures per day.

Reduction in unnecessary red blood cell folate testing by restricting computerized physician order entry in the electronic health record.

PubMed

MacMillan, Thomas E; Gudgeon, Patrick; Yip, Paul M; Cavalcanti, Rodrigo B

2018-05-02

Red blood cell folate is a laboratory test with limited clinical utility. Previous attempts to reduce physician ordering of unnecessary laboratory tests, including folate, have resulted in only modest success. The objective of this study was to assess the effectiveness and impacts of restricting red blood cell folate ordering in the electronic health record. This was a retrospective observational study from January 2010 to December 2016 at a large academic healthcare network in Toronto, Canada. All inpatients and outpatients who underwent at least 1 red blood cell folate or vitamin B12 test during the study period were included. Red blood cell folate ordering was restricted to clincians in gastroenterology and hematology and was removed from other physicians' computerized order entry screen in the electronic health record in June 2013. Red blood cell folate testing decreased by 94.4% during the study, from a mean of 493.0 (SD 48.0) tests/month before intervention to 27.6 (SD 10.3) tests/month after intervention (P<.001). Restricting red blood cell folate ordering in the electronic health record resulted in a large and sustained reduction in red blood cell folate testing. Significant cost savings estimated at over a quarter-million dollars (CAD) over three years were achieved. There was no significant clinical impact of the intervention on the diagnosis of folate deficiency. Copyright © 2018. Published by Elsevier Inc.

Procedures to develop a computerized adaptive test to assess patient-reported physical functioning.

PubMed

McCabe, Erin; Gross, Douglas P; Bulut, Okan

2018-06-07

The purpose of this paper is to demonstrate the procedures to develop and implement a computerized adaptive patient-reported outcome (PRO) measure using secondary analysis of a dataset and items from fixed-format legacy measures. We conducted secondary analysis of a dataset of responses from 1429 persons with work-related lower extremity impairment. We calibrated three measures of physical functioning on the same metric, based on item response theory (IRT). We evaluated efficiency and measurement precision of various computerized adaptive test (CAT) designs using computer simulations. IRT and confirmatory factor analyses support combining the items from the three scales for a CAT item bank of 31 items. The item parameters for IRT were calculated using the generalized partial credit model. CAT simulations show that reducing the test length from the full 31 items to a maximum test length of 8 items, or 20 items is possible without a significant loss of information (95, 99% correlation with legacy measure scores). We demonstrated feasibility and efficiency of using CAT for PRO measurement of physical functioning. The procedures we outlined are straightforward, and can be applied to other PRO measures. Additionally, we have included all the information necessary to implement the CAT of physical functioning in the electronic supplementary material of this paper.

EMR management system for patient pulse data.

PubMed

Lee, Junyoung

2012-10-01

The purpose of this study is to build an integrated medical information system for effective database management of clinical information and to improve the existing Electronic Medical Record (EMR)-based system that is currently being used in hospitals. The integrated medical information system of hospitals consists of an Order Communication System (OCS), Picture Archiving Communication System (PACS), and Laboratory Information System (LIS), as well as Electronic Medical Record (EMR). It is designed so that remote health screening and patient data search can be accessed through a high speed network-even in remote areas-in order to effectively manage data on medical treatment that patients received at their respective hospitals. The existing oriental treatment system is one in which the doctor requires the patient to visit the hospital in person, so as to be able to check the patient's pulse and measure it with his hand for proper diagnosis and treatment. However, due to the recent development of digitalized medical measurement equipment, not only can doctors now check a patient's pulse without touching it directly, but the measured data are computerized and stored into the database as the electronic obligation record. Thus, even if a patient cannot visit the hospital, proper medical treatment is available by analyzing the patient's medical history and diagnosis process in the remote area. Furthermore, when a comprehensive medical testing center system including the people medical examination and diverse physical examination is established, the quality of medical service is expected to be improved than now.

Computerized detection of unruptured aneurysms in MRA images: reduction of false positives using anatomical location features

NASA Astrophysics Data System (ADS)

Uchiyama, Yoshikazu; Gao, Xin; Hara, Takeshi; Fujita, Hiroshi; Ando, Hiromichi; Yamakawa, Hiroyasu; Asano, Takahiko; Kato, Hiroki; Iwama, Toru; Kanematsu, Masayuki; Hoshi, Hiroaki

2008-03-01

The detection of unruptured aneurysms is a major subject in magnetic resonance angiography (MRA). However, their accurate detection is often difficult because of the overlapping between the aneurysm and the adjacent vessels on maximum intensity projection images. The purpose of this study is to develop a computerized method for the detection of unruptured aneurysms in order to assist radiologists in image interpretation. The vessel regions were first segmented using gray-level thresholding and a region growing technique. The gradient concentration (GC) filter was then employed for the enhancement of the aneurysms. The initial candidates were identified in the GC image using a gray-level threshold. For the elimination of false positives (FPs), we determined shape features and an anatomical location feature. Finally, rule-based schemes and quadratic discriminant analysis were employed along with these features for distinguishing between the aneurysms and the FPs. The sensitivity for the detection of unruptured aneurysms was 90.0% with 1.52 FPs per patient. Our computerized scheme can be useful in assisting the radiologists in the detection of unruptured aneurysms in MRA images.

Impact of Computerized Student Information System.

ERIC Educational Resources Information Center

San Diego Community Coll. District, CA. Research Office.

A two-part study was conducted by the San Diego Community College District to assess the post-automation impact of the Student Information System (SIS) on the cost of providing student services. The study first determined the service areas most affected by the SIS and then assessed the savings potential of automation by: (1) interviewing personnel…

Employers' Perceptions of Information Technology Competency Requirements for Management Accounting Graduates

ERIC Educational Resources Information Center

Spraakman, Gary; O'Grady, Winifred; Askarany, Davood; Akroyd, Chris

2015-01-01

Management accountants work in a computerized workplace with information technology (IT) for producing financial ledgers and for reporting. Thus, the role of the management accountant has shifted from capturing and recording transactions to analyzing business issues. The research question is: what IT knowledge and skills do employers require of…

Education in the Workplace for the Physician: Clinical Management States as an Organizing Framework.

ERIC Educational Resources Information Center

Greenes, Robert A.

2000-01-01

Trends in health information technology include (1) improved access to patient care information; (2) methods for patient-doctor interaction and decision making; (3) computerized practice guidelines; and (4) the concept of patients being in clinical management states (CMS). Problem-specific environments and CMS-related resources should be the focus…

Coordinated Information Services For a Discipline- Or Mission-Oriented Community.

ERIC Educational Resources Information Center

Engelbart, Douglas C.

An overview is given of the potential contribution of computerized information services to communities involved with common disciplines or common missions. The author first describes the knowledge workshop--an environment in which knowledge workers do their knowledge work--and then discusses the prototype of the community workshop which has been…

Internet-Based Cervical Cancer Screening Program

DTIC Science & Technology

2008-05-01

information technology have facilitated the Internet transmission and archival storage of digital images and other clinical information . The combination of...Phase included: 1) development of hardware, software, and interfaces between computerized scanning device and Internet - linked servers and reading...AD_________________ Award Number: W81XWH-04-C-0083 TITLE: Internet -Based Cervical Cancer Screening

School Management and Evaluation System. Project Termination Report (PTR).

ERIC Educational Resources Information Center

Cincinnati Public Schools, OH.

Financed with ESEA Title III funds since 1970, the School Information System (SIS) was designed essentially to furnish school administrators with data and information with which to make better decisions. The basic means were to (1) build and improve a data bank, (2) prepare and disseminate computerized reports to the decisionmakers--especially…

45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

Code of Federal Regulations, 2010 CFR

2010-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding... subject to the limit determined under § 286.50. (b) Information technology and computerization for..., administering, monitoring, and controlling a sample are not inherent parts of information technology and...

45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

Code of Federal Regulations, 2014 CFR

2014-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding... subject to the limit determined under § 286.50. (b) Information technology and computerization for..., administering, monitoring, and controlling a sample are not inherent parts of information technology and...

45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

Code of Federal Regulations, 2013 CFR

2013-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding... subject to the limit determined under § 286.50. (b) Information technology and computerization for..., administering, monitoring, and controlling a sample are not inherent parts of information technology and...

45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

Code of Federal Regulations, 2011 CFR

2011-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding... subject to the limit determined under § 286.50. (b) Information technology and computerization for..., administering, monitoring, and controlling a sample are not inherent parts of information technology and...

45 CFR 286.55 - What types of costs are subject to the administrative cost limit on Tribal Family Assistance...

Code of Federal Regulations, 2012 CFR

2012-10-01

... CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL TANF PROVISIONS Tribal TANF Funding... subject to the limit determined under § 286.50. (b) Information technology and computerization for..., administering, monitoring, and controlling a sample are not inherent parts of information technology and...

Southern Pine Beetle Information System (SPBIS)

Treesearch

Valli Peacher

2011-01-01

The southern pine beetle (SPB) is the most destructive forest insect in the South. The SPB attacks all species of southern pine, but loblolly and shortleaf are most susceptible. The Southern Pine Beetle Information System (SPBIS) is the computerized database used by the national forests in the Southern Region for tracking individual southern pine beetle infestations....

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2012 CFR

2012-10-01

... if the State has chosen to pay such incentives; (7) Maintaining accounts receivable on all amounts... interfacing with State financial management and expenditure information; (9) Accepting electronic case...) Providing management information on all IV-D cases under the State plan from initial referral or application...

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2014 CFR

2014-10-01

... if the State has chosen to pay such incentives; (7) Maintaining accounts receivable on all amounts... interfacing with State financial management and expenditure information; (9) Accepting electronic case...) Providing management information on all IV-D cases under the State plan from initial referral or application...

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2013 CFR

2013-10-01

... if the State has chosen to pay such incentives; (7) Maintaining accounts receivable on all amounts... interfacing with State financial management and expenditure information; (9) Accepting electronic case...) Providing management information on all IV-D cases under the State plan from initial referral or application...

Integrative Education: Teaching Psychology with the Use of Literature and Informational Technology

ERIC Educational Resources Information Center

Toom, Anna

2013-01-01

In this work, a new method of teaching psychology based on the union of scientific, artistic, and information-technological knowledge is presented. The author teaches Cognitive Development in Early Childhood analyzing Anton Chekhov's short story "Grisha" and uses both traditional and computerized instructional methodology. In the authors' two…

Use of Order Sets in Inpatient Computerized Provider Order Entry Systems: A Comparative Analysis of Usage Patterns at Seven Sites

PubMed Central

Wright, Adam; Feblowitz, Joshua C.; Pang, Justine E.; Carpenter, James D.; Krall, Michael A.; Middleton, Blackford; Sittig, Dean F.

2012-01-01

Background Many computerized provider order entry (CPOE) systems include the ability to create electronic order sets: collections of clinically-related orders grouped by purpose. Order sets promise to make CPOE systems more efficient, improve care quality and increase adherence to evidence-based guidelines. However, the development and implementation of order sets can be expensive and time-consuming and limited literature exists about their utilization. Methods Based on analysis of order set usage logs from a diverse purposive sample of seven sites with commercially- and internally-developed inpatient CPOE systems, we developed an original order set classification system. Order sets were categorized across seven non-mutually exclusive axes: admission/discharge/transfer (ADT), perioperative, condition-specific, task-specific, service-specific, convenience, and personal. In addition, 731 unique subtypes were identified within five axes: four in ADT (S=4), three in perioperative, 144 in condition-specific, 513 in task-specific, and 67 in service-specific. Results Order sets (n=1,914) were used a total of 676,142 times at the participating sites during a one-year period. ADT and perioperative order sets accounted for 27.6% and 24.2% of usage respectively. Peripartum/labor, chest pain/Acute Coronary Syndrome/Myocardial Infarction and diabetes order sets accounted for 51.6% of condition-specific usage. Insulin, angiography/angioplasty and arthroplasty order sets accounted for 19.4% of task-specific usage. Emergency/trauma, Obstetrics/Gynecology/Labor Delivery and anesthesia accounted for 32.4% of service-specific usage. Overall, the top 20% of order sets accounted for 90.1% of all usage. Additional salient patterns are identified and described. Conclusion We observed recurrent patterns in order set usage across multiple sites as well as meaningful variations between sites. Vendors and institutional developers should identify high-value order set types through concrete data analysis in order to optimize the resources devoted to development and implementation. PMID:22819199

Implementation and evaluation of an integrated computerized asthma management system in a pediatric emergency department: a randomized clinical trial.

PubMed

Dexheimer, Judith W; Abramo, Thomas J; Arnold, Donald H; Johnson, Kevin; Shyr, Yu; Ye, Fei; Fan, Kang-Hsien; Patel, Neal; Aronsky, Dominik

2014-11-01

The use of evidence-based guidelines can improve the care for asthma patients. We implemented a computerized asthma management system in a pediatric emergency department (ED) to integrate national guidelines. Our objective was to determine whether patient eligibility identification by a probabilistic disease detection system (Bayesian network) combined with an asthma management system embedded in the workflow decreases time to disposition decision. We performed a prospective, randomized controlled trial in an urban, tertiary care pediatric ED. All patients 2-18 years of age presenting to the ED between October 2010 and February 2011 were screened for inclusion by the disease detection system. Patients identified to have an asthma exacerbation were randomized to intervention or control. For intervention patients, asthma management was computer-driven and workflow-integrated including computer-based asthma scoring in triage, and time-driven display of asthma-related reminders for re-scoring on the electronic patient status board combined with guideline-compliant order sets. Control patients received standard asthma management. The primary outcome measure was the time from triage to disposition decision. The Bayesian network identified 1339 patients with asthma exacerbations, of which 788 had an asthma diagnosis determined by an ED physician-established reference standard (positive predictive value 69.9%). The median time to disposition decision did not differ among the intervention (228 min; IQR=(141, 326)) and control group (223 min; IQR=(129, 316)); (p=0.362). The hospital admission rate was unchanged between intervention (25%) and control groups (26%); (p=0.867). ED length of stay did not differ among intervention (262 min; IQR=(165, 410)) and control group (247 min; IQR=(163, 379)); (p=0.818). The control and intervention groups were similar in regards to time to disposition; the computerized management system did not add additional wait time. The time to disposition decision did not change; however the management system integrated several different information systems to support clinicians' communication. Copyright © 2014. Published by Elsevier Ireland Ltd.

Youth Attitude Tracking Study II Wave 16 - Fall 1985,

DTIC Science & Technology

1986-06-01

AD-AI7I 517 YOUTH ATTITUDE TRACKING STUDY 11 NAVE 16 - FALL I9 M .’ (U) RESEARCH TRIANGLE INST RESEARCH TRIANGLE PARK NCELJN8 R136 /50F UNCL ASSIFIED...CATI System . .... ....................... .. 23 2. Phased Approach to Data Collection ........ .. 23 C. Survey Response Data and Performance Rates...Awareness of Military Advertising ......... 112 D. Computerized Career Information Systems ..... .......... 114 E. Informal Sources of Information

The digital pen and paper technology: implementation and use in an existing clinical information system.

PubMed

Despont-Gros, Christelle; Bœuf, Christophe; Geissbuhler, Antoine; Lovis, Christian

2005-01-01

Evaluation of the technical feasibility of tight integration of the digital pen and paper technology in an existing computerized patient record.Technology: The digital pen is a normal pen able to record all actions of the user and to analyze a micro pattern printed on the paper. The digital paper is a normal paper printed with an almost invisible micro pattern of small dots encoding information such as position and identifiers. We report our experience in the implementation and the use of this technology in an existing large clinical information system for acquiring clinical information. It is possible to print uniquely identified forms using the digital paper technology. These forms can be pre-filled with clinical readable information about the patient. When care providers complete these forms using the digital pen, it is possible to acquire the data in a structured computerized patient record. The technology is easy to integrate in a component-based architecture based on Web Services. The digital pen and paper is a cost-effective technology that can be integrated in an existing clinical information system and allows fast and easy bedside clinical information acquisition without the need for an expensive infrastructure based on traditional portable devices or wireless devices.

Vestibular rehabilitation outcomes in chronic vertiginous patients through computerized dynamic visual acuity and Gaze stabilization test.

PubMed

Badaracco, Carlo; Labini, Francesca Sylos; Meli, Annalisa; De Angelis, Ezio; Tufarelli, Davide

2007-09-01

To evaluate the efficiency of the rehabilitative protocols in patients with labyrinthine hypofunction, focusing on computerized dynamic visual acuity test (DVAt) and Gaze stabilization test (GST) specifically evaluating the vestibulo-oculomotor reflex (VOR) changes due to vestibular rehabilitation. Consecutive sample study. Day hospital in Ears, Nose, and Throat Rehabilitation Unit. Thirty-two patients with chronic dizziness with a mean age of 60.74 years. Patients performed one cycle of 12 daily rehabilitation sessions (2 h each) consisting of exercises aimed at improving VOR gain. The rehabilitation program included substitutional and/or habitudinal exercises, exercises on a stability platform, and exercises on a moving footpath with rehabilitative software. Dizziness Handicap Inventory and Activities-specific Balance Confidence Scale. Computerized dynamic posturography, computerized DVAt, and GST. The patients significantly improved in all the tests. Vestibular rehabilitation improved the quality of life by reducing the handicap index and improving the ability in everyday tasks. The recovery of the vestibular-ocular reflex and vestibular-spinal reflex efficiency was objectively proven by instrumental testing. The DVAt and the GST allow to objectively quantify the fixation ability at higher frequencies and speeds (main VOR function). Moreover, these new parameters permit to completely evaluate vestibular rehabilitation outcomes, adding new information to the generally used tests that only assess vestibulospinal reflex.

Organizing safety: conditions for successful information assurance programs.

PubMed

Collmann, Jeff; Coleman, Johnathan; Sostrom, Kristen; Wright, Willie

2004-01-01

Organizations must continuously seek safety. When considering computerized health information systems, "safety" includes protecting the integrity, confidentiality, and availability of information assets such as patient information, key components of the technical information system, and critical personnel. "High Reliability Theory" (HRT) argues that organizations with strong leadership support, continuous training, redundant safety mechanisms, and "cultures of high reliability" can deploy and safely manage complex, risky technologies such as nuclear weapons systems or computerized health information systems. In preparation for the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Office of the Assistant Secretary of Defense (Health Affairs), the Offices of the Surgeons General of the United States Army, Navy and Air Force, and the Telemedicine and Advanced Technology Research Center (TATRC), US Army Medical Research and Materiel Command sponsored organizational, doctrinal, and technical projects that individually and collectively promote conditions for a "culture of information assurance." These efforts include sponsoring the "P3 Working Group" (P3WG), an interdisciplinary, tri-service taskforce that reviewed all relevant Department of Defense (DoD), Miliary Health System (MHS), Army, Navy and Air Force policies for compliance with the HIPAA medical privacy and data security regulations; supporting development, training, and deployment of OCTAVE(sm), a self-directed information security risk assessment process; and sponsoring development of the Risk Information Management Resource (RIMR), a Web-enabled enterprise portal about health information assurance.

Implementation of a simple electronic transfusion alert system decreases inappropriate ordering of packed red blood cells and plasma in a multi-hospital health care system.

PubMed

Smith, Matthew; Triulzi, Darrell J; Yazer, Mark H; Rollins-Raval, Marian A; Waters, Jonathan H; Raval, Jay S

2014-12-01

Prescriber adherence to institutional blood component ordering guidelines can be low. The goal of this study was to decrease red blood cell (RBC) and plasma orders that did not meet institutional transfusion guidelines by using data within the laboratory information system to trigger alerts in the computerized order entry (CPOE) system at the time of order entry. At 10 hospitals within a regional health care system, discernment rules were created for RBC and plasma orders utilizing transfusion triggers of hemoglobin <8 gm/dl and INR >1.6, respectively, with subsequent alert generation that appears within the CPOE system when a prescriber attempts to order RBCs or plasma on a patient whose antecedent laboratory values do not suggest that a transfusion is indicated. Orders and subsequent alerts were tracked for RBCs and plasma over evaluation periods of 15 and 10 months, respectively, along with the hospital credentials of the ordering health care providers (physician or nurse). Alerts triggered which were heeded remained steady and averaged 11.3% for RBCs and 19.6% for plasma over the evaluation periods. Overall, nurses and physicians canceled statistically identical percentages of alerted RBC (10.9% vs. 11.5%; p = 0.78) and plasma (21.3% vs. 18.7%; p = 0.22) orders. Implementing a simple evidence-based transfusion alert system at the time of order entry decreased non-evidence based transfusion orders by both nurse and physician providers. Copyright © 2014 Elsevier Ltd. All rights reserved.

Computerized Dose Range Checking Using Hard and Soft Stop Alerts Reduces Prescribing Errors in a Pediatric Intensive Care Unit.

PubMed

Balasuriya, Lilanthi; Vyles, David; Bakerman, Paul; Holton, Vanessa; Vaidya, Vinay; Garcia-Filion, Pamela; Westdorp, Joan; Sanchez, Christine; Kurz, Rhonda

2017-09-01

An enhanced dose range checking (DRC) system was developed to evaluate prescription error rates in the pediatric intensive care unit and the pediatric cardiovascular intensive care unit. An enhanced DRC system incorporating "soft" and "hard" alerts was designed and implemented. Practitioner responses to alerts for patients admitted to the pediatric intensive care unit and the pediatric cardiovascular intensive care unit were retrospectively reviewed. Alert rates increased from 0.3% to 3.4% after "go-live" (P < 0.001). Before go-live, all alerts were soft alerts. In the period after go-live, 68% of alerts were soft alerts and 32% were hard alerts. Before go-live, providers reduced doses only 1 time for every 10 dose alerts. After implementation of the enhanced computerized physician order entry system, the practitioners responded to soft alerts by reducing doses to more appropriate levels in 24.7% of orders (70/283), compared with 10% (3/30) before go-live (P = 0.0701). The practitioners deleted orders in 9.5% of cases (27/283) after implementation of the enhanced DRC system, as compared with no cancelled orders before go-live (P = 0.0774). Medication orders that triggered a soft alert were submitted unmodified in 65.7% (186/283) as compared with 90% (27/30) of orders before go-live (P = 0.0067). After go-live, 28.7% of hard alerts resulted in a reduced dose, 64% resulted in a cancelled order, and 7.4% were submitted as written. Before go-live, alerts were often clinically irrelevant. After go-live, there was a statistically significant decrease in orders that were submitted unmodified and an increase in the number of orders that were reduced or cancelled.

Computerization and its contribution to care quality improvement: the nurses' perspective.

PubMed

Kagan, Ilya; Fish, Miri; Farkash-Fink, Naomi; Barnoy, Sivia

2014-12-01

Despite the widely held belief that the computerization of hospital medical systems contributes to improved patient care management, especially in the context of ordering medications and record keeping, extensive study of the attitudes of medical staff to computerization has found them to be negative. The views of nursing staff have been barely studied and so are unclear. The study reported here investigated the association between nurses' current computer use and skills, the extent of their involvement in quality control and improvement activities on the ward and their perception of the contribution of computerization to improving nursing care. The study was made in the context of a Joint Commission International Accreditation (JCIA) in a large tertiary medical center in Israel. The perception of the role of leadership commitment in the success of a quality initiative was also tested for. Two convenience samples were drawn from 33 clinical wards and units of the medical center. They were questioned at two time points, one before the JCIA and a second after JCIA completion. Of all nurses (N=489), 89 were paired to allow analysis of the study data in a before-and-after design. Thus, this study built three data sets: a pre-JCIA set, a post-JCIA set and a paired sample who completed the questionnaire both before and after JCIA. Data were collected by structured self-administered anonymous questionnaire. After the JCIA the participants ranked the role of leadership in quality improvement, the extent of their own quality control activity, and the contribution of computers to quality improvement higher than before the JCIA. Significant Pearson correlations were found showing that the higher the rating given to quality improvement leadership the more nurses reported quality improvement activities undertaken by them and the higher nurses rated the impact of computerization on the quality of care. In a regression analysis quality improvement leadership and computer use/skills accounted for 30% of the variance in the perceived contribution of computerization to quality improvement. (a) The present study is the first to show a relationship between organizational leadership and computer use by nurses for the purpose of improving clinical care. (b) The nurses' appreciation of the contribution computerization can make to data management and to clinical care quality improvement were both increased by the JCI accreditation process. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

1:1 Technology and Computerized State Assessments

ERIC Educational Resources Information Center

Medlin, Shane A.

2016-01-01

American students in the 21st century are growing up with Internet accessible technology available at their fingertips. Considering this and the continued pressure to compete in a global society, The United States' Department of Education's National Education Technology Plan (NETP) (2010) calls for educators to leverage technology in order to…

Pedagogical Strategies for Human and Computer Tutoring.

ERIC Educational Resources Information Center

Reiser, Brian J.

The pedagogical strategies of human tutors in problem solving domains are described and the possibility of incorporating these techniques into computerized tutors is examined. GIL (Graphical Instruction in LISP), an intelligent tutoring system for LISP programming, is compared to human tutors teaching the same material in order to identify how the…

The Development of Two Self-Assessment Work Value Instruments.

ERIC Educational Resources Information Center

Boyle, John R.

In response to input from the employment and training community, the Department of Labor's Assessment and Research Development Program (ARDP) and its state partners have developed two self-assessment work value instruments to be incorporated into career exploration and counseling programs. Computerized multiple rank-order and paper-and-pencil…

Developmental Changes in Face Processing Skills.

ERIC Educational Resources Information Center

Mondloch, Catherine J.; Geldart, Sybil; Maurer, Daphne; Le Grand, Richard

2003-01-01

Two experiments examined the impact of slow development of processing differences among faces in the spacing among facial features (second-order relations). Computerized tasks involving various face-processing skills were used. Results of experiment with 6-, 8-, and 10-year-olds and with adults indicated that slow development of sensitivity to…

Information and research: an essential partnership

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

Oen, C.J.; White, M.G.; Dunaway, P.B.

Information support is provided to the Nevada Applied Ecology Group (NAEG) through the Ecological Sciences Information Center (ESIC) at Oak Ridge National Laboratory to offer an effective, easy-to-use link between the individual researcher and the literature relevant to his work. Information within the interest areas defined by NAEG administration is identified and entered into a computerized system that provides rapid, accurate retrieval. The primary topics are the environmental aspects of the transuranic elements. (auth)

Prototype simulates remote sensing spectral measurements on fruits and vegetables

NASA Astrophysics Data System (ADS)

Hahn, Federico

1998-09-01

A prototype was designed to simulate spectral packinghouse measurements in order to simplify fruit and vegetable damage assessment. A computerized spectrometer is used together with lenses and an externally controlled illumination in order to have a remote sensing simulator. A laser is introduced between the spectrometer and the lenses in order to mark the zone where the measurement is being taken. This facilitates further correlation work and can assure that the physical and remote sensing measurements are taken in the same place. Tomato ripening and mango anthracnose spectral signatures are shown.

Technology for the product and process data base

NASA Technical Reports Server (NTRS)

Barnes, R. D.

1984-01-01

The computerized product and process data base is increasingly recognized to be the cornerstone component of an overall system aimed at the integrated automation of the industrial processes of a given company or enterprise. The technology needed to support these more effective computer integrated design and manufacturing methods, especially the concept of 3-D computer-sensible product definitions rather than engineering drawings, is not fully available and rationalized. Progress is being made, however, in bridging this technology gap with concentration on the modeling of sophisticated information and data structures, high-performance interactive user interfaces and comprehensive tools for managing the resulting computerized product definition and process data base.

Using computerized text analysis to assess communication within an Italian type 1 diabetes Facebook group.

PubMed

Troncone, Alda; Cascella, Crescenzo; Chianese, Antonietta; Iafusco, Dario

2015-07-01

The purpose of this study was to assess messages posted by mothers of children with type 1 diabetes in the Italian Facebook group "Mamme e diabete" using computerized text analysis. The data suggest that these mothers use online discussion boards as a place to seek and provide information to better manage the disease's daily demands-especially those tasks linked to insulin correction and administration, control of food intake, and bureaucratic duties, as well as to seek and give encouragement and to share experiences regarding diabetes and related impact on their life. The implications of these findings for the management of diabetes are discussed.

Information Processing in Nursing Information Systems: An Evaluation Study from a Developing Country.

PubMed

Samadbeik, Mahnaz; Shahrokhi, Nafiseh; Saremian, Marzieh; Garavand, Ali; Birjandi, Mahdi

2017-01-01

In recent years, information technology has been introduced in the nursing departments of many hospitals to support their daily tasks. Nurses are the largest end user group in Hospital Information Systems (HISs). This study was designed to evaluate data processing in the Nursing Information Systems (NISs) utilized in many university hospitals in Iran. This was a cross-sectional study. The population comprised all nurse managers and NIS users of the five training hospitals in Khorramabad city ( N = 71). The nursing subset of HIS-Monitor questionnaire was used to collect the data. Data were analyzed by the descriptive-analytical method and the inductive content analysis. The results indicated that the nurses participating in the study did not take a desirable advantage of paper (2.02) and computerized (2.34) information processing tools to perform nursing tasks. Moreover, the less work experience nurses have, the further they utilize computer tools for processing patient discharge information. The "readability of patient information" and "repetitive and time-consuming documentation" were stated as the most important expectations and problems regarding the HIS by the participating nurses, respectively. The nurses participating in the present study used to utilize paper and computerized information processing tools together to perform nursing practices. Therefore, it is recommended that the nursing process redesign coincides with NIS implementation in the health care centers.

Information security risk management for computerized health information systems in hospitals: a case study of Iran.

PubMed

Zarei, Javad; Sadoughi, Farahnaz

2016-01-01

In recent years, hospitals in Iran - similar to those in other countries - have experienced growing use of computerized health information systems (CHISs), which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran. This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts' opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health. Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals. Information security risk management is not followed by Iran's hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran's Ministry of Health should develop practical policies to improve information security risk management in the hospitals of Iran.

HRIS Vendor Selection.

ERIC Educational Resources Information Center

Moore, James C.

1985-01-01

Questions administrators need to answer when selecting or evaluating a computerized personnel and/or payroll information system cover the type of system, resources for purchasing and/or developing it, activities needed and used for, its use, and issues of responsibility. (MSE)

New York State energy-analytic information system: first-stage implementation

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

Allentuck, J.; Carroll, O.; Fiore, L.

1979-09-01

So that energy policy by state government may be formulated within the constraints imposed by policy determined at the national level - yet reflect the diverse interests of its citizens - large quantities of data and sophisticated analytic capabilities are required. This report presents the design of an energy-information/analytic system for New York State, the data for a base year, 1976, and projections of these data. At the county level, 1976 energy-supply demand data and electric generating plant data are provided as well. Data-base management is based on System 2000. Three computerized models provide the system's basic analytic capacity. Themore » Brookhaven Energy System Network Simulator provides an integrating framework while a price-response model and a weather sensitive energy demand model furnished a short-term energy response estimation capability. The operation of these computerized models is described. 62 references, 25 figures, 39 tables.« less

Educating Nurses in the Design and Use of a Nursing Data Base

PubMed Central

Carlsen, Ruth H.

1982-01-01

The arrival of a computerized medical information system on the health care scene has created new performance demands on nurses. Not only must nurses be able to use the computer to document medical and nursing care, but they must be able to contribute to the overall design of the nursing data base. This paper describes how nurses must be educated to perform these new job responsibilities. Discussion will center on the educational process developed by the Clinical Center at the National Institutes of Health to meet the needs of its nurses to design a nursing data base and learn the technical skill required to utilize a computerized medical information system. Recommendations are offered to the academic community charged with the formal education of nursing professionals and the staff development and continuing educational planners who share the accountability for educating the already licensed nurses.

A motion artefact study and locally deforming objects in computerized tomography

NASA Astrophysics Data System (ADS)

Hahn, Bernadette N.

2017-11-01

Movements of the object during the data collection in computerized tomography can introduce motion artefacts in the reconstructed image. They can be reduced by employing information about the dynamic behaviour within the reconstruction step. However, inaccuracies concerning the movement are inevitable in practice. In this article, we give an explicit characterization of what is visible in an image obtained by a reconstruction algorithm with incorrect motion information. Then, we use this result to study in detail the situation of locally deforming objects, i.e. individual parts of the object have a different dynamic behaviour. In this context, we prove that additional artefacts arise due to the global nature of the Radon transform, even if the motion is exactly known. Based on our analysis, we propose a numerical scheme to reduce these artefacts in the reconstructed image. All our results are illustrated by numerical examples.

Computer Technologies and Consumer Information. Interactive Videotex Systems. Report by the Committee on Consumer Policy.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France).

This report focuses on the consumer information potential of computerized telecommunication systems, their possible advantages and drawbacks for the consumer, and the new policy issues created by the new medium, i.e., the possible economic, social, and legal implications for consumers. Topics addressed include the main features of the new…

Personal Privacy in an Information Society: What are the Trade-Offs? Insights into Consumer Issues.

ERIC Educational Resources Information Center

J.C. Penney Co., Inc., New York, NY.

Insights into Consumer Issues is one of a group of educational publications and teaching units that J.C. Penney provides for consumer educators as a public service. This folder illustrates that although computerized processing of personal information has brought considerable convenience, the potential risk to personal privacy is of increasing…

Using the Experience of a Lifetime. NOWIS: An Employer-to-Employer Data Base of Programs Utilizing Experienced Workers.

ERIC Educational Resources Information Center

American Association of Retired Persons, Washington, DC. Work Force Programs Dept.

This publication gives examples of employment programs for experienced workers taken from the National Older Workers Information System (NOWIS), a computerized system of information on more than 140 experienced worker employment programs in public and private sector organizations. (Maintained by the Business Partnerships Program of the American…

The Other Memex: The Tangled Career of Vannevar Bush's Information Machine, the Rapid Selector.

ERIC Educational Resources Information Center

Burke, Colin

1992-01-01

Presents an historical overview of Vannevar Bush's efforts to develop a machine for free-form indexing and computerized information retrieval. Descriptions of the Memex concept and two related machines--the Rapid Selector and the Comparator--are provided; and the shift in emphasis to a device for business or cryptanalytic purposes is discussed.…

Work in the Navy--A Description of Navy Officer and Enlisted Occupations. Technical Report No. 923.

ERIC Educational Resources Information Center

McDermott, Michael N.; And Others

The manual contains career guidance materials describing occupations and career development opportunities in the Navy. The materials were developed for integration into the Oregon Career Information System, a career education program utilizing both computerized and manual information systems. The report includes a discussion of the general work of…

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

Today's Revolution: Computers in Education. Proceedings of the Association for Educational Data Systems International Convention (Phoenix, Arizona, May 3-7, 1976).

ERIC Educational Resources Information Center

Association for Educational Data Systems, Washington, DC.

The theme of the 1976 convention of the Association for Educational Data Systems (AEDS) was educational data processing and information systems. Special attention was focused on educational management information systems, computer centers and networks, computer assisted instruction, computerized testing, guidance, and higher education. This…

Proposal for a Spatial Organization Model in Soil Science (The Example of the European Communities Soil Map).

ERIC Educational Resources Information Center

King, D.; And Others

1994-01-01

Discusses the computational problems of automating paper-based spatial information. A new relational structure for soil science information based on the main conceptual concepts used during conventional cartographic work is proposed. This model is a computerized framework for coherent description of the geographical variability of soils, combined…

Impact of Violation of the Missing-at-Random Assumption on Full-Information Maximum Likelihood Method in Multidimensional Adaptive Testing

ERIC Educational Resources Information Center

Han, Kyung T.; Guo, Fanmin

2014-01-01

The full-information maximum likelihood (FIML) method makes it possible to estimate and analyze structural equation models (SEM) even when data are partially missing, enabling incomplete data to contribute to model estimation. The cornerstone of FIML is the missing-at-random (MAR) assumption. In (unidimensional) computerized adaptive testing…

Frequently Asked Questions: An Effective Way to Store and Retrieve Reference Information?

ERIC Educational Resources Information Center

Stalker, John C.; Murfin, Marjorie E.

1996-01-01

Describes a computerized program presently being developed on the World Wide Web, which is designed to locate and store reference information through the use of FAQs (Frequently Asked Questions). Reports a preliminary investigation of the adequacy of FAQs to cover a sample of questions on American government, politics, elections and law. (AEF)

Utilizing Response Time Distributions for Item Selection in CAT

ERIC Educational Resources Information Center

Fan, Zhewen; Wang, Chun; Chang, Hua-Hua; Douglas, Jeffrey

2012-01-01

Traditional methods for item selection in computerized adaptive testing only focus on item information without taking into consideration the time required to answer an item. As a result, some examinees may receive a set of items that take a very long time to finish, and information is not accrued as efficiently as possible. The authors propose two…

Mapping individual logical processes in information searching

NASA Technical Reports Server (NTRS)

Smetana, F. O.

1974-01-01

An interactive dialog with a computerized information collection was recorded and plotted in the form of a flow chart. The process permits one to identify the logical processes employed in considerable detail and is therefore suggested as a tool for measuring individual thought processes in a variety of situations. A sample of an actual test case is given.

National Education Practice File. Final Report. Evaluation Report.

ERIC Educational Resources Information Center

Clay, Katherine; Davis, James E.

The purpose of the National Education Practice File (NEPF) was to find out from educational practitioners what types of materials would be of value to them; to locate the types of information identified; and to make this information available to them through the development of a computerized file of practitioner-oriented materials. The 2-year,…

Comparison of four stable numerical methods for Abel's integral equation

NASA Technical Reports Server (NTRS)

Murio, Diego A.; Mejia, Carlos E.

1991-01-01

The 3-D image reconstruction from cone-beam projections in computerized tomography leads naturally, in the case of radial symmetry, to the study of Abel-type integral equations. If the experimental information is obtained from measured data, on a discrete set of points, special methods are needed in order to restore continuity with respect to the data. A new combined Regularized-Adjoint-Conjugate Gradient algorithm, together with two different implementations of the Mollification Method (one based on a data filtering technique and the other on the mollification of the kernal function) and a regularization by truncation method (initially proposed for 2-D ray sample schemes and more recently extended to 3-D cone-beam image reconstruction) are extensively tested and compared for accuracy and numerical stability as functions of the level of noise in the data.

Structural and morphological approach of Co-Cr dental alloys processed by alternative manufacturing technologies

NASA Astrophysics Data System (ADS)

Porojan, Sorin; Bîrdeanu, Mihaela; Savencu, Cristina; Porojan, Liliana

2017-08-01

The integration of digitalized processing technologies in traditional dental restorations manufacturing is an emerging application. The objective of this study was to identify the different structural and morphological characteristics of Co-Cr dental alloys processed by alternative manufacturing techniques in order to understand the influence of microstructure on restorations properties and their clinical behavior. Metallic specimens made of Co-Cr dental alloys were prepared using traditional casting (CST), and computerized milling (MIL), selective laser sintering (SLS) and selective laser melting (SLM). The structural information of the samples was obtained by X-ray diffraction, the morphology and the topography of the samples were investigated by Scanning Electron Microscopy and Atomic Force Microscope. Given that the microstructure was significantly different, further differences in the clinical behavior of prosthetic restorations manufactured using additive techniques are anticipated.

Effectiveness of a computerized alert system based on re-testing intervals for limiting the inappropriateness of laboratory test requests.

PubMed

Lippi, Giuseppe; Brambilla, Marco; Bonelli, Patrizia; Aloe, Rosalia; Balestrino, Antonio; Nardelli, Anna; Ceda, Gian Paolo; Fabi, Massimo

2015-11-01

There is consolidated evidence that the burden of inappropriate laboratory test requests is very high, up to 70%. We describe here the function of a computerized alert system linked to the order entry, designed to limit the number of potentially inappropriate laboratory test requests. A computerized alert system based on re-testing intervals and entailing the generation of pop-up alerts when preset criteria of appropriateness for 15 laboratory tests were violated was implemented in two clinical wards of the University Hospital of Parma. The effectiveness of the system for limiting potentially inappropriate tests was monitored for 6months. Overall, 765/3539 (22%) test requests violated the preset criteria of appropriateness and generated the appearance of electronic alert. After alert appearance, 591 requests were annulled (17% of total tests requested and 77% of tests alerted, respectively). The total number of test requests violating the preset criteria of inappropriateness constantly decreased over time (26% in the first three months of implementation versus 17% in the following period; p<0.001). The total financial saving of test withdrawn was 3387 Euros (12.8% of the total test cost) throughout the study period. The results of this study suggest that a computerized alert system may be effective to limit the inappropriateness of laboratory test requests, generating significant economic saving and educating physicians to a more efficient use of laboratory resources. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Evaluation of Internet-Based Clinical Decision Support Systems

PubMed Central

Thomas, Karl W; Dayton, Charles S

1999-01-01

Background Scientifically based clinical guidelines have become increasingly used to educate physicians and improve quality of care. While individual guidelines are potentially useful, repeated studies have shown that guidelines are ineffective in changing physician behavior. The Internet has evolved as a potentially useful tool for guideline education, dissemination, and implementation because of its open standards and its ability to provide concise, relevant clinical information at the location and time of need. Objective Our objective was to develop and test decision support systems (DSS) based on clinical guidelines which could be delivered over the Internet for two disease models: asthma and tuberculosis (TB) preventive therapy. Methods Using open standards of HTML and CGI, we developed an acute asthma severity assessment DSS and a preventative tuberculosis treatment DSS based on content from national guidelines that are recognized as standards of care. Both DSS's are published on the Internet and operate through a decision algorithm developed from the parent guidelines with clinical information provided by the user at the point of clinical care. We tested the effectiveness of each DSS in influencing physician decisions using clinical scenario testing. Results We first validated the asthma algorithm by comparing asthma experts' decisions with the decisions reached by nonpulmonary nurses using the computerized DSS. Using the DSS, nurses scored the same as experts (89% vs. 88%; p = NS). Using the same scenario test instrument, we next compared internal medicine residents using the DSS with residents using a printed version of the National Asthma Education Program-2 guidelines. Residents using the computerized DSS scored significantly better than residents using the paper-based guidelines (92% vs. 84%; p <0.002). We similarly compared residents using the computerized TB DSS to residents using a printed reference card; the residents using the computerized DSS scored significantly better (95.8% vs. 56.6% correct; p<0.001). Conclusions Previous work has shown that guidelines disseminated through traditional educational interventions have minimal impact on physician behavior. Although computerized DSS have been effective in altering physician behavior, many of these systems are not widely available. We have developed two clinical DSS's based on national guidelines and published them on the Internet. Both systems improved physician compliance with national guidelines when tested in clinical scenarios. By providing information that is coupled to relevant activity, we expect that these widely available DSS's will serve as effective educational tools to positively impact physician behavior. PMID:11720915

Information resources in the USA on new and renewable energy, a description and directory

NASA Astrophysics Data System (ADS)

1981-06-01

The production dissemination, and availability of US scientific and technical information about new and renewable energy resources, the policy framework within which the technologies are developed, and the roles of public and private sectors are reported. A directory of sources of additional information, printed material, computerized data bases, institutional services, personal contacts, about the use of new and renewable energy is included.

A Tentative Career Development Curriculum and Its Implications for the Patterning of Supervisory Responsibilities in the Information System for Vocational Decisions. Information System for Vocational Decisions. Project Report Number 10.

ERIC Educational Resources Information Center

Fletcher, Wallace J.; And Others

The goals of the Information System for Vocational Decisions (ISVD), a computerized vocational development program which emphasized goal setting and purposeful action, are related to a tentative curriculum context called a Career Development Program. This Program is learner centered with process and subject matter a function of individual…

Using Decision Analysis to Select Facility Maintenance Management Information Systems

DTIC Science & Technology

2010-03-01

efficient way possible. Many of today’s maintenance managers thus apply computerized tools that come in the form of information systems that assist in... apply to effectively select a maintenance management information system that enables them to meet the needs of their customers. 3 1.2 Background...recession of the early 1990s. During this time, companies downsized their white-collar workforce performing daily operation and maintenance functions

Clinical Information Systems - From Yesterday to Tomorrow.

PubMed

Gardner, R M

2016-06-30

To review the history of clinical information systems over the past twenty-five years and project anticipated changes to those systems over the next twenty-five years. Over 250 Medline references about clinical information systems, quality of patient care, and patient safety were reviewed. Books, Web resources, and the author's personal experience with developing the HELP system were also used. There have been dramatic improvements in the use and acceptance of clinical computing systems and Electronic Health Records (EHRs), especially in the United States. Although there are still challenges with the implementation of such systems, the rate of progress has been remarkable. Over the next twenty-five years, there will remain many important opportunities and challenges. These opportunities include understanding complex clinical computing issues that must be studied, understood and optimized. Dramatic improvements in quality of care and patient safety must be anticipated as a result of the use of clinical information systems. These improvements will result from a closer involvement of clinical informaticians in the optimization of patient care processes. Clinical information systems and computerized clinical decision support have made contributions to medicine in the past. Therefore, by using better medical knowledge, optimized clinical information systems, and computerized clinical decision, we will enable dramatic improvements in both the quality and safety of patient care in the next twenty-five years.

Paving the COWpath: data-driven design of pediatric order sets

PubMed Central

Zhang, Yiye; Padman, Rema; Levin, James E

2014-01-01

Objective Evidence indicates that users incur significant physical and cognitive costs in the use of order sets, a core feature of computerized provider order entry systems. This paper develops data-driven approaches for automating the construction of order sets that match closely with user preferences and workflow while minimizing physical and cognitive workload. Materials and methods We developed and tested optimization-based models embedded with clustering techniques using physical and cognitive click cost criteria. By judiciously learning from users’ actual actions, our methods identify items for constituting order sets that are relevant according to historical ordering data and grouped on the basis of order similarity and ordering time. We evaluated performance of the methods using 47 099 orders from the year 2011 for asthma, appendectomy and pneumonia management in a pediatric inpatient setting. Results In comparison with existing order sets, those developed using the new approach significantly reduce the physical and cognitive workload associated with usage by 14–52%. This approach is also capable of accommodating variations in clinical conditions that affect order set usage and development. Discussion There is a critical need to investigate the cognitive complexity imposed on users by complex clinical information systems, and to design their features according to ‘human factors’ best practices. Optimizing order set generation using cognitive cost criteria introduces a new approach that can potentially improve ordering efficiency, reduce unintended variations in order placement, and enhance patient safety. Conclusions We demonstrate that data-driven methods offer a promising approach for designing order sets that are generalizable, data-driven, condition-based, and up to date with current best practices. PMID:24674844

Hospitality Management Education and Training.

ERIC Educational Resources Information Center

Brotherton, Bob, Ed.; And Others

1995-01-01

Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

BIBLIO: A Computerized Retrieval System for Communication Education.

ERIC Educational Resources Information Center

Williams, M. Lee; Edwards, Renee

1983-01-01

Describes BIBLIO, a computer program created for the storage and retrieval of articles in the 1970-80 issues of "Communication Education." Tells how articles were coded, method used to retrieve information, and advantages and uses of the system. (PD)

Pedestrian injury causation study (pedestrian accident typing)

DOT National Transportation Integrated Search

1982-08-01

A new computerized pedestrian accident typing procedure was tested on 1,997 cases from the Pedestrian Injury Causation Study (PICS). Two coding procedures were used to determine the effects of quantity and quality of information on accident typing ac...

TOXNET (TOXICOLOGY DATA NETWORK)

EPA Science Inventory

TOXNET (Toxicology Data Network) is a computerized system of files oriented to toxicology and related areas. It is managed by the National Library of Medicines Toxicology and Environmental Health Information Program (TEHIP) and runs on a series of microcomputers in a networked cl...

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2011 CFR

2011-10-01

... information such as social security numbers, names, dates of birth, home addresses and mailing addresses... enable the Office to monitor State operations and assess program performance through the audit conducted...

Home Data Banks Turn British On

ERIC Educational Resources Information Center

Science News, 1978

1978-01-01

Describes the operation and numerous capabilities of a British computerized data retrieval system named Prestel. It provides access, through the regular telephone network and a TV screen, to computer-based information supplied by many companies, agencies and commercial outlets. (GA)

Rhesus Monkeys (Macaca Mulatta) Maintain Learning Set Despite Second-Order Stimulus-Response Spatial Discontiguity

ERIC Educational Resources Information Center

Beran, Michael J.; Washburn, David A.; Rumbaugh, Duane M.

2007-01-01

In many discrimination-learning tests, spatial separation between stimuli and response loci disrupts performance in rhesus macaques. However, monkeys are unaffected by such stimulus-response spatial discontiguity when responses occur through joystick-based computerized movement of a cursor. To examine this discrepancy, five monkeys were tested on…

Conjoint analysis of nature tourism values in Bahia, Brazil

Treesearch

Thomas Holmes; Chris Zinkhan; Keith Alger; D. Evan Mercer

1996-01-01

This paper uses conjoint analysis to estimate the value of nature tourism attributes in a threatened forest ecosystem in northeastern Brazil. Computerized interviews were conducted using a paired comparison design. An ordinal interpretation of the rating scale was used and marginal utilities were estimated using ordered probit. The empirical results showed that the...

An inventory of publications on electronic medical records revisited.

PubMed

Moorman, P W; Schuemie, M J; van der Lei, J

2009-01-01

In this short review we provide an update of our earlier inventories of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. We retrieved and analyzed all references to English articles published before January 1, 2008, and indexed in PubMed with the MeSH term 'Medical Records Systems, Computerized'. We retrieved a total of 11,924 publications, of which 3937 (33%) appeared in a journal with an impact factor. Since 2002 the number of yearly publications, and the number of journals in which those publications appeared, increased. A cluster analysis revealed three clusters: an organizational issues cluster, a technically oriented cluster and a cluster about order-entry and research. Although our previous inventory in 2003 suggested a constant yearly production of publications on electronic medical records since 1998, the current inventory shows another rise in production since 2002. In addition, many new journals and countries have shown interest during the last five years. In the last 15 years, interest in organizational issues remained fairly constant, order entry and research with systems gained attention, while interest in technical issues relatively decreased.

Use of health information technology by children's hospitals in the United States.

PubMed

Menachemi, Nir; Brooks, Robert G; Schwalenstocker, Ellen; Simpson, Lisa

2009-01-01

The purpose of this study was to examine the adoption of health information technology by children's hospitals and to document barriers and priorities as they relate to health information technology adoption. Primary data of interest were obtained through the use of a survey instrument distributed to the chief information officers of 199 children's hospitals in the United States. Data were collected on current and future use of a variety of clinical health information technology and telemedicine applications, organizational priorities, barriers to use of health information technology, and hospital and chief information officer characteristics. Among the 109 responding hospitals (55%), common clinical applications included clinical scheduling (86.2%), transcription (85.3%), and pharmacy (81.9%) and laboratory (80.7%) information. Electronic health records (48.6%), computerized order entry (40.4%), and clinical decision support systems (35.8%) were less common. The most common barriers to health information technology adoption were vendors' inability to deliver products or services to satisfaction (85.4%), lack of staffing resources (82.3%), and difficulty in achieving end-user acceptance (80.2%). The most frequent priority for hospitals was to implement technology to reduce medical errors or to promote safety (72.5%). This first national look at health information technology use by children's hospitals demonstrates the progress in health information technology adoption, current barriers, and priorities for these institutions. In addition, the findings can serve as important benchmarks for future study in this area.

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

Szluha, A.T.; Summers, J.R.; Nicholas, W.D.

Current response technologies for floating hazardous chemicals were organized into a response manual. Technologies for spill containment, vapor suppression, and spill removal were included. A decision-making process was developed and work sheets included in an appendix. Physical properties and response information are also included in an appendix for each of the floating CHRIS chemicals. This information has been organized into a computerized data base for easy access.

Microcomputer and Bibliographic Information Systems in Latin America: Problems, Experiences and Projections. Proceedings of a Meeting (Santiago, Chile, April 24-27, 1984).

ERIC Educational Resources Information Center

Economic Commission for Latin America and the Caribbean, Santiago (Chile).

In areas such as Latin America and the Caribbean, many institutions are setting up databases using existing computerized information and documentation networks, and relying on new microcomputer equipment for their implementation. Increasing awareness of the implications of this practice prompted this conference, which provided the first step of a…

An Index to All "Query" Computer Searches Completed from July 1973 to June 1974. Search Number 0403-0619. Information Series No. 24.

ERIC Educational Resources Information Center

Wilder, Dolores J., Comp.; Hines, Rella, Comp.

The Tennessee Research Coordinating Unit (RCU) has implemented a computerized information retrieval system known as "Query," which allows for the retrieval of documents indexed in Research in Education (RIE), Current Index to Journals in Education (CIJE), and Abstracts of Instructional and Research Materials (AIM/ARM). The document…

NASA Operational Environment Team (NOET) - NASA's key to environmental technology

NASA Technical Reports Server (NTRS)

Cook, Beth

1993-01-01

NOET is a NASA-wide team which supports the research and development community by sharing information both in person and via a computerized network, assisting in specification and standard revisions, developing cleaner propulsion systems, and exploring environmentally compliant alternatives to current processes. NOET's structure, dissemination of materials, electronic information, EPA compliance, specifications and standards, and environmental research and development are discussed.