A systematic approach to baseline assessment of nursing documentation and enterprise-wide prioritization for electronic conversion.

PubMed

Dykes, Patricia C; Spurr, Cindy; Gallagher, Joan; Li, Qi; Ives Erickson, Jeanette

2006-01-01

An important challenge associated with making the transition from paper to electronic documentation systems is achieving consensus regarding priorities for electronic conversion across diverse groups. In our work we focus on applying a systematic approach to evaluating the baseline state of nursing documentation across a large healthcare system and establishing a unified vision for electronic conversion. A review of the current state of nursing documentation across PHS was conducted using structured tools. Data from this assessment was employed to facilitate an evidence-based approach to decision-making regarding conversion to electronic documentation at local and PHS levels. In this paper we present highlights of the assessment process and the outcomes of this multi-site collaboration.

Development of a prediction model on the acceptance of electronic laboratory notebooks in academic environments.

PubMed

Kloeckner, Frederik; Farkas, Robert; Franken, Tobias; Schmitz-Rode, Thomas

2014-04-01

Documentation of research data plays a key role in the biomedical engineering innovation processes. It makes an important contribution to the protection of intellectual property, the traceability of results and fulfilling the regulatory requirement. Because of the increasing digitalization in laboratories, an electronic alternative to the commonly-used paper-bound notebooks could contribute to the production of sophisticated documentation. However, compared to in an industrial environment, the use of electronic laboratory notebooks is not widespread in academic laboratories. Little is known about the acceptance of an electronic documentation system and the underlying reasons for this. Thus, this paper aims to establish a prediction model on the potential preference and acceptance of scientists either for paper-based or electronic documentation. The underlying data for the analysis originate from an online survey of 101 scientists in industrial, academic and clinical environments. Various parameters were analyzed to identify crucial factors for the system preference using binary logistic regression. The analysis showed significant dependency between the documentation system preference and the supposed workload associated with the documentation system (p<0.006; odds ratio=58.543) and an additional personal component. Because of the dependency of system choice on specific parameters it is possible to predict the acceptance of an electronic laboratory notebook before implementation.

Facing the Limitations of Electronic Document Handling.

ERIC Educational Resources Information Center

Moralee, Dennis

1985-01-01

This essay addresses problems associated with technology used in the handling of high-resolution visual images in electronic document delivery. Highlights include visual fidelity, laser-driven optical disk storage, electronics versus micrographics for document storage, videomicrographics, and system configurations and peripherals. (EJS)

NLS Flight Simulation Laboratory (FSL) documentation

NASA Technical Reports Server (NTRS)

1995-01-01

The Flight Simulation Laboratory (FSL) Electronic Documentation System design consists of modification and utilization of the MSFC Integrated Engineering System (IES), translation of the existing FSL documentation to an electronic format, and generation of new drawings to represent the Engine Flight Simulation Laboratory design and implementation. The intent of the electronic documentation is to provide ease of access, local print/plot capabilities, as well as the ability to correct and/or modify the stored data by network users who are authorized to access this information.

76 FR 61937 - Practice and Procedure: Rules of General Application, Safeguards, Antidumping and Countervailing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... System Web site at https://edis.usitc.gov . Failure to comply with the requirements of this chapter and... Electronic Document Information System (EDIS) already accepts electronic filing of certain documents, and..., regardless of whether the electronic docketing system is operational. The ITC TLA makes a similar comment...

The quality of paper-based versus electronic nursing care plan in Australian aged care homes: A documentation audit study.

PubMed

Wang, Ning; Yu, Ping; Hailey, David

2015-08-01

The nursing care plan plays an essential role in supporting care provision in Australian aged care. The implementation of electronic systems in aged care homes was anticipated to improve documentation quality. Standardized nursing terminologies, developed to improve communication and advance the nursing profession, are not required in aged care practice. The language used by nurses in the nursing care plan and the effect of the electronic system on documentation quality in residential aged care need to be investigated. To describe documentation practice for the nursing care plan in Australian residential aged care homes and to compare the quantity and quality of documentation in paper-based and electronic nursing care plans. A nursing documentation audit was conducted in seven residential aged care homes in Australia. One hundred and eleven paper-based and 194 electronic nursing care plans, conveniently selected, were reviewed. The quantity of documentation in a care plan was determined by the number of phrases describing a resident problem and the number of goals and interventions. The quality of documentation was measured using 16 relevant questions in an instrument developed for the study. There was a tendency to omit 'nursing problem' or 'nursing diagnosis' in the nursing process by changing these terms (used in the paper-based care plan) to 'observation' in the electronic version. The electronic nursing care plan documented more signs and symptoms of resident problems and evaluation of care than the paper-based format (48.30 vs. 47.34 out of 60, P<0.01), but had a lower total mean quality score. The electronic care plan contained fewer problem or diagnosis statements, contributing factors and resident outcomes than the paper-based system (P<0.01). Both types of nursing care plan were weak in documenting measurable and concrete resident outcomes. The overall quality of documentation content for the nursing process was no better in the electronic system than in the paper-based system. Omission of the nursing problem or diagnosis from the nursing process may reflect a range of factors behind the practice that need to be understood. Further work is also needed on qualitative aspects of the nurse care plan, nurses' attitudes towards standardized terminologies and the effect of different documentation practice on care quality and resident outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Document-Based EHR System That Controls the Disclosure of Clinical Documents Using an Access Control List File Based on the HL7 CDA Header.

PubMed

Takeda, Toshihiro; Ueda, Kanayo; Nakagawa, Akito; Manabe, Shirou; Okada, Katsuki; Mihara, Naoki; Matsumura, Yasushi

2017-01-01

Electronic health record (EHR) systems are necessary for the sharing of medical information between care delivery organizations (CDOs). We developed a document-based EHR system in which all of the PDF documents that are stored in our electronic medical record system can be disclosed to selected target CDOs. An access control list (ACL) file was designed based on the HL7 CDA header to manage the information that is disclosed.

Managing the life cycle of electronic clinical documents.

PubMed

Payne, Thomas H; Graham, Gail

2006-01-01

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

XML and its impact on content and structure in electronic health care documents.

PubMed Central

Sokolowski, R.; Dudeck, J.

1999-01-01

Worldwide information networks have the requirement that electronic documents must be easily accessible, portable, flexible and system-independent. With the development of XML (eXtensible Markup Language), the future of electronic documents, health care informatics and the Web itself are about to change. The intent of the recently formed ASTM E31.25 subcommittee, "XML DTDs for Health Care", is to develop standard electronic document representations of paper-based health care documents and forms. A goal of the subcommittee is to work together to enhance existing levels of interoperability among the various XML/SGML standardization efforts, products and systems in health care. The ASTM E31.25 subcommittee uses common practices and software standards to develop the implementation recommendations for XML documents in health care. The implementation recommendations are being developed to standardize the many different structures of documents. These recommendations are in the form of a set of standard DTDs, or document type definitions that match the electronic document requirements in the health care industry. This paper discusses recent efforts of the ASTM E31.25 subcommittee. PMID:10566338

Randomised trial comparing the recording ability of a novel, electronic emergency documentation system with the AHA paper cardiac arrest record.

PubMed

Grigg, Eliot; Palmer, Andrew; Grigg, Jeffrey; Oppenheimer, Peter; Wu, Tim; Roesler, Axel; Nair, Bala; Ross, Brian

2014-10-01

To evaluate the ability of an electronic system created at the University of Washington to accurately document prerecorded VF and pulseless electrical activity (PEA) cardiac arrest scenarios compared with the American Heart Association paper cardiac arrest record. 16 anaesthesiology residents were randomly assigned to view one of two prerecorded, simulated VF and PEA scenarios and asked to document the event with either the paper or electronic system. Each subject then repeated the process with the other video and documentation method. Five types of documentation errors were defined: (1) omission, (2) specification, (3) timing, (4) commission and (5) noise. The mean difference in errors between the paper and electronic methods was analysed using a single factor repeated measures ANOVA model. Compared with paper records, the electronic system omitted 6.3 fewer events (95% CI -10.1 to -2.5, p=0.003), which represents a 28% reduction in omission errors. Users recorded 2.9 fewer noise items (95% CI -5.3 to -0.6, p=0.003) when compared with paper, representing a 36% decrease in redundant or irrelevant information. The rate of timing (Δ=-3.2, 95% CI -9.3 to 3.0, p=0.286) and commission (Δ=-4.4, 95% CI -9.4 to 0.5, p=0.075) errors were similar between the electronic system and paper, while the rate of specification errors were about a third lower for the electronic system when compared with the paper record (Δ=-3.2, 95% CI -6.3 to -0.2, p=0.037). Compared with paper documentation, documentation with the electronic system captured 24% more critical information during a simulated medical emergency without loss in data quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

PubMed

Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

2011-01-01

Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

GUI-Based Document Access via SATCOMMS: Online Electronic Document Retrieval at the European Telecommunications Satellite Organization EUTELSAT.

ERIC Educational Resources Information Center

Burton, Adrian P.

1995-01-01

Discusses accessing online electronic documents at the European Telecommunications Satellite Organization (EUTELSAT). Highlights include off-site paper document storage, the document management system, benefits, the EUTELSAT Standard IBM Access software, implementation, the development process, and future enhancements. (AEF)

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 7 2013-01-01 2013-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

7 CFR 735.401 - Electronic warehouse receipt and USWA electronic document providers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Electronic warehouse receipt and USWA electronic... UNITED STATES WAREHOUSE ACT Electronic Providers § 735.401 Electronic warehouse receipt and USWA electronic document providers. (a) To establish a USWA-authorized system to issue and transfer EWR's and USWA...

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

PubMed

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

2010-10-01

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

Document Storage and Retrieval in the Electronic Office.

ERIC Educational Resources Information Center

Ashford, John

1985-01-01

Proposals are made for practical approaches to the design of electronic office systems to provide for the effective storage and retrieval of the documents that they generate. Problems of records management and requirements to be met by the designer of an electronic office system are highlighted. Nineteen references are cited. (EJS)

Electronic availability of microgravity experiments safety and integration requirements documents

NASA Technical Reports Server (NTRS)

Hogan, Jean M.

1995-01-01

This follow-on to NASA Contractor Report 195447, Microgravity Experiments Safety and Integration Requirements Document Tree, provides the details for accessing the systems that contain the official, electronic versions of the documents initially researched in NASA Contractor Report 195447. The data in this report serves as a valuable information source for the NASA Lewis Research Center Project Documentation Center (PDC), as well as for all developers of space experiments. The PDC has acquired the hardware, software, ID's, and passwords necessary to access most of these systems and is now able to provide customers with current document information as well as immediate delivery of available documents in either electronic or hard copy format.

Design and implementation of an inpatient physician documentation system using off-the-shelf components.

PubMed

Cucina, Russell J; Bokser, Seth J; Carter, Jonathan T; McLaren, Kevin M; Blum, Michael S

2007-10-11

We report the development and implementation of an electronic inpatient physician documentation system using off-the-shelf components, rapidly and at low cost. Within 9 months of deployment, over half of physician notes were electronic, and within 20 months, paper physician notes were eliminated. Our results suggest institutions can prioritize conversion to inpatient electronic physician documentation without waiting for development of sophisticated software packages or large capital investments.

Using electronic document management systems to manage highway project files.

DOT National Transportation Integrated Search

2011-12-12

"WisDOTs Bureau of Technical Services is interested in learning about the practices of other state departments of : transportation in developing and implementing an electronic document management system to manage highway : project files"

Medication order communication using fax and document-imaging technologies.

PubMed

Simonian, Armen I

2008-03-15

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

Implementation of a next-generation electronic nursing records system based on detailed clinical models and integration of clinical practice guidelines.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Chung, Eunja; Lee, Hyunsook

2013-12-01

The purpose of this paper is to describe the components of a next-generation electronic nursing records system ensuring full semantic interoperability and integrating evidence into the nursing records system. A next-generation electronic nursing records system based on detailed clinical models and clinical practice guidelines was developed at Seoul National University Bundang Hospital in 2013. This system has two components, a terminology server and a nursing documentation system. The terminology server manages nursing narratives generated from entity-attribute-value triplets of detailed clinical models using a natural language generation system. The nursing documentation system provides nurses with a set of nursing narratives arranged around the recommendations extracted from clinical practice guidelines. An electronic nursing records system based on detailed clinical models and clinical practice guidelines was successfully implemented in a hospital in Korea. The next-generation electronic nursing records system can support nursing practice and nursing documentation, which in turn will improve data quality.

Developing an Interface to Order and Document Health Education Videos in the Electronic Health Record.

PubMed

Wojcik, Lauren

2015-01-01

Transitioning to electronic health records (EHRs) provides an opportunity for health care systems to integrate educational content available on interactive patient systems (IPS) with the medical documentation system. This column discusses how one hospital simplified providers' workflow by making it easier to order educational videos and ensure that completed education is documented within the medical record. Integrating the EHR and IPS streamlined the provision of patient education, improved documentation, and supported the organization in meeting core requirements for Meaningful Use.

Methods, media, and systems for detecting attack on a digital processing device

DOEpatents

Stolfo, Salvatore J.; Li, Wei-Jen; Keromylis, Angelos D.; Androulaki, Elli

2014-07-22

Methods, media, and systems for detecting attack are provided. In some embodiments, the methods include: comparing at least part of a document to a static detection model; determining whether attacking code is included in the document based on the comparison of the document to the static detection model; executing at least part of the document; determining whether attacking code is included in the document based on the execution of the at least part of the document; and if attacking code is determined to be included in the document based on at least one of the comparison of the document to the static detection model and the execution of the at least part of the document, reporting the presence of an attack. In some embodiments, the methods include: selecting a data segment in at least one portion of an electronic document; determining whether the arbitrarily selected data segment can be altered without causing the electronic document to result in an error when processed by a corresponding program; in response to determining that the arbitrarily selected data segment can be altered, arbitrarily altering the data segment in the at least one portion of the electronic document to produce an altered electronic document; and determining whether the corresponding program produces an error state when the altered electronic document is processed by the corresponding program.

Methods, media, and systems for detecting attack on a digital processing device

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

Stolfo, Salvatore J.; Li, Wei-Jen; Keromytis, Angelos D.

Methods, media, and systems for detecting attack are provided. In some embodiments, the methods include: comparing at least part of a document to a static detection model; determining whether attacking code is included in the document based on the comparison of the document to the static detection model; executing at least part of the document; determining whether attacking code is included in the document based on the execution of the at least part of the document; and if attacking code is determined to be included in the document based on at least one of the comparison of the document tomore » the static detection model and the execution of the at least part of the document, reporting the presence of an attack. In some embodiments, the methods include: selecting a data segment in at least one portion of an electronic document; determining whether the arbitrarily selected data segment can be altered without causing the electronic document to result in an error when processed by a corresponding program; in response to determining that the arbitrarily selected data segment can be altered, arbitrarily altering the data segment in the at least one portion of the electronic document to produce an altered electronic document; and determining whether the corresponding program produces an error state when the altered electronic document is processed by the corresponding program.« less

The Effect of an Electronic SBAR Communication Tool on Documentation of Acute Events in the Pediatric Intensive Care Unit.

PubMed

Panesar, Rahul S; Albert, Ben; Messina, Catherine; Parker, Margaret

2016-01-01

The Situation, Background, Assessment, Recommendation (SBAR) handoff tool is designed to improve communication. The effects of integrating an electronic medical record (EMR) with a SBAR template are unclear. The research team hypothesizes that an electronic SBAR template improves documentation and communication between nurses and physicians. In all, 84 patient events were recorded from 542 admissions to the pediatric intensive care unit. Three time periods were studied: (a) paper documentation only, (b) electronic documentation, and (c) electronic documentation with an SBAR template. Documentation quality was assessed using a 4-point scoring system. The frequency of event notes increased progressively during the 3 study periods. Mean quality scores improved significantly from paper documentation to EMR free-text notes and to electronic SBAR-template notes, as did nurse and attending physician notification. The implementation of an electronic SBAR note is associated with more complete documentation and increased frequency of documentation of communication among nurses and physicians. © The Author(s) 2014.

Electronic Derivative Classifier/Reviewing Official

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

Harris, Joshua C; McDuffie, Gregory P; Light, Ken L

2017-02-17

The electronic Derivative Classifier, Reviewing Official (eDC/RO) is a web based document management and routing system that reduces security risks and increases workflow efficiencies. The system automates the upload, notification review request, and document status tracking of documents for classification review on a secure server. It supports a variety of document formats (i.e., pdf, doc, docx, xls, xlsx, xlsm, ppt, pptx, vsd, vsdx and txt), and allows for the dynamic placement of classification markings such as the classification level, category and caveats on the document, in addition to a document footer and digital signature.

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

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

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

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

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

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

14 CFR 302.3 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

Electronic palliative care coordination systems: Devising and testing a methodology for evaluating documentation

PubMed Central

Allsop, Matthew J; Kite, Suzanne; McDermott, Sarah; Penn, Naomi; Millares-Martin, Pablo; Bennett, Michael I

2016-01-01

Background: The need to improve coordination of care at end of life has driven electronic palliative care coordination systems implementation across the United Kingdom and internationally. No approaches for evaluating electronic palliative care coordination systems use in practice have been developed. Aim: This study outlines and applies an evaluation framework for examining how and when electronic documentation of advance care planning is occurring in end of life care services. Design: A pragmatic, formative process evaluation approach was adopted. The evaluation drew on the Project Review and Objective Evaluation methodology to guide the evaluation framework design, focusing on clinical processes. Setting/participants: Data were extracted from electronic palliative care coordination systems for 82 of 108 general practices across a large UK city. All deaths (n = 1229) recorded on electronic palliative care coordination systems between April 2014 and March 2015 were included to determine the proportion of all deaths recorded, median number of days prior to death that key information was recorded and observations about routine data use. Results: The evaluation identified 26.8% of all deaths recorded on electronic palliative care coordination systems. The median number of days to death was calculated for initiation of an electronic palliative care coordination systems record (31 days), recording a patient’s preferred place of death (8 days) and entry of Do Not Attempt Cardiopulmonary Resuscitation decisions (34 days). Where preferred and actual place of death was documented, these were matching for 75% of patients. Anomalies were identified in coding used during data entry on electronic palliative care coordination systems. Conclusion: This study reports the first methodology for evaluating how and when electronic palliative care coordination systems documentation is occurring. It raises questions about what can be drawn from routine data collected through electronic palliative care coordination systems and outlines considerations for future evaluation. Future evaluations should consider work processes of health professionals using electronic palliative care coordination systems. PMID:27507636

Electronic palliative care coordination systems: Devising and testing a methodology for evaluating documentation.

PubMed

Allsop, Matthew J; Kite, Suzanne; McDermott, Sarah; Penn, Naomi; Millares-Martin, Pablo; Bennett, Michael I

2017-05-01

The need to improve coordination of care at end of life has driven electronic palliative care coordination systems implementation across the United Kingdom and internationally. No approaches for evaluating electronic palliative care coordination systems use in practice have been developed. This study outlines and applies an evaluation framework for examining how and when electronic documentation of advance care planning is occurring in end of life care services. A pragmatic, formative process evaluation approach was adopted. The evaluation drew on the Project Review and Objective Evaluation methodology to guide the evaluation framework design, focusing on clinical processes. Data were extracted from electronic palliative care coordination systems for 82 of 108 general practices across a large UK city. All deaths ( n = 1229) recorded on electronic palliative care coordination systems between April 2014 and March 2015 were included to determine the proportion of all deaths recorded, median number of days prior to death that key information was recorded and observations about routine data use. The evaluation identified 26.8% of all deaths recorded on electronic palliative care coordination systems. The median number of days to death was calculated for initiation of an electronic palliative care coordination systems record (31 days), recording a patient's preferred place of death (8 days) and entry of Do Not Attempt Cardiopulmonary Resuscitation decisions (34 days). Where preferred and actual place of death was documented, these were matching for 75% of patients. Anomalies were identified in coding used during data entry on electronic palliative care coordination systems. This study reports the first methodology for evaluating how and when electronic palliative care coordination systems documentation is occurring. It raises questions about what can be drawn from routine data collected through electronic palliative care coordination systems and outlines considerations for future evaluation. Future evaluations should consider work processes of health professionals using electronic palliative care coordination systems.

Low Adoption Rates of Electronic Medical Records Systems: A Qualitative Study

ERIC Educational Resources Information Center

Slaughter, Andre

2017-01-01

This qualitative phenomenological research study explored the challenges of physicians working with Electronic Medical Records (EMR) systems for medical documentation. Additionally, this study sought to understand why many providers sought alternate means of patient documentation. Previous research studies focused on the use of EMR systems from…

Using an Educational Electronic Documentation System to Help Nursing Students Accurately Identify Nursing Diagnoses

ERIC Educational Resources Information Center

Pobocik, Tamara J.

2013-01-01

The use of technology and electronic medical records in healthcare has exponentially increased. This quantitative research project used a pretest/posttest design, and reviewed how an educational electronic documentation system helped nursing students to identify the accurate related to statement of the nursing diagnosis for the patient in the case…

Data from clinical notes: a perspective on the tension between structure and flexible documentation

PubMed Central

Denny, Joshua C; Xu, Hua; Lorenzi, Nancy; Stead, William W; Johnson, Kevin B

2011-01-01

Clinical documentation is central to patient care. The success of electronic health record system adoption may depend on how well such systems support clinical documentation. A major goal of integrating clinical documentation into electronic heath record systems is to generate reusable data. As a result, there has been an emphasis on deploying computer-based documentation systems that prioritize direct structured documentation. Research has demonstrated that healthcare providers value different factors when writing clinical notes, such as narrative expressivity, amenability to the existing workflow, and usability. The authors explore the tension between expressivity and structured clinical documentation, review methods for obtaining reusable data from clinical notes, and recommend that healthcare providers be able to choose how to document patient care based on workflow and note content needs. When reusable data are needed from notes, providers can use structured documentation or rely on post-hoc text processing to produce structured data, as appropriate. PMID:21233086

Improving documentation of a beta-blocker quality measure through an anesthesia information management system and real-time notification of documentation errors.

PubMed

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

2012-06-01

Continuation of perioperative beta-blockers for surgical patients who are receiving beta-blockers prior to arrival for surgery is an important quality measure (SCIP-Card-2). For this measure to be considered successful, name, date, and time of the perioperative beta-blocker must be documented. Alternately, if the beta-blocker is not given, the medical reason for not administering must be documented. Before the study was conducted, the institution lacked a highly reliable process to document the date and time of self-administration of beta-blockers prior to hospital admission. Because of this, compliance with the beta-blocker quality measure was poor (-65%). To improve this measure, the anesthesia care team was made responsible for documenting perioperative beta-blockade. Clear documentation guidelines were outlined, and an electronic Anesthesia Information Management System (AIMS) was configured to facilitate complete documentation of the beta-blocker quality measure. In addition, real-time electronic alerts were generated using Smart Anesthesia Messenger (SAM), an internally developed decision-support system, to notify users concerning incomplete beta-blocker documentation. Weekly compliance for perioperative beta-blocker documentation before the study was 65.8 +/- 16.6%, which served as the baseline value. When the anesthesia care team started documenting perioperative beta-blocker in AIMS, compliance was 60.5 +/- 8.6% (p = .677 as compared with baseline). Electronic alerts with SAM improved documentation compliance to 94.6 +/- 3.5% (p < .001 as compared with baseline). To achieve high compliance for the beta-blocker measure, it is essential to (1) clearly assign a medical team to perform beta-blocker documentation and (2) enhance features in the electronic medical systems to alert the user concerning incomplete documentation.

Electronic document management systems: an overview.

PubMed

Kohn, Deborah

2002-08-01

For over a decade, most health care information technology (IT) professionals erroneously learned that document imaging, which is one of the many component technologies of an electronic document management system (EDMS), is the only technology of an EDMS. In addition, many health care IT professionals erroneously believed that EDMSs have either a limited role or no place in IT environments. As a result, most health care IT professionals do not understand documents and unstructured data and their value as structured data partners in most aspects of transaction and information processing systems.

Seamless Management of Paper and Electronic Documents for Task Knowledge Sharing

NASA Astrophysics Data System (ADS)

Kojima, Hiroyuki; Iwata, Ken

Due to the progress of Internet technology and the increase of distributed information on networks, the present knowledge management has been based more and more on the performance of various experienced users. In addition to the increase of electronic documents, the use of paper documents has not been reduced because of their convenience. This paper describes a method of tracking paper document locations and contents using radio frequency identification (RFID) technology. This research also focuses on the expression of a task process and the seamless structuring of related electronic and paper documents as a result of task knowledge formalization using information organizing. A system is proposed here that implements information organization for both Web documents and paper documents with the task model description and RFID technology. Examples of a prototype system are also presented.

Implementation of standardized nomenclature in the electronic medical record.

PubMed

Klehr, Joan; Hafner, Jennifer; Spelz, Leah Mylrea; Steen, Sara; Weaver, Kathy

2009-01-01

To describe a customized electronic medical record documentation system which provides an electronic health record, Epic, which was implemented in December 2006 using standardized taxonomies for nursing documentation. Descriptive data is provided regarding the development, implementation, and evaluation processes for the electronic medical record system. Nurses used standardized nursing nomenclature including NANDA-I diagnoses, Nursing Interventions Classification, and Nursing Outcomes Classification in a measurable and user-friendly format using the care plan activity. Key factors in the success of the project included close collaboration among staff nurses and information technology staff, ongoing support and encouragement from the vice president/chief nursing officer, the ready availability of expert resources, and nursing ownership of the project. Use of this evidence-based documentation enhanced institutional leadership in clinical documentation.

Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

ERIC Educational Resources Information Center

Farri, Oladimeji Feyisetan

2012-01-01

Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

Loan Stars: ILL Comes of Age.

ERIC Educational Resources Information Center

Jackson, Mary E.

1998-01-01

Assesses the changes in interlibrary loan (ILL) practices, and points the way to an ideal future. Discusses patron-initiated document request systems; library-mediated ordering systems; document delivery suppliers; accessing electronic resources; ILL management software; paying ILL invoices; new electronic delivery options; and results of a…

Integrated information systems for electronic chemotherapy medication administration.

PubMed

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

2011-07-01

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

U.S. Central Command Headquarters’ Use of the Government Purchase Card

DTIC Science & Technology

2011-01-25

required the coordinator to document training sessions. During our review, the squadron was developing a new electronic system to support the...approving officials and cardholders. 2. Establish a plan to ensure that the new electronic Government Purchase Card Tracking system is completed...tickets,” invoices, shipping/packing documents or receiving reports, or electronic purchase confirmations are acceptable) for each purchase and other

Inter-professional electronic documents and child health: a study of persisting non-electronic communication in the use of electronic documents.

PubMed

Saario, Sirpa; Hall, Christopher; Peckover, Sue

2012-12-01

Information and communication technologies are widely used in health and social care settings to replace previous means of record keeping, assessment and communication. Commentary on the strengths and weaknesses of such systems abound, thus it is useful to examine how they are used in practice. This article draws on findings from two separate studies, conducted between 2005 and 2007, which examined how child health and welfare professionals use electronic documents in Finland and England. Known respectively as Miranda and CAF, these systems are different in terms of structure and function but in their everyday use common features are identified, notably the continued use of and reliance on non-electronic means of communication. Based on interviews with professionals, three forms of non-electronic communication are described: alternative records, phone calls and letters, which facilitate the sharing of the electronic record. Finally, the electronic documents are further analysed as potential boundary objects which aim to create common understanding between sites and professionals. Copyright © 2012 Elsevier Ltd. All rights reserved.

Electronic Document Delivery: New Options for Libraries.

ERIC Educational Resources Information Center

Leach, Ronald G.; Tribble, Judith E.

1993-01-01

Examines commercial electronic document delivery services that are available to academic libraries. Highlights include collection development issues; criteria for selection and evaluation; remote access systems, including CARL UnCover 2, Faxon Finder and Faxon Xpress, ContentsFirst and ArticleFirst, and CitaDel; and on-site access systems,…

75 FR 1382 - Wireless Telecommunications Bureau Seeks Comment on Petition for Reconsideration or Clarification...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

... its Electronic Document Management System (EDOCS): http://hraunfoss.fcc.gov/edocs_public/SilverStream... Communications Commission. ACTION: Notice. SUMMARY: In this document, comment is sought on a December 17, 2009...'s Electronic Comment Filing System (ECFS), (2) the Federal Government's eRulemaking Portal, or (3...

Smart roadside initiative : system design document.

DOT National Transportation Integrated Search

2015-09-01

This document describes the software design for the Smart Roadside Initiative (SRI) for the delivery of capabilities related to wireless roadside inspections, electronic screening/virtual weigh stations, universal electronic commercial vehicle identi...

10 CFR 13.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... identity when filing documents and serving participants electronically through the E-Filing system, and... transmitted electronically from the E-Filing system to the submitter confirming receipt of electronic filing... presentation of the docket and a link to its files. E-Filing System means an electronic system that receives...

The need for academic electronic health record systems in nurse education.

PubMed

Chung, Joohyun; Cho, Insook

2017-07-01

The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems. Copyright © 2017. Published by Elsevier Ltd.

Electronic Document Imaging and Optical Storage Systems for Local Governments: An Introduction. Local Government Records Technical Information Series. Number 21.

ERIC Educational Resources Information Center

Schwartz, Stanley F.

This publication introduces electronic document imaging systems and provides guidance for local governments in New York in deciding whether such systems should be adopted for their own records and information management purposes. It advises local governments on how to develop plans for using such technology by discussing its advantages and…

Integrated Information Systems for Electronic Chemotherapy Medication Administration

PubMed Central

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

2011-01-01

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

Information retrieval system utilizing wavelet transform

DOEpatents

Brewster, Mary E.; Miller, Nancy E.

2000-01-01

A method for automatically partitioning an unstructured electronically formatted natural language document into its sub-topic structure. Specifically, the document is converted to an electronic signal and a wavelet transform is then performed on the signal. The resultant signal may then be used to graphically display and interact with the sub-topic structure of the document.

75 FR 75705 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-06

..., Rockville, Maryland. NRC's Agencywide Documents Access and Management System (ADAMS): Publicly available documents created or received at the NRC are available electronically at the NRC's Electronic Reading Room... Specifications End States (BAW- 2441).'' TSTF-431, Revision 3, is available in the Agencywide Documents Access...

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

PubMed

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

2013-01-01

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

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

PubMed

Cheng, Jiangbo; Wang, Weidong

2010-07-01

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

A strategy for electronic dissemination of NASA Langley technical publications

NASA Technical Reports Server (NTRS)

Roper, Donna G.; Mccaskill, Mary K.; Holland, Scott D.; Walsh, Joanne L.; Nelson, Michael L.; Adkins, Susan L.; Ambur, Manjula Y.; Campbell, Bryan A.

1994-01-01

To demonstrate NASA Langley Research Center's relevance and to transfer technology to external customers in a timely and efficient manner, Langley has formed a working group to study and recommend a course of action for the electronic dissemination of technical reports (EDTR). The working group identified electronic report requirements (e.g., accessibility, file format, search requirements) of customers in U.S. industry through numerous site visits and personal contacts. Internal surveys were also used to determine commonalities in document preparation methods. From these surveys, a set of requirements for an electronic dissemination system was developed. Two candidate systems were identified and evaluated against the set of requirements: the Full-Text Electronic Documents System (FEDS), which is a full-text retrieval system based on the commercial document management package Interleaf, and the Langley Technical Report Server (LTRS), which is a Langley-developed system based on the publicly available World Wide Web (WWW) software system. Factors that led to the selection of LTRS as the vehicle for electronic dissemination included searching and viewing capability, current system operability, and client software availability for multiple platforms at no cost to industry. This report includes the survey results, evaluations, a description of the LTRS architecture, recommended policy statement, and suggestions for future implementations.

The present status and problems in document retrieval system : document input type retrieval system

NASA Astrophysics Data System (ADS)

Inagaki, Hirohito

The office-automation (OA) made many changes. Many documents were begun to maintained in an electronic filing system. Therefore, it is needed to establish efficient document retrieval system to extract useful information. Current document retrieval systems are using simple word-matching, syntactic-matching, semantic-matching to obtain high retrieval efficiency. On the other hand, the document retrieval systems using special hardware devices, such as ISSP, were developed for aiming high speed retrieval. Since these systems can accept a single sentence or keywords as input, it is difficult to explain searcher's request. We demonstrated document input type retrieval system, which can directly accept document as an input, and can search similar documents from document data-base.

Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort.

PubMed

Goudra, B; Singh, P M; Borle, A; Gouda, G

2016-01-01

Use of electronic medical record systems has increased in the recent years. Epic is one such system gaining popularity in the USA. Epic is a private company, which invented the electronic documentation system adopted in our hospital. In spite of many presumed advantages, its use is not critically analyzed. Some of the perceived advantages are increased efficiency and protection against litigation as a result of accurate documentation. In this study, retrospective data of 305 patients who underwent endoscopic retrograde cholangiopancreatography (wherein electronic charting was used - "Epic group") were compared with 288 patients who underwent the same procedure with documentation saved on a paper chart ("paper group"). Time of various events involved in the procedure such as anesthesia start, endoscope insertion, endoscope removal, and transfer to the postanesthesia care unit were routinely documented. From this data, the various time durations were calculated. Both "anesthesia start to scope insertion" times and "scope removal to transfer" times were significantly less in the Epic group compared to the paper group. Use of Epic system led to a saving of 4 min of procedure time per patient. However, the mean oxygen saturation was significantly less in the Epic group. In spite of perceived advantages of Epic documentation system, significant hurdles remain with its use. Although the system allows seamless flow of patients, failure to remove all artifacts can lead to errors and become a source of potential litigation hazard.

Advanced Electronics. Curriculum Development. Bulletin 1778.

ERIC Educational Resources Information Center

Eppler, Thomas

This document is a curriculum guide for a 180-hour course in advanced electronics for 11th and 12th grades that has four instructional units. The instructional units are orientation, discrete components, integrated circuits, and electronic systems. The document includes a course flow chart; a two-page section that describes the course, lists…

Evaluation of a System of Electronic Documentation for the Nursing Process

PubMed Central

de Oliveira, Neurilene Batista; Peres, Heloisa Helena Ciqueto

2012-01-01

The objective of this study is to evaluate the functional performance and the technical quality of an electronic documentation system designed to document the data of the Nursing Process. The Model of Quality will be the one established by the ISO/IEC 25010. Such research will allow the spreading of the knowledge of an emerging area, thus adding a further initiative to the growing efforts made in the information technology area for health and nursing. PMID:24199110

Quality of nursing documentation: Paper-based health records versus electronic-based health records.

PubMed

Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

2018-02-01

To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients' outcomes. © 2017 John Wiley & Sons Ltd.

Electronic flight bag (EFB) : 2010 industry survey

DOT National Transportation Integrated Search

2010-09-01

This document provides an overview of Electronic Flight Bag (EFB) systems and capabilities, as of June 2010. This document updates and replaces the April 2007 EFB Industry Review (Yeh and Chandra, 2007). As with the previous industry survey, the focu...

Information retrieval system utilizing wavelet transform

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

Brewster, M.E.; Miller, N.E.

A method is disclosed for automatically partitioning an unstructured electronically formatted natural language document into its sub-topic structure. Specifically, the document is converted to an electronic signal and a wavelet transform is then performed on the signal. The resultant signal may then be used to graphically display and interact with the sub-topic structure of the document.

Development of an electronic claim system based on an integrated electronic health record platform to guarantee interoperability.

PubMed

Kim, Hwa Sun; Cho, Hune; Lee, In Keun

2011-06-01

We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data.

10 CFR 2.305 - Service of documents, methods, proof.

Code of Federal Regulations, 2013 CFR

2013-01-01

... optical storage media containing the electronic document. (3) A participant granted an exemption under § 2... certificate of service. (i) If a document is served on participants through only the E-filing system, then the certificate of service must state that the document has been filed through the E-Filing system. (ii) If a...

10 CFR 2.305 - Service of documents, methods, proof.

Code of Federal Regulations, 2014 CFR

2014-01-01

... optical storage media containing the electronic document. (3) A participant granted an exemption under § 2... certificate of service. (i) If a document is served on participants through only the E-filing system, then the certificate of service must state that the document has been filed through the E-Filing system. (ii) If a...

Developing an acute-physical-examination template for a Tegional EHR system aimed at improving inexperienced physician's documentation.

PubMed

Lilholt, Lars; Haubro, Camilla Dremstrup; Møller, Jørn Munkhof; Aarøe, Jens; Højen, Anne Randorff; Gøeg, Kirstine Rosenbeck

2013-01-01

It is well-established that to increase acceptance of electronic clinical documentation tools, such as electronic health record (EHR) systems, it is important to have a strong relationship between those who document the clinical encounters and those who reaps the benefit of digitalized and more structured documentation. [1] Therefore, templates for EHR systems benefit from being closely related to clinical practice with a strong focus on primarily solving clinical problems. Clinical use as a driver for structured documentation has been the focus of the acute-physical-examination template (APET) development in the North Denmark Region. The template was developed through a participatory design where precision and clarity of documentation was prioritized as well as fast registration. The resulting template has approximately 700 easy accessible input possibilities and will be evaluated in clinical practice in the first quarter of 2013.

Get It Right First Time: A Beginner's Guide to Document Management.

ERIC Educational Resources Information Center

Hayes, Mike

1997-01-01

Document management (DM) systems capture, store, index, retrieve, route, distribute, and archive information in organizations. Discusses "passive" electronic libraries and "active" systems; characteristics of effective systems; implementing a system; fitting a new system to an existing infrastructure; budgets; system…

36 CFR 1236.12 - What other records management and preservation considerations must be incorporated into the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... exchange of electronic documents between offices using different software or operating systems. ... of electronic information systems? 1236.12 Section 1236.12 Parks, Forests, and Public Property... Management and Preservation Considerations for Designing and Implementing Electronic Information Systems...

36 CFR 1236.12 - What other records management and preservation considerations must be incorporated into the...

Code of Federal Regulations, 2012 CFR

2012-07-01

... exchange of electronic documents between offices using different software or operating systems. ... of electronic information systems? 1236.12 Section 1236.12 Parks, Forests, and Public Property... Management and Preservation Considerations for Designing and Implementing Electronic Information Systems...

36 CFR 1236.12 - What other records management and preservation considerations must be incorporated into the...

Code of Federal Regulations, 2014 CFR

2014-07-01

... exchange of electronic documents between offices using different software or operating systems. ... of electronic information systems? 1236.12 Section 1236.12 Parks, Forests, and Public Property... Management and Preservation Considerations for Designing and Implementing Electronic Information Systems...

Exploring Midwives' Need and Intention to Adopt Electronic Integrated Antenatal Care.

PubMed

Markam, Hosizah; Hochheiser, Harry; Kuntoro, Kuntoro; Notobroto, Hari Basuki

2018-01-01

Documentation requirements for the Indonesian integrated antenatal care (ANC) program suggest the need for electronic systems to address gaps in existing paper documentation practices. Our goals were to quantify midwives' documentation completeness in a primary healthcare center, understand documentation challenges, develop a tool, and assess intention to use the tool. We analyzed existing ANC records in a primary healthcare center in Bangkalan, East Java, and conducted interviews with stakeholders to understand needs for an electronic system in support of ANC. Development of the web-based Electronic Integrated ANC (e-iANC) system used the System Development Life Cycle method. Training on the use of the system was held in the computer laboratory for 100 midwives chosen from four primary healthcare centers in each of five regions. The Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire was used to assess their intention to adopt e-iANC. The midwives' intention to adopt e-iANC was significantly influenced by performance expectancy, effort expectancy and facilitating conditions. Age, education level, and computer literacy did not significantly moderate the effects of performance expectancy and effort expectancy on adoption intention. The UTAUT results indicated that the factors that might influence intention to adopt e-iANC are potentially addressable. Results suggest that e-iANC might well be accepted by midwives.

Implementation of the Nutrition Care Process and International Dietetics and Nutrition Terminology in a single-center hemodialysis unit: comparing paper vs electronic records.

PubMed

Rossi, Megan; Campbell, Katrina Louise; Ferguson, Maree

2014-01-01

There is little doubt surrounding the benefits of the Nutrition Care Process and International Dietetics and Nutrition Terminology (IDNT) to dietetics practice; however, evidence to support the most efficient method of incorporating these into practice is lacking. The main objective of our study was to compare the efficiency and effectiveness of an electronic and a manual paper-based system for capturing the Nutrition Care Process and IDNT in a single in-center hemodialysis unit. A cohort of 56 adult patients receiving maintenance hemodialysis were followed for 12 months. During the first 6 months, patients received the usual standard care, with documentation via a manual paper-based system. During the following 6-month period (Months 7 to 12), nutrition care was documented by an electronic system. Workload efficiency, number of IDNT codes used related to nutrition-related diagnoses, interventions, monitoring and evaluation using IDNT, nutritional status using the scored Patient-Generated Subjective Global Assessment Tool of Quality of Life were the main outcome measures. Compared with paper-based documentation of nutrition care, our study demonstrated that an electronic system improved the efficiency of total time spent by the dietitian by 13 minutes per consultation. There were also a greater number of nutrition-related diagnoses resolved using the electronic system compared with the paper-based documentation (P<0.001). In conclusion, the implementation of an electronic system compared with a paper-based system in a population receiving hemodialysis resulted in significant improvements in the efficiency of nutrition care and effectiveness related to patient outcomes. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Navy Controls for Invoice, Receipt, Acceptance, and Property Transfer System Need Improvement

DTIC Science & Technology

2016-02-25

iR APT as a web-based system to electronically invoice, receipt, and accept ser vices and product s from its contractors and vendors. The iR APT system...electronically shares document s bet ween DoD and it s contractors and vendors to eliminate redundant data entr y, increase data accuracy, and reduce...The iR APT system allows contractors to submit and track invoices and receipt and acceptance documents over the web and allows government personnel to

Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery.

PubMed

Read-Brown, Sarah; Sanders, David S; Brown, Anna S; Yackel, Thomas R; Choi, Dongseok; Tu, Daniel C; Chiang, Michael F

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design.

Time-Motion Analysis of Clinical Nursing Documentation During Implementation of an Electronic Operating Room Management System for Ophthalmic Surgery

PubMed Central

Read-Brown, Sarah; Sanders, David S.; Brown, Anna S.; Yackel, Thomas R.; Choi, Dongseok; Tu, Daniel C.; Chiang, Michael F.

2013-01-01

Efficiency and quality of documentation are critical in surgical settings because operating rooms are a major source of revenue, and because adverse events may have enormous consequences. Electronic health records (EHRs) have potential to impact surgical volume, quality, and documentation time. Ophthalmology is an ideal domain to examine these issues because procedures are high-throughput and demand efficient documentation. This time-motion study examines nursing documentation during implementation of an EHR operating room management system in an ophthalmology department. Key findings are: (1) EHR nursing documentation time was significantly worse during early implementation, but improved to a level near but slightly worse than paper baseline, (2) Mean documentation time varied significantly among nurses during early implementation, and (3) There was no decrease in operating room turnover time or surgical volume after implementation. These findings have important implications for ambulatory surgery departments planning EHR implementation, and for research in system design. PMID:24551402

Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores.

PubMed

Skyttberg, Niclas; Chen, Rong; Blomqvist, Hans; Koch, Sabine

2017-08-30

Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores. The study also provides reference data on triage vital signs in Swedish emergency care. We extracted a dataset including vital signs, demographic and administrative data from emergency care visits (n=335027) at five Swedish emergency hospitals during 2013 using either completely paper-based, completely electronic or mixed documentation practices. Descriptive statistics were used to assess fitness for use in emergency care decision support systems aiming to calculate warning and triage scores, and data quality was described in three categories: currency, completeness and correctness. To estimate correctness, two further categories - plausibility and concordance - were used. The study showed an acceptable correctness of the registered vital signs irrespectively of the type of documentation practice. Completeness was high in sites where registrations were routinely entered into the Electronic Health Record (EHR). The currency was only acceptable in sites with a completely electronic documentation practice. Although vital signs that were recorded in completely electronic documentation practices showed plausible results regarding correctness, completeness and currency, the study concludes that vital signs documented in Swedish emergency care EHRs cannot generally be considered fit for use for calculation of triage and warning scores. Low completeness and currency were found if the documentation was not completely electronic.

Electronic Document Delivery: OCLC's Prototype System.

ERIC Educational Resources Information Center

Hickey, Thomas B.; Calabrese, Andrew M.

1986-01-01

Describes development of system for retrieval of documents from magnetic storage that uses stored font definition codes to control an inexpensive laser printer in the production of copies that closely resemble original document. Trends in information equipment and printing industries that will govern future application of this technology are…

Piloting a logic-based framework for understanding organisational change process for a health IT implementation.

PubMed

Diment, Kieren; Garrety, Karin; Yu, Ping

2011-01-01

This paper describes how a method for evaluating organisational change based on the theory of logical types can be used for classifying organisational change processes to understand change after the implementation of an electronic documentation system in a residential aged care facility. In this instance we assess the organisational change reflected by care staff's perceptions of the benefits of the new documentation system at one site, at pre-implementation, and at 12 months post-implementation. The results show how a coherent view from the staff as a whole of the personal benefits, the benefits for others and the benefits for the organization create a situation of positive feedback leading to embeddedness of the documentation system into the site, and a broader appreciation of the potential capabilities of the electronic documentation system.

Considerations regarding the deployment of hypermedia at JSC

NASA Technical Reports Server (NTRS)

Kacmar, Charles J.

1993-01-01

Electronic documents and systems are becoming the primary means of managing information for ground and space operations at NASA. These documents will utilize hypertext and hypermedia technologies to aid users in structuring and accessing information. Documents will be composed of static and dynamic data consisting of user-defined annotations and hypermedia links. The report consists of three major sections. First, it provides an overview of hypermedia and surveys the use of hypermedia throughout JSC. Second, it briefly describes a prototypical hypermedia system that was developed in conjunction with this work. This system was constructed to demonstrate various hypermedia features and to serve as a platform for supporting the electronic documentation needs for the MIDAS system developed by the Intelligent Systems Branch of the Automation and Robotics Division (Pac92). Third, it discusses emerging hypermedia technologies which have either been untapped by vendors or present significant challenges to the Agency.

76 FR 4390 - Draft Regulatory Guide: Comment Period Extension and Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

....'' This Federal Register notice stated that electronic copies of DG-1229 were available in the NRC's Agencywide Documents Access and Management System (ADAMS) ( http://www.nrc.gov/reading-rm/adams.html ), under... Documents Access and Management System (ADAMS): Publicly available documents created or received at the NRC...

36 CFR § 1236.12 - What other records management and preservation considerations must be incorporated into the...

Code of Federal Regulations, 2013 CFR

2013-07-01

... exchange of electronic documents between offices using different software or operating systems. ... of electronic information systems? § 1236.12 Section § 1236.12 Parks, Forests, and Public Property... Management and Preservation Considerations for Designing and Implementing Electronic Information Systems...

Teaching home care electronic documentation skills to undergraduate nursing students.

PubMed

Nokes, Kathleen M; Aponte, Judith; Nickitas, Donna M; Mahon, Pamela Y; Rodgers, Betsy; Reyes, Nancy; Chaya, Joan; Dornbaum, Martin

2012-01-01

Although there is general consensus that nursing students need knowledge and significant skill to document clinical findings electronically, nursing faculty face many barriers in ensuring that undergraduate students can practice on electronic health record systems (EHRS). External funding supported the development of an educational innovation through a partnership between a home care agency staff and nursing faculty. Modules were developed to teach EHRS skills using a case study of a homebound person requiring wound care and the Medicare-required OASIS documentation system. This article describes the development and implementation of the module for an upper-level baccalaureate nursing program located in New York City. Nursing faculty are being challenged to develop creative and economical solutions to expose nursing students to EHRSs in nonclinical settings.

Using an educational electronic documentation system to help nursing students accurately identify patient data.

PubMed

Pobocik, Tamara

2015-01-01

This quantitative research study used a pretest/posttest design and reviewed how an educational electronic documentation system helped nursing students to identify the accurate "related to" statement of the nursing diagnosis for the patient in the case study. Students in the sample population were senior nursing students in a bachelor of science nursing program in the northeastern United States. Two distinct groups were used for a control and intervention group. The intervention group used the educational electronic documentation system for three class assignments. Both groups were given a pretest and posttest case study. The Accuracy Tool was used to score the students' responses to the related to statement of a nursing diagnosis given at the end of the case study. The scores of the Accuracy Tool were analyzed, and then the numeric scores were placed in SPSS, and the paired t test scores were analyzed for statistical significance. The intervention group's scores were statistically different from the pretest scores to posttest scores, while the control group's scores remained the same from pretest to posttest. The recommendation to nursing education is to use the educational electronic documentation system as a teaching pedagogy to help nursing students prepare for nursing practice. © 2014 NANDA International, Inc.

Document Management in Local Government.

ERIC Educational Resources Information Center

Williams, Bernard J. S.

1998-01-01

The latest in electronic document management in British local government is discussed. Finance, revenues, and benefits systems of leading vendors to local authorities are highlighted. A planning decisions archive management system and other information services are discussed. (AEF)

75 FR 42462 - Notice of Acceptance for Docketing of the Application and Notice of Opportunity for Hearing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... NRC's Agencywide Documents Access and Management System (ADAMS) Public Electronic Reading Room on the... receipt of the document. The E-Filing system also distributes an e-mail notice that provides access to the... intervene is filed so that they can obtain access to the document via the E-Filing system. A person filing...

48 CFR 252.232-7006 - Wide Area WorkFlow Payment Instructions.

Code of Federal Regulations, 2013 CFR

2013-10-01

...— (1) Have a designated electronic business point of contact in the System for Award Management at... submission. Document submissions may be via Web entry, Electronic Data Interchange, or File Transfer Protocol... that uniquely identifies a unit, activity, or organization. Document type means the type of payment...

48 CFR 252.232-7006 - Wide Area WorkFlow Payment Instructions.

Code of Federal Regulations, 2014 CFR

2014-10-01

...— (1) Have a designated electronic business point of contact in the System for Award Management at... submission. Document submissions may be via Web entry, Electronic Data Interchange, or File Transfer Protocol... that uniquely identifies a unit, activity, or organization. Document type means the type of payment...

The Document Management Alliance.

ERIC Educational Resources Information Center

Fay, Chuck

1998-01-01

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

Exploring Midwives' Need and Intention to Adopt Electronic Integrated Antenatal Care

PubMed Central

Markam, Hosizah; Hochheiser, Harry; Kuntoro, Kuntoro; Notobroto, Hari Basuki

2018-01-01

Documentation requirements for the Indonesian integrated antenatal care (ANC) program suggest the need for electronic systems to address gaps in existing paper documentation practices. Our goals were to quantify midwives' documentation completeness in a primary healthcare center, understand documentation challenges, develop a tool, and assess intention to use the tool. We analyzed existing ANC records in a primary healthcare center in Bangkalan, East Java, and conducted interviews with stakeholders to understand needs for an electronic system in support of ANC. Development of the web-based Electronic Integrated ANC (e-iANC) system used the System Development Life Cycle method. Training on the use of the system was held in the computer laboratory for 100 midwives chosen from four primary healthcare centers in each of five regions. The Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire was used to assess their intention to adopt e-iANC. The midwives' intention to adopt e-iANC was significantly influenced by performance expectancy, effort expectancy and facilitating conditions. Age, education level, and computer literacy did not significantly moderate the effects of performance expectancy and effort expectancy on adoption intention. The UTAUT results indicated that the factors that might influence intention to adopt e-iANC are potentially addressable. Results suggest that e-iANC might well be accepted by midwives. PMID:29618961

77 FR 26791 - Records Schedules; Availability and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

...-374- 09-7, 1 item, 1 temporary item). Master files of an electronic information system containing...-2012-0006, 1 item, 1 temporary item). Master files of an electronic information system used to document...-0001, 2 items, 2 temporary items). Master files and outputs of an electronic information system used to...

An electronic registry for physiotherapists in Belgium.

PubMed

Buyl, Ronald; Nyssen, Marc

2008-01-01

This paper describes the results of the KINELECTRICS project. Since more and more clinical documents are stored and transmitted in an electronic way, the aim of this project was to design an electronic version of the registry that contains all acts of physiotherapists. The solution we present here, not only meets all legal constraints, but also enables to verify the traceability and inalterability of the generated documents, by means of SHA-256 codes. The proposed structure, using XML technology can also form a basis for the development of tools that can be used by the controlling authorities. By means of a certification procedure for software systems, we succeeded in developing a user friendly system that enables end-users that use a quality labeled software package, to automatically produce all the legally necessary documents concerning the registry. Moreover, we hope that this development will be an incentive for non-users to start working in an electronic way.

Procedure for Implementing the Cross-Media Electronic Reporting Regulation (CROMERR) for EPA and Co-Regulator Systems

EPA Pesticide Factsheets

This procedure describes how to apply for and obtain approval of electronic reporting systems used to receive electronic documents in lieu of paper where the report is made pursuant to requirements or authority codified in CFR 40.

The development of efficient coding for an electronic mail system

NASA Technical Reports Server (NTRS)

Rice, R. F.

1983-01-01

Techniques for efficiently representing scanned electronic documents were investigated. Major results include the definition and preliminary performance results of a Universal System for Efficient Electronic Mail (USEEM), offering a potential order of magnitude improvement over standard facsimile techniques for representing textual material.

Electronic Nursing Documentation: Patient Care Continuity Using the Clinical Care Classification System (CCC).

PubMed

Whittenburg, Luann; Meetim, Aunchisa

2016-01-01

An innovative nursing documentation project conducted at Bumrungrad International Hospital in Bangkok, Thailand demonstrated patient care continuity between nursing patient assessments and nursing Plans of Care using the Clinical Care Classification System (CCC). The project developed a new generation of interactive nursing Plans of Care using the six steps of the American Nurses Association (ANA) Nursing process and the MEDCIN^® clinical knowledgebase to present CCC coded concepts as a natural by-product of a nurse's documentation process. The MEDCIN^® clinical knowledgebase is a standardized point-of-care terminology intended for use in electronic health record systems. The CCC is an ANA recognized nursing terminology.

A Business Case for Electronic Commerce

DTIC Science & Technology

1990-09-01

Electronic Commerce . This report presents the results of that examination. Based upon an examination of 16 key documents, we estimate that DoD could realize direct and indirect cost savings of almost $1.2 billion over a 10-year period by replacing these manually processed documents with their electronic equivalents. To achieve those savings, DoD would need to make investments totaling approximately $80 million in new systems and procedures. (Author)

75 FR 48629 - Electronic Tariff Filing System (ETFS)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

...In this document, the Federal Communications Commission (Commission) seeks comment on extending the electronic tariff filing requirement for incumbent local exchange carriers to all carriers that file tariffs and related documents. Additionally, the Commission seeks comment on the appropriate time frame for implementing this proposed requirement. The Commission also seeks comment on the proposal that the Chief of the Wireline Competition Bureau administer the adoption of this extended electronic filing requirement. Also, the Commission seeks comment on proposed rule changes to implement mandatory electronic tariff filing.

Nurses' Perceptions of Nursing Care Documentation in the Electronic Health Record

ERIC Educational Resources Information Center

Jensen, Tracey A.

2013-01-01

Electronic health records (EHRs) will soon become the standard for documenting nursing care. The EHR holds the promise of rapid access to complete records of a patient's encounter with the healthcare system. It is the expectation that healthcare providers input essential data that communicates important patient information to support quality…

Defining Usability Heuristics for Adoption and Efficiency of an Electronic Workflow Document Management System

ERIC Educational Resources Information Center

Fuentes, Steven

2017-01-01

Usability heuristics have been established for different uses and applications as general guidelines for user interfaces. These can affect the implementation of industry solutions and play a significant role regarding cost reduction and process efficiency. The area of electronic workflow document management (EWDM) solutions, also known as…

An Automated System for the Maintenance of Multiform Documentation

NASA Astrophysics Data System (ADS)

Rousseau, Bertrand; Ruggier, Mario; Smith, Matthiew

Software documentation for the user often exists in several forms including paper, electronic, on-line help, etc. We have build a system to help with the writing and maintenance of such kinds of documentation which relies on the FrameMaker product. As an example, we show how it is used to maintain the ADAMO documentation, delivered in 4 incarnations on paper, WWW hypertext, KUIP and running examples. The use of the system results in both time saving and quality improvements.

Procedure for Electronic Management of Rulemaking and Other Docketed Records in the Federal Docket Management System

EPA Pesticide Factsheets

This procedure identifies the specific requirements, processes and supporting documents EPA uses to electronically manage rulemaking and other docketed records in the Federal Docket Management System (FDMS).

An analysis of electronic document management in oncology care.

PubMed

Poulter, Thomas; Gannon, Brian; Bath, Peter A

2012-06-01

In this research in progress, a reference model for the use of electronic patient record (EPR) systems in oncology is described. The model, termed CICERO, comprises technical and functional components, and emphasises usability, clinical safety and user acceptance. One of the functional components of the model-an electronic document and records management (EDRM) system-is monitored in the course of its deployment at a leading oncology centre in the UK. Specifically, the user requirements and design of the EDRM solution are described.The study is interpretative and forms part a wider research programme to define and validate the CICERO model. Preliminary conclusions confirm the importance of a socio-technical perspective in Onco-EPR system design.

End-User Imaging DISKussions.

ERIC Educational Resources Information Center

McConnell, Pamela Jean

1993-01-01

This third in a series of articles on EDIS (Electronic Document Imaging System) technology focuses on organizational issues. Highlights include computer platforms; management information systems; computer-based skills of staff; new technology and change; time factors; financial considerations; document conversion costs; the benefits of EDIS…

Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation.

PubMed

Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E D

2017-05-01

Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team.

Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

PubMed

Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

2014-05-01

Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P < .001). This improved to baseline levels by the late EHR period (46%, P = .28), although POTD in the cataract group remained worse than at baseline (64%, P < .001). There was a worsening in absolute mean documentation time in the early EHR period (16.7 minutes) vs paper baseline (7.5 minutes) (P < .001). This improved in the late EHR period (9.2 minutes) but remained worse than in the paper baseline (P < .001). While cataract procedures required more circulating nurses in the early EHR (mean, 1.9 nurses/procedure) and late EHR (mean, 1.5 nurses/procedure) periods than in the paper baseline (mean, 1.0 nurses/procedure) (P < .001), overall staffing requirements and surgical volume were not significantly different between the periods. Electronic health record OR management system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

Centralized Accounting and Electronic Filing Provides Efficient Receivables Collection.

ERIC Educational Resources Information Center

School Business Affairs, 1983

1983-01-01

An electronic filing system makes financial control manageable at Bowling Green State University, Ohio. The system enables quick access to computer-stored consolidated account data and microfilm images of charges, statements, and other billing documents. (MLF)

An electronic regulatory document management system for a clinical trial network.

PubMed

Zhao, Wenle; Durkalski, Valerie; Pauls, Keith; Dillon, Catherine; Kim, Jaemyung; Kolk, Deneil; Silbergleit, Robert; Stevenson, Valerie; Palesch, Yuko

2010-01-01

A computerized regulatory document management system has been developed as a module in a comprehensive Clinical Trial Management System (CTMS) designed for an NIH-funded clinical trial network in order to more efficiently manage and track regulatory compliance. Within the network, several institutions and investigators are involved in multiple trials, and each trial has regulatory document requirements. Some of these documents are trial specific while others apply across multiple trials. The latter causes a possible redundancy in document collection and management. To address these and other related challenges, a central regulatory document management system was designed. This manuscript shares the design of the system as well as examples of it use in current studies. Copyright (c) 2009 Elsevier Inc. All rights reserved.

Culture Shock!! "Lesson" the Blow.

ERIC Educational Resources Information Center

Duffin, Ken

1996-01-01

Designing, developing, and implementing an electronic document management system involves preparation. Areas to consider when facilitating technological change include staff input and business and customer needs and wants. Further discussion addresses value assessment of document type, providing a pilot system for staff experiment and practice,…

Advance Care Planning Documentation in Electronic Health Records: Current Challenges and Recommendations for Change.

PubMed

Lamas, Daniela; Panariello, Natalie; Henrich, Natalie; Hammes, Bernard; Hanson, Laura C; Meier, Diane E; Guinn, Nancy; Corrigan, Janet; Hubber, Sean; Luetke-Stahlman, Hannah; Block, Susan

2018-04-01

To develop a set of clinically relevant recommendations to improve the state of advance care planning (ACP) documentation in the electronic health record (EHR). Advance care planning (ACP) is a key process that supports goal-concordant care. For preferences to be honored, clinicians must be able to reliably record, find, and use ACP documentation. However, there are no standards to guide ACP documentation in the electronic health record (EHR). We interviewed 21 key informants to understand the strengths and weaknesses of EHR documentation systems for ACP and identify best practices. We analyzed these interviews using a qualitative content analysis approach and subsequently developed a preliminary set of recommendations. These recommendations were vetted and refined in a second round of input from a national panel of content experts. Informants identified six themes regarding current inadequacies in documentation and accessibility of ACP information and opportunities for improvement. We offer a set of concise, clinically relevant recommendations, informed by expert opinion, to improve the state of ACP documentation in the EHR.

Heuristic evaluation of eNote: an electronic notes system.

PubMed

Bright, Tiffani J; Bakken, Suzanne; Johnson, Stephen B

2006-01-01

eNote is an electronic health record (EHR) system based on semi-structured narrative documents. A heuristic evaluation was conducted with a sample of five usability experts. eNote performed highly in: 1)consistency with standards and 2)recognition rather than recall. eNote needs improvement in: 1)help and documentation, 2)aesthetic and minimalist design, 3)error prevention, 4)helping users recognize, diagnosis, and recover from errors, and 5)flexibility and efficiency of use. The heuristic evaluation was an efficient method of evaluating our interface.

Electronic flight bag (EFB) : 2007 industry review

DOT National Transportation Integrated Search

2007-04-01

This document, which is based on information from March 2007, proivdes an overview of Electronic Flight Bag (EFB) systems and capabilities, with particular focus on the systems' human interface. It updates the April 2005 EFB Industry Review (Yeh and ...

Association of Medical Directors of Information Systems consensus on inpatient electronic health record documentation.

PubMed

Shoolin, J; Ozeran, L; Hamann, C; Bria, W

2013-01-01

In 2013, electronic documentation of clinical care stands at a crossroads. The benefits of creating digital notes are at risk of being overwhelmed by the inclusion of easily importable detail. Providers are the primary authors of encounters with patients. We must document clearly our understanding of patients and our communication with them and our colleagues. We want to document efficiently to meet without exceeding documentation guidelines. We copy and paste documentation, because it not only simplifies the documentation process generally, but also supports meeting coding and regulatory requirements specifically. Since the primary goal of our profession is to spend as much time as possible listening to, understanding and helping patients, clinicians need information technology to make electronic documentation easier, not harder. At the same time, there should be reasonable restrictions on the use of copy and paste to limit the growing challenge of 'note bloat'. We must find the right balance between ease of use and thoughtless documentation. The guiding principles in this document may be used to launch an interdisciplinary dialogue that promotes useful and necessary documentation that best facilitates efficient information capture and effective display.

Document Monitor

NASA Technical Reports Server (NTRS)

1988-01-01

The charters of Freedom Monitoring System will periodically assess the physical condition of the U.S. Constitution, Declaration of Independence and Bill of Rights. Although protected in helium filled glass cases, the documents are subject to damage from light vibration and humidity. The photometer is a CCD detector used as the electronic film for the camera system's scanning camera which mechanically scans the document line by line and acquires a series of images, each representing a one square inch portion of the document. Perkin-Elmer Corporation's photometer is capable of detecting changes in contrast, shape or other indicators of degradation with 5 to 10 times the sensitivity of the human eye. A Vicom image processing computer receives the data from the photometer stores it and manipulates it, allowing comparison of electronic images over time to detect changes.

Tracking Patient Education Documentation across Time and Care Settings

PubMed Central

Janousek, Lisa; Heermann, Judith; Eilers, June

2005-01-01

Results of a formative evaluation of a patient education documentation system will be presented. Both quantitative and qualitative approaches to data collection are being used. The goal of integrating patient education documentation into the electronic patient record is to facilitate seamless, multidisciplinary patient/family education across time and settings. The system is being piloted by oncology services at The Nebraska Medical Center. The evaluation addresses the usability and comprehensiveness of the system. PMID:16779280

A Framework for Global Electronic Commerce: An Executive Summary.

ERIC Educational Resources Information Center

Office of the Press Secretary of the White House

1997-01-01

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

Large-Scale Document Automation: The Systems Integration Issue.

ERIC Educational Resources Information Center

Kalthoff, Robert J.

1985-01-01

Reviews current technologies for electronic imaging and its recording and transmission, including digital recording, optical data disks, automated image-delivery micrographics, high-density-magnetic recording, and new developments in telecommunications and computers. The role of the document automation systems integrator, who will bring these…

Nurses' Experiences of an Initial and Reimplemented Electronic Health Record Use.

PubMed

Chang, Chi-Ping; Lee, Ting-Ting; Liu, Chia-Hui; Mills, Mary Etta

2016-04-01

The electronic health record is a key component of healthcare information systems. Currently, numerous hospitals have adopted electronic health records to replace paper-based records to document care processes and improve care quality. Integrating healthcare information system into traditional nursing daily operations requires time and effort for nurses to become familiarized with this new technology. In the stages of electronic health record implementation, smooth adoption can streamline clinical nursing activities. In order to explore the adoption process, a descriptive qualitative study design and focus group interviews were conducted 3 months after and 2 years after electronic health record system implementation (system aborted 1 year in between) in one hospital located in southern Taiwan. Content analysis was performed to analyze the interview data, and six main themes were derived, in the first stage: (1) liability, work stress, and anticipation for electronic health record; (2) slow network speed, user-unfriendly design for learning process; (3) insufficient information technology/organization support; on the second stage: (4) getting used to electronic health record and further system requirements, (5) benefits of electronic health record in time saving and documentation, (6) unrealistic information technology competence expectation and future use. It concluded that user-friendly design and support by informatics technology and manpower backup would facilitate this adoption process as well.

Imaged Document Optical Correlation and Conversion System (IDOCCS)

NASA Astrophysics Data System (ADS)

Stalcup, Bruce W.; Dennis, Phillip W.; Dydyk, Robert B.

1999-03-01

Today, the paper document is fast becoming a thing of the past. With the rapid development of fast, inexpensive computing and storage devices, many government and private organizations are archiving their documents in electronic form (e.g., personnel records, medical records, patents, etc.). In addition, many organizations are converting their paper archives to electronic images, which are stored in a computer database. Because of this, there is a need to efficiently organize this data into comprehensive and accessible information resources. The Imaged Document Optical Correlation and Conversion System (IDOCCS) provides a total solution to the problem of managing and retrieving textual and graphic information from imaged document archives. At the heart of IDOCCS, optical correlation technology provides the search and retrieval capability of document images. The IDOCCS can be used to rapidly search for key words or phrases within the imaged document archives and can even determine the types of languages contained within a document. In addition, IDOCCS can automatically compare an input document with the archived database to determine if it is a duplicate, thereby reducing the overall resources required to maintain and access the document database. Embedded graphics on imaged pages can also be exploited, e.g., imaged documents containing an agency's seal or logo, or documents with a particular individual's signature block, can be singled out. With this dual capability, IDOCCS outperforms systems that rely on optical character recognition as a basis for indexing and storing only the textual content of documents for later retrieval.

Locating and Searching Electronic Documents: A User Study of Supply Publications in the United States Marine Corps

DTIC Science & Technology

2007-12-01

Boyle, “Important issues in hypertext documentation usability,” In Proceedings of the 9th Annual international Conference on Systems Documentation...Tufte’s principles of information design to creating effective Web sites.” In Proceedings of the 15th Annual international Conference on Computer...usability,” In Proceedings of the 9th Annual international Conference on Systems Documentation (Chicago, Illinois, 1991). SIGDOC 󈨟. ACM, New York, NY

To Image...or Not to Image?

ERIC Educational Resources Information Center

Bruley, Karina

1996-01-01

Provides a checklist of considerations for installing document image processing with an electronic document management system. Other topics include scanning; indexing; the image file life cycle; benefits of imaging; document-driven workflow; and planning for workplace changes like postsorting, creating a scanning room, redeveloping job tasks and…

Family Registration Card as electronic medical carrier in Bosnia and Herzegovina.

PubMed

Novo, Ahmed; Masic, Izet; Toromanovic, Selim; Loncarevic, Nedim; Junuzovic, Dzelaludin; Dizdarevic, Jadranka

2004-01-01

Medical documentation is a very important part of the medical documentalistics and is occupies a large part of daily work of medical staff working in Primary Health Care. Paper documentation is going to be replaced by electronic cards in Bosnia and Herzegovina and a new Health Care System is under development, based on an Electronic Family Registration Card. Developed countries proceeded from the manual and semiautomatic method of medical data processing to the new method of entering, storage, transferring, searching and protecting data, using electronic equipment. Currently, many European countries have developed a Medical Card Based Electronic Information System. Three types of electronic card are currently in use: a Hybrid Card, a Smart Card and a Laser Card. The dilemma is which card should be used as a data carrier. The Electronic Family Registration Cared is a question of strategic interest for B&H, but also a great investment. We should avoid the errors of other countries that have been developing card-based system. In this article we present all mentioned cards and compare advantages and disadvantages of different technologies.

Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation

PubMed Central

Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E.D.

2017-01-01

Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined “norm.” Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team. PMID:27832032

Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems

PubMed Central

2012-01-01

Background Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT. Methods Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed. Results 417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions. Conclusions Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT. Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care. PMID:22230095

Evidence-based use of electronic clinical tracking systems in advanced practice registered nurse education: an integrative review.

PubMed

Branstetter, M Laurie; Smith, Lynette S; Brooks, Andrea F

2014-07-01

Over the past decade, the federal government has mandated healthcare providers to incorporate electronic health records into practice by 2015. This technological update in healthcare documentation has generated a need for advanced practice RN programs to incorporate information technology into education. The National Organization of Nurse Practitioner Faculties created core competencies to guide program standards for advanced practice RN education. One core competency is Technology and Information Literacy. Educational programs are moving toward the utilization of electronic clinical tracking systems to capture students' clinical encounter data. The purpose of this integrative review was to evaluate current research on advanced practice RN students' documentation of clinical encounters utilizing electronic clinical tracking systems to meet advanced practice RN curriculum outcome goals in information technology as defined by the National Organization of Nurse Practitioner Faculties. The state of the science depicts student' and faculty attitudes, preferences, opinions, and data collections of students' clinical encounters. Although electronic clinical tracking systems were utilized to track students' clinical encounters, these systems have not been evaluated for meeting information technology core competency standards. Educational programs are utilizing electronic clinical tracking systems with limited evidence-based literature evaluating the ability of these systems to meet the core competencies in advanced practice RN programs.

Fast title extraction method for business documents

NASA Astrophysics Data System (ADS)

Katsuyama, Yutaka; Naoi, Satoshi

1997-04-01

Conventional electronic document filing systems are inconvenient because the user must specify the keywords in each document for later searches. To solve this problem, automatic keyword extraction methods using natural language processing and character recognition have been developed. However, these methods are slow, especially for japanese documents. To develop a practical electronic document filing system, we focused on the extraction of keyword areas from a document by image processing. Our fast title extraction method can automatically extract titles as keywords from business documents. All character strings are evaluated for similarity by rating points associated with title similarity. We classified these points as four items: character sitting size, position of character strings, relative position among character strings, and string attribution. Finally, the character string that has the highest rating is selected as the title area. The character recognition process is carried out on the selected area. It is fast because this process must recognize a small number of patterns in the restricted area only, and not throughout the entire document. The mean performance of this method is an accuracy of about 91 percent and a 1.8 sec. processing time for an examination of 100 Japanese business documents.

32 CFR 989.35 - Reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... documents electronically. Public review comments should be required in writing, rather than by electronic... measures will be tracked at bases and MAJCOMs through an appropriate environmental management system. (b...

32 CFR 989.35 - Reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... documents electronically. Public review comments should be required in writing, rather than by electronic... measures will be tracked at bases and MAJCOMs through an appropriate environmental management system. (b...

32 CFR 989.35 - Reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... documents electronically. Public review comments should be required in writing, rather than by electronic... measures will be tracked at bases and MAJCOMs through an appropriate environmental management system. (b...

32 CFR 989.35 - Reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documents electronically. Public review comments should be required in writing, rather than by electronic... measures will be tracked at bases and MAJCOMs through an appropriate environmental management system. (b...

32 CFR 989.35 - Reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documents electronically. Public review comments should be required in writing, rather than by electronic... measures will be tracked at bases and MAJCOMs through an appropriate environmental management system. (b...

76 FR 61956 - Electronic Tariff Filing System (ETFS)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

...] Electronic Tariff Filing System (ETFS) AGENCY: Federal Communications Commission. ACTION: Final rule; announcement of effective date. SUMMARY: In this document, the Commission announces that the Office of Management and Budget (OMB) has approved, for a period of three years, the information collection associated...

Pilot production system cost/benefit analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage (DDS)/Pilot Production System (PPS) will provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The DDS/PPS will result in major benefits, such as improved document reproduction quality within a shorter time frame than is currently possible. In addition, the DDS/PPS will provide an important strategic value through the construction of a digital document archive. It is highly recommended that NASA proceed with the DDS Prototype System and a rapid prototyping development methodology in order to validate recent working assumptions upon which the success of the DDS/PPS is dependent.

Electronic Document Management Systems: Where Are They Today?

ERIC Educational Resources Information Center

Koulopoulos, Thomas M.; Frappaolo, Carl

1993-01-01

Discusses developments in document management systems based on a survey of over 400 corporations and government agencies. Text retrieval and imaging markets, architecture and integration, purchasing plans, and vendor market leaders are covered. Five graphs present data on user preferences for improvements. A sidebar article reviews the development…

Automating Document Delivery: A Conference Report.

ERIC Educational Resources Information Center

Ensor, Pat

1992-01-01

Describes presentations made at a forum on automation, interlibrary loan (ILL), and document delivery sponsored by the Houston Area Library Consortium. Highlights include access versus ownership; software for ILL; fee-based services; automated management systems for ILL; and electronic mail and online systems for end-user-generated ILL requests.…

Designing an Electronic Patient Management System for Multiple Sclerosis: Building a Next Generation Multiple Sclerosis Documentation System.

PubMed

Kern, Raimar; Haase, Rocco; Eisele, Judith Christina; Thomas, Katja; Ziemssen, Tjalf

2016-01-08

Technologies like electronic health records or telemedicine devices support the rapid mediation of health information and clinical data independent of time and location between patients and their physicians as well as among health care professionals. Today, every part of the treatment process from diagnosis, treatment selection, and application to patient education and long-term care may be enhanced by a quality-assured implementation of health information technology (HIT) that also takes data security standards and concerns into account. In order to increase the level of effectively realized benefits of eHealth services, a user-driven needs assessment should ensure the inclusion of health care professional perspectives into the process of technology development as we did in the development process of the Multiple Sclerosis Documentation System 3D. After analyzing the use of information technology by patients suffering from multiple sclerosis, we focused on the needs of neurological health care professionals and their handling of health information technology. Therefore, we researched the status quo of eHealth adoption in neurological practices and clinics as well as health care professional opinions about potential benefits and requirements of eHealth services in the field of multiple sclerosis. We conducted a paper-and-pencil-based mail survey in 2013 by sending our questionnaire to 600 randomly chosen neurological practices in Germany. The questionnaire consisted of 24 items covering characteristics of participating neurological practices (4 items), the current use of network technology and the Internet in such neurological practices (5 items), physicians' attitudes toward the general and MS-related usefulness of eHealth systems (8 items) and toward the clinical documentation via electronic health records (4 items), and physicians' knowledge about the Multiple Sclerosis Documentation System (3 items). From 600 mailed surveys, 74 completed surveys were returned. As much as 9 of the 10 practices were already connected to the Internet (67/74), but only 49% preferred a permanent access. The most common type of HIT infrastructure was a complete practice network with several access points. Considering data sharing with research registers, 43% opted for an online interface, whereas 58% decided on an offline method of data transmission. eHealth services were perceived as generally useful for physicians and nurses in neurological practices with highest capabilities for improvements in clinical documentation, data acquisition, diagnosis of specific MS symptoms, physician-patient communication, and patient education. Practices specialized in MS in comparison with other neurological practices presented an increased interest in online documentation. Among the participating centers, 91% welcomed the opportunity of a specific clinical documentation for MS and 87% showed great interest in an extended and more interconnected electronic documentation of MS patients. Clinical parameters (59/74) were most important in documentation, followed by symptomatic parameters like measures of fatigue or depression (53/74) and quality of life (47/74). Physicians and nurses may significantly benefit from an electronically assisted documentation and patient management. Many aspects of patient documentation and education will be enhanced by eHealth services if the most informative measures are integrated in an easy-to-use and easily connectable approach. MS-specific eHealth services were highly appreciated, but the current level of adoption is still behind the level of interest in an extended and more interconnected electronic documentation of MS patients.

Definition of an XML markup language for clinical laboratory procedures and comparison with generic XML markup.

PubMed

Saadawi, Gilan M; Harrison, James H

2006-10-01

Clinical laboratory procedure manuals are typically maintained as word processor files and are inefficient to store and search, require substantial effort for review and updating, and integrate poorly with other laboratory information. Electronic document management systems could improve procedure management and utility. As a first step toward building such systems, we have developed a prototype electronic format for laboratory procedures using Extensible Markup Language (XML). Representative laboratory procedures were analyzed to identify document structure and data elements. This information was used to create a markup vocabulary, CLP-ML, expressed as an XML Document Type Definition (DTD). To determine whether this markup provided advantages over generic markup, we compared procedures structured with CLP-ML or with the vocabulary of the Health Level Seven, Inc. (HL7) Clinical Document Architecture (CDA) narrative block. CLP-ML includes 124 XML tags and supports a variety of procedure types across different laboratory sections. When compared with a general-purpose markup vocabulary (CDA narrative block), CLP-ML documents were easier to edit and read, less complex structurally, and simpler to traverse for searching and retrieval. In combination with appropriate software, CLP-ML is designed to support electronic authoring, reviewing, distributing, and searching of clinical laboratory procedures from a central repository, decreasing procedure maintenance effort and increasing the utility of procedure information. A standard electronic procedure format could also allow laboratories and vendors to share procedures and procedure layouts, minimizing duplicative word processor editing. Our results suggest that laboratory-specific markup such as CLP-ML will provide greater benefit for such systems than generic markup.

[Resources of information in the field of bioethics in Italy: survey of the present state and perspectives].

PubMed

Della Seta, Maurella; Sellitri, Cinzia

2004-01-01

The research project "Collection and dissemination of bioethical information through an integrated electronic system", started in 2001 by the Istituto Superiore di Sanità (ISS), had among its objectives, the realization of an integrated system for data collection and exchange of documents related to bioethics. The system should act as a reference tool for those research activities impacting on citizens' health and welfare. This paper aims at presenting some initiatives, developed in the project framework, in order to establish an Italian documentation network, among which: a) exchange of ISS publications with Italian institutions active in this field; b) survey through a questionnaire aimed at assessing Italian informative resources, state-of-the-art and holdings of documentation centres and ethical committees; c) Italian Internet resources analysis. The results of the survey, together with the analysis of web sites, show that at present in Italy there are many interesting initiatives for collecting and spreading of documentation in the bioethical fields, but there is an urgent need for an integration of such resources. Ethical committees generally speaking need a larger availability of documents, while there are good potentialities for the establishment of an electronic network for document retrieval and delivery.

76 FR 64115 - Privacy Act of 1974; Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

...-leaf binders or file folders, and in electronic media, including NASA's Ethics Program Tracking System... documents, electronic media, micrographic media, photographs, or motion pictures film, and various medical....; General Accounting Office's General Policies/Procedures and Communications Manual, Chapter 7; Treasury...

48 CFR 252.232-7003 - Electronic submission of payment requests and receiving reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... not acceptable electronic forms for submission of payment requests. However, scanned documents are... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Electronic submission of... PROVISIONS AND CONTRACT CLAUSES Text of Provisions And Clauses 252.232-7003 Electronic submission of payment...

48 CFR 252.232-7003 - Electronic submission of payment requests and receiving reports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... not acceptable electronic forms for submission of payment requests. However, scanned documents are... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Electronic submission of... PROVISIONS AND CONTRACT CLAUSES Text of Provisions And Clauses 252.232-7003 Electronic submission of payment...

48 CFR 252.232-7003 - Electronic submission of payment requests and receiving reports.

Code of Federal Regulations, 2014 CFR

2014-10-01

... not acceptable electronic forms for submission of payment requests. However, scanned documents are... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Electronic submission of... PROVISIONS AND CONTRACT CLAUSES Text of Provisions And Clauses 252.232-7003 Electronic submission of payment...

48 CFR 252.232-7003 - Electronic submission of payment requests and receiving reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... not acceptable electronic forms for submission of payment requests. However, scanned documents are... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Electronic submission of... PROVISIONS AND CONTRACT CLAUSES Text of Provisions And Clauses 252.232-7003 Electronic submission of payment...

48 CFR 252.232-7003 - Electronic submission of payment requests and receiving reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... not acceptable electronic forms for submission of payment requests. However, scanned documents are... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Electronic submission of... PROVISIONS AND CONTRACT CLAUSES Text of Provisions And Clauses 252.232-7003 Electronic submission of payment...

Categories of Electronic Publications in a College Information System. AIR 1992 Annual Forum Paper.

ERIC Educational Resources Information Center

Taylor, Allan

This paper identifies and describes the categories of electronic publications (EPs) in a document-based communication and information system called JIMMY, developed by Queen Margaret College (Edinburgh, Scotland) for use by students and staff in general arts and paramedical courses. The use of computer-mediated communication systems like bulletin…

Functional Requirements for an Electronic Work Package System

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

Oxstrand, Johanna H.

This document provides a set of high level functional requirements for a generic electronic work package (eWP) system. The requirements have been identified by the U.S. nuclear industry as a part of the Nuclear Electronic Work Packages - Enterprise Requirements (NEWPER) initiative. The functional requirements are mainly applied to eWP system supporting Basic and Moderate types of smart documents, i.e., documents that have fields for recording input such as text, dates, numbers, and equipment status, and documents which incorporate additional functionalities such as form field data “type“ validation (e.g. date, text, number, and signature) of data entered and/or self-populate basicmore » document information (usually from existing host application meta data) on the form when the user first opens it. All the requirements are categorized by the roles; Planner, Supervisor, Craft, Work Package Approval Reviewer, Operations, Scheduling/Work Control, and Supporting Functions. The categories Statistics, Records, Information Technology are also included used to group the requirements. All requirements are presented in Section 2 through Section 11. Examples of more detailed requirements are provided for the majority of high level requirements. These examples are meant as an inspiration to be used as each utility goes through the process of identifying their specific requirements. The report’s table of contents provides a summary of the high level requirements.« less

Full-scale system impact analysis: Digital document storage project

NASA Technical Reports Server (NTRS)

1989-01-01

The Digital Document Storage Full Scale System can provide cost effective electronic document storage, retrieval, hard copy reproduction, and remote access for users of NASA Technical Reports. The desired functionality of the DDS system is highly dependent on the assumed requirements for remote access used in this Impact Analysis. It is highly recommended that NASA proceed with a phased, communications requirement analysis to ensure that adequate communications service can be supplied at a reasonable cost in order to validate recent working assumptions upon which the success of the DDS Full Scale System is dependent.

Metrics for Electronic-Nursing-Record-Based Narratives: cross-sectional analysis.

PubMed

Kim, Kidong; Jeong, Suyeon; Lee, Kyogu; Park, Hyeoun-Ae; Min, Yul Ha; Lee, Joo Yun; Kim, Yekyung; Yoo, Sooyoung; Doh, Gippeum; Ahn, Soyeon

2016-11-30

We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system. The standardized number of nursing narratives (i.e., the total number of nursing narratives divided by the length of the hospital stay) was suggested to integrate the frequency and quantity of nursing documentation. The standardized number of nursing narratives was higher for patients aged ≥ 70 years (median = 30.2 narratives/day, interquartile range [IQR] = 24.0-39.4 narratives/day), long (≥ 8 days) hospital stays (median = 34.6 narratives/day, IQR = 27.2-43.5 narratives/day), and hospital deaths (median = 59.1 narratives/day, IQR = 47.0-74.8 narratives/day). The standardized number of narratives was higher in "pregnancy, childbirth, and puerperium" (median = 46.5, IQR = 39.0-54.7) and "diseases of the circulatory system" admissions (median = 35.7, IQR = 29.0-43.4). Diverse hospital admissions can be consistently described with nursing-document-derived metrics for similar hospital admissions and diagnoses. Some areas of hospital admissions may have consistently increasing volumes of nursing documentation across years. Usability of electronic nursing document metrics for evaluating healthcare requires multiple aspects of hospital admissions to be considered.

Security and Privacy in a DACS.

PubMed

Delgado, Jaime; Llorente, Silvia; Pàmies, Martí; Vilalta, Josep

2016-01-01

The management of electronic health records (EHR), in general, and clinical documents, in particular, is becoming a key issue in the daily work of Healthcare Organizations (HO). The need for providing secure and private access to, and storage for, clinical documents together with the need for HO to interoperate, raises a number of issues difficult to solve. Many systems are in place to manage EHR and documents. Some of these Healthcare Information Systems (HIS) follow standards in their document structure and communications protocols, but many do not. In fact, they are mostly proprietary and do not interoperate. Our proposal to solve the current situation is the use of a DACS (Document Archiving and Communication System) for providing security, privacy and standardized access to clinical documents.

The NPG 7120.5A Electronic Review Process

NASA Technical Reports Server (NTRS)

McBrayer, Robert; Ives, Mark

1998-01-01

The use of electronics to review a document is well within the technical realm of today's state-of-the-art workplace. File servers and web site interaction are common tools for many NASA employees. The electronic comment processing described here was developed for the NPG 7120.5A review to augment the existing NASA Online Directives Information System (NODIS). The NODIS system is NASA's official system for formal review, approval and storage of NASA Directives. The electronic review process worked so well that NASA and other agencies may want to consider it as one of our "best practices." It was participatory decision making at its very best, a process that attracted dozens of very good ideas to improve the document as well as the way we can be managing projects far more effectively. The revision of NPG 7120.5A has significant implications for the way all elements of the Agency accomplish program and project management. Therefore, the review of NPG 7120.5A was an Agencywide effort with high visibility, heavy participation and a short schedule. The level of involvement created interest in supplementing the formal NODIS system with a system to collect comments efficiently and to allow the Centers and Codes to review and consolidate their comments into the official system in a short period of time. In addition, the Program Management Council Working Group (PMCWG), responsible for the revision of the document and the disposition of official comments, needed an electronic system to manage the disposition of comments, obtain PMCWG consensus on each disposition, and coordinate the disposition with the appropriate Headquarters Code that had submitted the official comment. The combined NASA and contractor talents and resources provided a system that supplemented the NODIS system and its operating personnel to produce a thorough review and approval of NPG 7120.5A on April 3, 1998, 7.5 months from the start of the process. The original six-month schedule is indicated. All milestones occurred on time, except for completion of comment disposition, which required an additional 30 days. Approval of the document occurred sixteen days after completion of the "Purple Package."

Electronic Approval: Another Step toward a Paperless Office.

ERIC Educational Resources Information Center

Blythe, Kenneth C.; Morrison, Dennis L.

1992-01-01

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

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... this part shall be electronically transmitted through the E-Filing system, unless the Commission or... all methods of filing have been completed. (e) For filings by electronic transmission, the filer must... digital ID certificates, the NRC permits participants in the proceeding to access the E-Filing system to...

Imaged document information location and extraction using an optical correlator

NASA Astrophysics Data System (ADS)

Stalcup, Bruce W.; Dennis, Phillip W.; Dydyk, Robert B.

1999-12-01

Today, the paper document is fast becoming a thing of the past. With the rapid development of fast, inexpensive computing and storage devices, many government and private organizations are archiving their documents in electronic form (e.g., personnel records, medical records, patents, etc.). Many of these organizations are converting their paper archives to electronic images, which are then stored in a computer database. Because of this, there is a need to efficiently organize this data into comprehensive and accessible information resources and provide for rapid access to the information contained within these imaged documents. To meet this need, Litton PRC and Litton Data Systems Division are developing a system, the Imaged Document Optical Correlation and Conversion System (IDOCCS), to provide a total solution to the problem of managing and retrieving textual and graphic information from imaged document archives. At the heart of IDOCCS, optical correlation technology provide a means for the search and retrieval of information from imaged documents. IDOCCS can be used to rapidly search for key words or phrases within the imaged document archives and has the potential to determine the types of languages contained within a document. In addition, IDOCCS can automatically compare an input document with the archived database to determine if it is a duplicate, thereby reducing the overall resources required to maintain and access the document database. Embedded graphics on imaged pages can also be exploited, e.g., imaged documents containing an agency's seal or logo can be singled out. In this paper, we present a description of IDOCCS as well as preliminary performance results and theoretical projections.

76 FR 80980 - Notice of Acceptance for Docketing of the Application, Notice of Opportunity for Hearing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Agencywide Documents Access and Management System (ADAMS) Public Electronic Reading Room online in the NRC... of the document. The E-Filing system also distributes an email notice that provides access to the... Docketing of the Application, Notice of Opportunity for Hearing, Regarding Renewal of Facility Operating...

Use of Electronic Documentation for Quality Improvement in Hospice

PubMed Central

Cagle, John G.; Rokoske, Franziska S.; Durham, Danielle; Schenck, Anna P.; Spence, Carol; Hanson, Laura C.

2015-01-01

Little evidence exists on the use of electronic documentation in hospice and its relationship to quality improvement practices. The purposes of this study were to: (1) estimate the prevalence of electronic documentation use in hospice; (2) identify organizational characteristics associated with use of electronic documentation; and (3) determine whether quality measurement practices differed based on documentation format (electronic vs. nonelectronic). Surveys concerning the use of electronic documentation for quality improvement practices and the monitoring of quality-related care and outcomes were collected from 653 hospices. Users of electronic documentation were able to monitor a wider range of quality-related data than users of nonelectronic documentation. Quality components such as advanced care planning, cultural needs, experience during care of the actively dying, and the number/types of care being delivered were more likely to be documented by users of electronic documentation. Use of electronic documentation may help hospices to monitor quality and compliance. PMID:22267819

Conceptual design of a monitoring system for the Charters of Freedom

NASA Technical Reports Server (NTRS)

Cutts, J. A.

1984-01-01

A conceptual design of a monitoring system for the Charters of Freedom was developed for the National Archives and Records Service. The monitoring system would be installed at the National Archives and used to document the condition of the Charters as part of a regular inspection program. The results of an experimental measurements program that led to the definition of analysis system requirements are presented, a conceptual design of the monitoring system is described and the alternative approaches to implementing this design were discussed. The monitoring system is required to optically detect and measure deterioration in documents that are permanently encapsulated in glass cases. An electronic imaging system with the capability for precise photometric measurements of the contrast of the script on the documents can perform this task. Two general types of imaging systems are considered (line and area array), and their suitability for performing these required measurements are compared. A digital processing capability for analyzing the electronic imaging data is also required, and several optional levels of complexity for this digital analysis system are evaluated.

Impact of implementing an EMR on physical exam documentation by ambulance personnel.

PubMed

Katzer, R; Barton, D J; Adelman, S; Clark, S; Seaman, E L; Hudson, K B

2012-01-01

Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs. This study looked retrospectively at 154 PCRs. 77 were hand written PCRs from before the electronic system. The PCRs involved chief complaints that were primarily respiratory, neurologic, or both. 77 ePCRs of matching chief complaint categories were used for comparison. Each chart was reviewed for completion of certain physical exam findings. The mean percentage of documented components from the ePCRs was compared to that of the hand written PCRs. The null hypothesis was that the absolute increase in the mean was not more than 20 percent. The two exclusion criteria were PCRs completed by study investigators after the design of the project and partially or completely missing PCRs. The absolute increase in mean physical exam component documentation was 36% (95% CI = 29-43%). A weighted kappa of 0.894 showed very good agreement between chart reviewers. This study rejected the null hypothesis that the ePCR system was associated with a mean increase of no more than 20%. It observed increase in physical exam documentation. Limitations of this study included the inability to determine whether documentation of physical exam findings reflected performance of the physical exam, and what components of the ePCR system bundle were responsible for the increase in physical exam component documentation.

Impact of implementing an EMR on physical exam documentation by ambulance personnel

PubMed Central

Katzer, R.; Barton, D.J.; Adelman, S.; Clark, S.; Seaman, E.L.; Hudson, K.B.

2012-01-01

Objectives Georgetown University has a student run Emergency Medical Services (EMS) organization with over 100 emergency medical technicians (EMTs). We set out to determine whether implementing an electronic patient care report (ePCR) system was associated with improved physical exam documentation. Methods This study evaluated documentation of the physical exam on prehospital patient care reports (PCRs). An ePCR system was implemented. ePCR documentation was compared to that of the previously used paper PCRs. This study looked retrospectively at 154 PCRs. 77 were hand written PCRs from before the electronic system. The PCRs involved chief complaints that were primarily respiratory, neurologic, or both. 77 ePCRs of matching chief complaint categories were used for comparison. Each chart was reviewed for completion of certain physical exam findings. The mean percentage of documented components from the ePCRs was compared to that of the hand written PCRs. The null hypothesis was that the absolute increase in the mean was not more than 20 percent. The two exclusion criteria were PCRs completed by study investigators after the design of the project and partially or completely missing PCRs. Results The absolute increase in mean physical exam component documentation was 36% (95% CI = 29–43%). A weighted kappa of 0.894 showed very good agreement between chart reviewers. Conclusions This study rejected the null hypothesis that the ePCR system was associated with a mean increase of no more than 20%. It observed increase in physical exam documentation. Limitations of this study included the inability to determine whether documentation of physical exam findings reflected performance of the physical exam, and what components of the ePCR system bundle were responsible for the increase in physical exam component documentation. PMID:23646077

Component-Level Electronic-Assembly Repair (CLEAR) System Architecture

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

2011-01-01

This document captures the system architecture for a Component-Level Electronic-Assembly Repair (CLEAR) capability needed for electronics maintenance and repair of the Constellation Program (CxP). CLEAR is intended to improve flight system supportability and reduce the mass of spares required to maintain the electronics of human rated spacecraft on long duration missions. By necessity it allows the crew to make repairs that would otherwise be performed by Earth based repair depots. Because of practical knowledge and skill limitations of small spaceflight crews they must be augmented by Earth based support crews and automated repair equipment. This system architecture covers the complete system from ground-user to flight hardware and flight crew and defines an Earth segment and a Space segment. The Earth Segment involves database management, operational planning, and remote equipment programming and validation processes. The Space Segment involves the automated diagnostic, test and repair equipment required for a complete repair process. This document defines three major subsystems including, tele-operations that links the flight hardware to ground support, highly reconfigurable diagnostics and test instruments, and a CLEAR Repair Apparatus that automates the physical repair process.

A study on design and development of enterprise-wide concepts for clinical documentation templates.

PubMed

Zhou, Li; Gurjar, Rupali; Regier, Rachel; Morgan, Stephen; Meyer, Theresa; Aroy, Teal; Goldman, Debora Scavone; Hongsermeier, Tonya; Middleton, Blackford

2008-11-06

Structured clinical documents are associated with many potential benefits. Underlying terminologies and structure of information are keys to their successful implementation and use. This paper presents a methodology for design and development of enterprise-wide concepts for clinical documentation templates for an ambulatory Electronic Medical Record (EMR) system.

75 FR 35510 - License Renewal Interim Staff Guidance Process, Revision 2 Notice of Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-22

... Related Regulatory Functions.'' An electronic copy of the revised LR-ISG process is available in the NRC's Agencywide Documents Access and Management System (ADAMS) under Accession No. ML100920158. The revised LR-ISG... interim changes to certain NRC license renewal guidance documents. These guidance documents facilitate the...

49 CFR 237.155 - Documents and records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the information required by this part; (3) The track owner monitors its electronic records database...; (4) The track owner shall train its employees who use the system on the proper use of the electronic...

Mediagraphy: Print and Nonprint Resources.

ERIC Educational Resources Information Center

Educational Media and Technology Yearbook, 1998

1998-01-01

Lists educational media-related journals, books, ERIC documents, journal articles, and nonprint resources classified by Artificial Intelligence, Robotics, Electronic Performance Support Systems; Computer-Assisted Instruction; Distance Education; Educational Research; Educational Technology; Electronic Publishing; Information Science and…

Organizational Influences on the University Electronic Library.

ERIC Educational Resources Information Center

Davies, Clare

1997-01-01

Reviews the literature on the development of full-text electronic libraries in the academic setting. Organizational factors can have impact on electronic library development and ultimate usability. Topics include strategic management, planning and implementation; system specification and design; document provision; user support and training; and…

Electronic Equipment Maintenance Training (EEMT) System: System Definition Phase.

ERIC Educational Resources Information Center

Pine, S. M.; And Others

The second in a series of four reports on the Electronic Equipment Maintenance Training (EEMT) project, this document summarizes the system definition phase of the EEMT program. The purpose of this phase of the project was to define a comprehensive set of functions and training requirements that the EEMT must satisfy within the training mission of…

Evaluating, Comparing, and Best Practice in Electronic Portfolio System Use

ERIC Educational Resources Information Center

San Jose, David L.

2017-01-01

Electronic portfolios (e-portfolios) are commonly positioned to show evidence of student learning with formative and summative assessment benefits. At the University of Auckland teacher education program, two e-portfolio systems were adopted to document preservice teacher's course work and to attest to the Graduating Teacher Standards. This…

Thinking About Taking The Leap? Hear From Those Who Did So...and Survived A Case Study: NASA Stennis Space Center Electronic Records Management

NASA Technical Reports Server (NTRS)

Albasini, Colby V.

2008-01-01

Increased visibility into records management: a) Partnered with NARA to provide electronic records management and Emergency Response training; b) Mandate all civil servants and records personnel attend training.Improve Disaster Recovery: a) TechDoc considered a vital system; b) All electronic documentation and records managed by our system available offsite.

Architecture for networked electronic patient record systems.

PubMed

Takeda, H; Matsumura, Y; Kuwata, S; Nakano, H; Sakamoto, N; Yamamoto, R

2000-11-01

There have been two major approaches to the development of networked electronic patient record (EPR) architecture. One uses object-oriented methodologies for constructing the model, which include the GEHR project, Synapses, HL7 RIM and so on. The second approach uses document-oriented methodologies, as applied in examples of HL7 PRA. It is practically beneficial to take the advantages of both approaches and to add solution technologies for network security such as PKI. In recognition of the similarity with electronic commerce, a certificate authority as a trusted third party will be organised for establishing networked EPR system. This paper describes a Japanese functional model that has been developed, and proposes a document-object-oriented architecture, which is-compared with other existing models.

Improvement of medication event interventions through use of an electronic database.

PubMed

Merandi, Jenna; Morvay, Shelly; Lewe, Dorcas; Stewart, Barb; Catt, Char; Chanthasene, Phillip P; McClead, Richard; Kappeler, Karl; Mirtallo, Jay M

2013-10-01

Patient safety enhancements achieved through the use of an electronic Web-based system for responding to adverse drug events (ADEs) are described. A two-phase initiative was carried out at an academic pediatric hospital to improve processes related to "medication event huddles" (interdisciplinary meetings focused on ADE interventions). Phase 1 of the initiative entailed a review of huddles and interventions over a 16-month baseline period during which multiple databases were used to manage the huddle process and staff interventions were assigned via manually generated e-mail reminders. Phase 1 data collection included ADE details (e.g., medications and staff involved, location and date of event) and the types and frequencies of interventions. Based on the phase 1 analysis, an electronic database was created to eliminate the use of multiple systems for huddle scheduling and documentation and to automatically generate e-mail reminders on assigned interventions. In phase 2 of the initiative, the impact of the database during a 5-month period was evaluated; the primary outcome was the percentage of interventions documented as completed after database implementation. During the postimplementation period, 44.7% of assigned interventions were completed, compared with a completion rate of 21% during the preimplementation period, and interventions documented as incomplete decreased from 77% to 43.7% (p < 0.0001). Process changes, education, and medication order improvements were the most frequently documented categories of interventions. Implementation of a user-friendly electronic database improved intervention completion and documentation after medication event huddles.

Automated documentation generator for advanced protein crystal growth

NASA Technical Reports Server (NTRS)

Maddux, Gary A.; Provancha, Anna; Chattam, David; Ford, Ronald

1993-01-01

The System Management and Production Laboratory at the Research Institute, the University of Alabama in Huntsville (UAH), was tasked by the Microgravity Experiment Projects (MEP) Office of the Payload Projects Office (PPO) at Marshall Space Flight Center (MSFC) to conduct research in the current methods of written documentation control and retrieval. The goals of this research were to determine the logical interrelationships within selected NASA documentation, and to expand on a previously developed prototype system to deliver a distributable, electronic knowledge-based system. This computer application would then be used to provide a paperless interface between the appropriate parties for the required NASA document.

Customer Communication Document

NASA Technical Reports Server (NTRS)

2009-01-01

This procedure communicates to the Customers of the Automation, Robotics and Simulation Division (AR&SD) Dynamics Systems Test Branch (DSTB) how to obtain services of the Six-Degrees-Of-Freedom Dynamic Test System (SDTS). The scope includes the major communication documents between the SDTS and its Customer. It established the initial communication and contact points as well as provides the initial documentation in electronic media for the customer. Contact the SDTS Manager (SM) for the names of numbers of the current contact points.

Management Information System for Vocational Education. MISVE Technical Description. Research and Development Series No. 127E.

ERIC Educational Resources Information Center

Hulse, Ira; And Others

One of six documents describing the Management Information System for Vocational Education (MISVE), this document is intended for MISVE managers and electronic data processing (EDP) operations staff who would be responsible for the implementation and maintenance of the MISVE on the computer. (MISVE was designed to provide users with an advanced…

Potential of spark ignition engine, electronic engine and transmission control : final report

DOT National Transportation Integrated Search

1980-03-01

This report identifies, evaluates, and documents the characteristics and functions of significant electronic engine and powertrain control systems. Important considerations in the assessment are the powertrain variables controlled, the technology uti...

Commercial applications for optical data storage

NASA Astrophysics Data System (ADS)

Tas, Jeroen

1991-03-01

Optical data storage has spurred the market for document imaging systems. These systems are increasingly being used to electronically manage the processing, storage and retrieval of documents. Applications range from straightforward archives to sophisticated workflow management systems. The technology is developing rapidly and within a few years optical imaging facilities will be incorporated in most of the office information systems. This paper gives an overview of the status of the market, the applications and the trends of optical imaging systems.

Hyper-Book: A Formal Model for Electronic Books.

ERIC Educational Resources Information Center

Catenazzi, Nadia; Sommaruga, Lorenzo

1994-01-01

Presents a model for electronic books based on the paper book metaphor. Discussion includes how the book evolves under the effects of its functional components; the use and impact of the model for organizing and presenting electronic documents in the context of electronic publishing; and the possible applications of a system based on the model.…

Understanding Providers' Interaction with Graphical User Interface Pertaining to Clinical Document Usage in an Electronic Health Record System

ERIC Educational Resources Information Center

Rizvi, Rubina Fatima

2017-01-01

Despite high Electronic Health Record (EHR) system adoption rates by hospital and office-based practices, many users remain highly dissatisfied with the current state of EHRs. Sub-optimal EHR usability as a result of insufficient incorporation of User-Centered Design (UCD) approach during System Development Life Cycle process (SDLC) is considered…

SpecialNet. A National Computer-Based Communications Network.

ERIC Educational Resources Information Center

Morin, Alfred J.

1986-01-01

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

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

ERIC Educational Resources Information Center

Davis, Diane, Ed.

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

Diesel Technology: Electrical and Electronic Systems. Teacher Edition [and] Student Edition.

ERIC Educational Resources Information Center

Ready, Allan; Kauffman, Ricky; Bogle, Jerry

This document contains the materials for a competency-based course in diesel technology and electrical and electronic systems that is tied to measurable and observable learning outcomes identified and validated by an advisory committee of business and industry representatives and teachers. The competencies addressed align with the medium/heavy…

Library Systems Office Organization. SPEC Kit and SPEC Flyer 211.

ERIC Educational Resources Information Center

Muir, Scott P., Comp.

The roles and responsibilities of the library systems officer continues to change as libraries move beyond the automation of library functions to offering resources in electronic formats and electronic access to information about collections beyond the walls of the home institution. This survey was designed to collect data and document some of the…

iSMART: Ontology-based Semantic Query of CDA Documents

PubMed Central

Liu, Shengping; Ni, Yuan; Mei, Jing; Li, Hanyu; Xie, Guotong; Hu, Gang; Liu, Haifeng; Hou, Xueqiao; Pan, Yue

2009-01-01

The Health Level 7 Clinical Document Architecture (CDA) is widely accepted as the format for electronic clinical document. With the rich ontological references in CDA documents, the ontology-based semantic query could be performed to retrieve CDA documents. In this paper, we present iSMART (interactive Semantic MedicAl Record reTrieval), a prototype system designed for ontology-based semantic query of CDA documents. The clinical information in CDA documents will be extracted into RDF triples by a declarative XML to RDF transformer. An ontology reasoner is developed to infer additional information by combining the background knowledge from SNOMED CT ontology. Then an RDF query engine is leveraged to enable the semantic queries. This system has been evaluated using the real clinical documents collected from a large hospital in southern China. PMID:20351883

Utilizing IHE-based Electronic Health Record systems for secondary use.

PubMed

Holzer, K; Gall, W

2011-01-01

Due to the increasing adoption of Electronic Health Records (EHRs) for primary use, the number of electronic documents stored in such systems will soar in the near future. In order to benefit from this development in secondary fields such as medical research, it is important to define requirements for the secondary use of EHR data. Furthermore, analyses of the extent to which an IHE (Integrating the Healthcare Enterprise)-based architecture would fulfill these requirements could provide further information on upcoming obstacles for the secondary use of EHRs. A catalog of eight core requirements for secondary use of EHR data was deduced from the published literature, the risk analysis of the IHE profile MPQ (Multi-Patient Queries) and the analysis of relevant questions. The IHE-based architecture for cross-domain, patient-centered document sharing was extended to a cross-patient architecture. We propose an IHE-based architecture for cross-patient and cross-domain secondary use of EHR data. Evaluation of this architecture concerning the eight core requirements revealed positive fulfillment of six and the partial fulfillment of two requirements. Although not regarded as a primary goal in modern electronic healthcare, the re-use of existing electronic medical documents in EHRs for research and other fields of secondary application holds enormous potential for the future. Further research in this respect is necessary.

Integrated Information Support System (IISS). Volume 8. User Interface Subsystem. Part 39. Electronic Documentation System (EDS) User’s Manual

DTIC Science & Technology

1990-09-30

conveying any rights or permission to manufacture, use, or market any patented invention that may in any way be related thereto. This technical report...Definition - Select .... 7-9 7-6 Character Class Definition - Other Options 7-10 7-7 Pattern/Action/State Defintion -Select 7-11 7-8 Pattern/Action/State...representation. Compound Document: A document which may contain mixed content i.e. text, graphics, etc. Conforming SGML Application: An SGML application that

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

The impact of using electronic patient records on practices of reading and writing.

PubMed

Laitinen, Heleena; Kaunonen, Marja; Åstedt-Kurki, Paivi

2014-12-01

The aim of this study was to investigate the use of electronic patient records in daily practice. In four wards of a large hospital district in Finland, N = 43 patients' care and activities were observed and analysed in terms of the Grounded Theory method. The findings revealed that using electronic patient records created a particular process of writing and reading. Wireless technology enabled simultaneous patient involvement and point-of-care documentation, additionally supporting real-time reading. Remote and retrospective documentation was distant in terms of both space and time. The remoteness caused double documentation, reduced accuracy and less-efficient use of time. 'Non-reading' practices were witnessed in retrospective reading, causing delays in patient care and increase in workload. Similarly, if documentation was insufficient or non-existent, the consequences were found to be detrimental to the patients. The use of an electronic patient record system has a significant impact on patient care. Therefore, it is crucial to develop wireless technology and interdisciplinary collaboration in order to improve and support high-quality patient care. © The Author(s) 2013.

Automated document analysis system

NASA Astrophysics Data System (ADS)

Black, Jeffrey D.; Dietzel, Robert; Hartnett, David

2002-08-01

A software application has been developed to aid law enforcement and government intelligence gathering organizations in the translation and analysis of foreign language documents with potential intelligence content. The Automated Document Analysis System (ADAS) provides the capability to search (data or text mine) documents in English and the most commonly encountered foreign languages, including Arabic. Hardcopy documents are scanned by a high-speed scanner and are optical character recognized (OCR). Documents obtained in an electronic format bypass the OCR and are copied directly to a working directory. For translation and analysis, the script and the language of the documents are first determined. If the document is not in English, the document is machine translated to English. The documents are searched for keywords and key features in either the native language or translated English. The user can quickly review the document to determine if it has any intelligence content and whether detailed, verbatim human translation is required. The documents and document content are cataloged for potential future analysis. The system allows non-linguists to evaluate foreign language documents and allows for the quick analysis of a large quantity of documents. All document processing can be performed manually or automatically on a single document or a batch of documents.

cost and benefits optimization model for fault-tolerant aircraft electronic systems

NASA Technical Reports Server (NTRS)

1983-01-01

The factors involved in economic assessment of fault tolerant systems (FTS) and fault tolerant flight control systems (FTFCS) are discussed. Algorithms for optimization and economic analysis of FTFCS are documented.

TERMTrial--terminology-based documentation systems for cooperative clinical trials.

PubMed

Merzweiler, A; Weber, R; Garde, S; Haux, R; Knaup-Gregori, P

2005-04-01

Within cooperative groups of multi-center clinical trials a standardized documentation is a prerequisite for communication and sharing of data. Standardizing documentation systems means standardizing the underlying terminology. The management and consistent application of terminology systems is a difficult and fault-prone task, which should be supported by appropriate software tools. Today, documentation systems for clinical trials are often implemented as so-called Remote-Data-Entry-Systems (RDE-systems). Although there are many commercial systems, which support the development of RDE-systems there is none offering a comprehensive terminological support. Therefore, we developed the software system TERMTrial which consists of a component for the definition and management of terminology systems for cooperative groups of clinical trials and two components for the terminology-based automatic generation of trial databases and terminology-based interactive design of electronic case report forms (eCRFs). TERMTrial combines the advantages of remote data entry with a comprehensive terminological control.

Factors Shaping the Evolution of Electronic Documentation Systems. Research Activity No. IM.4.

ERIC Educational Resources Information Center

Dede, C. J.; And Others

The first of 10 sections in this report focuses on factors that will affect the evolution of Space Station Project (SSP) documentation systems. The goal of this project is to prepare the space station technical and managerial structure for likely changes in the creation, capture, transfer, and utilization of knowledge about the space station which…

KernPaeP - a web-based pediatric palliative documentation system for home care.

PubMed

Hartz, Tobias; Verst, Hendrik; Ueckert, Frank

2009-01-01

KernPaeP is a new web-based on- and offline documentation system, which has been developed for pediatric palliative care-teams supporting patient documentation and communication among health care professionals. It provides a reliable system making fast and secure home care documentation possible. KernPaeP is accessible online by registered users using any web-browser. Home care teams use an offline version of KernPaeP running on a netbook for patient documentation on site. Identifying and medical patient data are strictly separated and stored on two database servers. The system offers a stable, enhanced two-way algorithm for synchronization between the offline component and the central database servers. KernPaeP is implemented meeting highest security standards while still maintaining high usability. The web-based documentation system allows ubiquitous and immediate access to patient data. Sumptuous paper work is replaced by secure and comprehensive electronic documentation. KernPaeP helps saving time and improving the quality of documentation. Due to development in close cooperation with pediatric palliative professionals, KernPaeP fulfils the broad needs of home-care documentation. The technique of web-based online and offline documentation is in general applicable for arbitrary home care scenarios.

Using Natural Language Processing to Improve Efficiency of Manual Chart Abstraction in Research: The Case of Breast Cancer Recurrence

PubMed Central

Carrell, David S.; Halgrim, Scott; Tran, Diem-Thy; Buist, Diana S. M.; Chubak, Jessica; Chapman, Wendy W.; Savova, Guergana

2014-01-01

The increasing availability of electronic health records (EHRs) creates opportunities for automated extraction of information from clinical text. We hypothesized that natural language processing (NLP) could substantially reduce the burden of manual abstraction in studies examining outcomes, like cancer recurrence, that are documented in unstructured clinical text, such as progress notes, radiology reports, and pathology reports. We developed an NLP-based system using open-source software to process electronic clinical notes from 1995 to 2012 for women with early-stage incident breast cancers to identify whether and when recurrences were diagnosed. We developed and evaluated the system using clinical notes from 1,472 patients receiving EHR-documented care in an integrated health care system in the Pacific Northwest. A separate study provided the patient-level reference standard for recurrence status and date. The NLP-based system correctly identified 92% of recurrences and estimated diagnosis dates within 30 days for 88% of these. Specificity was 96%. The NLP-based system overlooked 5 of 65 recurrences, 4 because electronic documents were unavailable. The NLP-based system identified 5 other recurrences incorrectly classified as nonrecurrent in the reference standard. If used in similar cohorts, NLP could reduce by 90% the number of EHR charts abstracted to identify confirmed breast cancer recurrence cases at a rate comparable to traditional abstraction. PMID:24488511

Cross-institutional document exchange system using clinical document architecture (CDA) with virtual printing method.

PubMed

Mihara, Naoki; Ueda, Kanayo; Manabe, Shirou; Takeda, Toshihiro; Shimai, Yoshie; Horishima, Hiroyuki; Murata, Taizo; Fujii, Ayumi; Matsumura, Yasushi

2015-01-01

Recently one patient received care from several hospitals at around the same time. When the patient visited a new hospital, the new hospital's physician tried to get patient information the previous hospital. Thus, patient information is frequently exchanged between them. Many types of healthcare facilities have implemented an electronic medical record system, but in Japan, healthcare information exchange is often done by paper. In other words, after a clinical doctor prints a referral document and sends it to another hospital's physician, another hospital's doctor receives it and scans to store the EMR in his own hospital's system. It is a wasteful way to exchange healthcare information about a patient. In order to solve this problem, we have developed a cross-institutional document exchange system using clinical document architecture (CDA) with a virtual printing method.

Computer-based nursing documentation in nursing homes: A feasibility study.

PubMed

Yu, Ping; Qiu, Yiyu; Crookes, Patrick

2006-01-01

The burden of paper-based nursing documentation has led to increasing complaints and decreasing job satisfaction amongst aged-care workers in Australian nursing homes. The automation of nursing documentation has been identified as one of the possible strategies to address this issue. A major obstacle to the introduction of IT solutions, however, has been a prevailing doubt concerning the ability and/or the willingness of aged-care workers to accept such innovation. This research investigates the attitudes of aged-care workers towards adopting IT innovation. Questionnaire survey were conducted in 13 nursing homes around the Illawarra and Sydney regions in Australia. The survey found that an unexpected 89.3% of participants supported the strategy of introducing electronic nursing documentation systems into residential aged-care facilities. 94.3% of them would use such a system depending on circumstances. Despite a shortage of computers in the workplace, which is a major barrier, this research provides strong evidence that care workers in residential aged-care facilities are willing to accept electronic nursing documentation practice and the uptake of information technology in residential aged-care is feasible in Australia.

A ward-based time study of paper and electronic documentation for recording vital sign observations.

PubMed

Wong, David; Bonnici, Timothy; Knight, Julia; Gerry, Stephen; Turton, James; Watkinson, Peter

2017-07-01

To investigate time differences in recording observations and an early warning score using traditional paper charts and a novel e-Obs system in clinical practice. Researchers observed the process of recording observations and early warning scores across 3 wards in 2 university teaching hospitals immediately before and after introduction of the e-Obs system. The process of recording observations included both measurement and documentation of vital signs. Interruptions were timed and subtracted from the measured process duration. Multilevel modeling was used to compensate for potential confounding factors. In all, 577 nurse events were observed (281 paper, 296 e-Obs). The geometric mean time to take a complete set of vital signs was 215 s (95% confidence interval [CI], 177 s-262 s) on paper, and 150 s (95% CI, 130 s-172 s) electronically. The treatment effect ratio was 0.70 (95% CI, 0.57-0.85, P  < .001). The treatment effect ratio in ward 1 was 0.37 (95% CI, 0.26-0.53), in ward 2 was 0.98 (95% CI, 0.70-1.38), and in ward 3 was 0.93 (95% CI, 0.66-1.33). Introduction of an e-Obs system was associated with a statistically significant reduction in overall time to measure and document vital signs electronically compared to paper documentation. The reductions in time varied among wards and were of clinical significance on only 1 of 3 wards studied. Our results suggest that introduction of an e-Obs system could lower nursing workload as well as increase documentation quality. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

27 CFR 73.31 - May I submit forms electronically to TTB?

Code of Federal Regulations, 2010 CFR

2010-04-01

... requirement in this chapter, only if: (a) We have published a notice in the Federal Register and on our Web... Register and on our Web site as stated above; (c) You submit the electronic form to an electronic document receiving system that we have designated for the receipt of that specific form; and (d) The electronic form...

Component-Level Electronic-Assembly Repair (CLEAR) Operational Concept

NASA Technical Reports Server (NTRS)

Oeftering, Richard C.; Bradish, Martin A.; Juergens, Jeffrey R.; Lewis, Michael J.; Vrnak, Daniel R.

2011-01-01

This Component-Level Electronic-Assembly Repair (CLEAR) Operational Concept document was developed as a first step in developing the Component-Level Electronic-Assembly Repair (CLEAR) System Architecture (NASA/TM-2011-216956). The CLEAR operational concept defines how the system will be used by the Constellation Program and what needs it meets. The document creates scenarios for major elements of the CLEAR architecture. These scenarios are generic enough to apply to near-Earth, Moon, and Mars missions. The CLEAR operational concept involves basic assumptions about the overall program architecture and interactions with the CLEAR system architecture. The assumptions include spacecraft and operational constraints for near-Earth orbit, Moon, and Mars missions. This document addresses an incremental development strategy where capabilities evolve over time, but it is structured to prevent obsolescence. The approach minimizes flight hardware by exploiting Internet-like telecommunications that enables CLEAR capabilities to remain on Earth and to be uplinked as needed. To minimize crew time and operational cost, CLEAR exploits offline development and validation to support online teleoperations. Operational concept scenarios are developed for diagnostics, repair, and functional test operations. Many of the supporting functions defined in these operational scenarios are further defined as technologies in NASA/TM-2011-216956.

A Case Study: Implementing an Interactive Video Instruction System in Teaching Electronics and Industrial Maintenance.

ERIC Educational Resources Information Center

Shipe, Ron; And Others

A study examined the development and implementation of an interactive video instruction system for teaching electronics and industrial maintenance at the University of Tennessee. The specific purposes of the study were to document unusual problems that may be encountered when this new technology is implemented, suggest corrective actions, and…

Automated Methods to Extract Patient New Information from Clinical Notes in Electronic Health Record Systems

ERIC Educational Resources Information Center

Zhang, Rui

2013-01-01

The widespread adoption of Electronic Health Record (EHR) has resulted in rapid text proliferation within clinical care. Clinicians' use of copying and pasting functions in EHR systems further compounds this by creating a large amount of redundant clinical information in clinical documents. A mixture of redundant information (especially outdated…

Electronic Medical Records (EMR): An Empirical Testing of Factors Contributing to Healthcare Professionals' Resistance to Use EMR Systems

ERIC Educational Resources Information Center

Bazile, Emmanuel Patrick

2016-01-01

The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to…

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

DOT National Transportation Integrated Search

1996-10-28

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

Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers.

PubMed

Makam, Anil N; Lanham, Holly J; Batchelor, Kim; Samal, Lipika; Moran, Brett; Howell-Stampley, Temple; Kirk, Lynne; Cherukuri, Manjula; Santini, Noel; Leykum, Luci K; Halm, Ethan A

2013-08-09

Despite considerable financial incentives for adoption, there is little evidence available about providers' use and satisfaction with key functions of electronic health records (EHRs) that meet "meaningful use" criteria. We surveyed primary care providers (PCPs) in 11 general internal medicine and family medicine practices affiliated with 3 health systems in Texas about their use and satisfaction with performing common tasks (documentation, medication prescribing, preventive services, problem list) in the Epic EHR, a common commercial system. Most practices had greater than 5 years of experience with the Epic EHR. We used multivariate logistic regression to model predictors of being a structured documenter, defined as using electronic templates or prepopulated dot phrases to document at least two of the three note sections (history, physical, assessment and plan). 146 PCPs responded (70%). The majority used free text to document the history (51%) and assessment and plan (54%) and electronic templates to document the physical exam (57%). Half of PCPs were structured documenters (55%) with family medicine specialty (adjusted OR 3.3, 95% CI, 1.4-7.8) and years since graduation (nonlinear relationship with youngest and oldest having lowest probabilities) being significant predictors. Nearly half (43%) reported spending at least one extra hour beyond each scheduled half-day clinic completing EHR documentation. Three-quarters were satisfied with documenting completion of pneumococcal vaccinations and half were satisfied with documenting cancer screening (57% for breast, 45% for colorectal, and 46% for cervical). Fewer were satisfied with reminders for overdue pneumococcal vaccination (48%) and cancer screening (38% for breast, 37% for colorectal, and 31% for cervical). While most believed the problem list was helpful (70%) and kept an up-to-date list for their patients (68%), half thought they were unreliable and inaccurate (51%). Dissatisfaction with and suboptimal use of key functions of the EHR may mitigate the potential for EHR use to improve preventive health and chronic disease management. Future work should optimize use of key functions and improve providers' time efficiency.

Managing complex research datasets using electronic tools: A meta-analysis exemplar

PubMed Central

Brown, Sharon A.; Martin, Ellen E.; Garcia, Theresa J.; Winter, Mary A.; García, Alexandra A.; Brown, Adama; Cuevas, Heather E.; Sumlin, Lisa L.

2013-01-01

Meta-analyses of broad scope and complexity require investigators to organize many study documents and manage communication among several research staff. Commercially available electronic tools, e.g., EndNote, Adobe Acrobat Pro, Blackboard, Excel, and IBM SPSS Statistics (SPSS), are useful for organizing and tracking the meta-analytic process, as well as enhancing communication among research team members. The purpose of this paper is to describe the electronic processes we designed, using commercially available software, for an extensive quantitative model-testing meta-analysis we are conducting. Specific electronic tools improved the efficiency of (a) locating and screening studies, (b) screening and organizing studies and other project documents, (c) extracting data from primary studies, (d) checking data accuracy and analyses, and (e) communication among team members. The major limitation in designing and implementing a fully electronic system for meta-analysis was the requisite upfront time to: decide on which electronic tools to use, determine how these tools would be employed, develop clear guidelines for their use, and train members of the research team. The electronic process described here has been useful in streamlining the process of conducting this complex meta-analysis and enhancing communication and sharing documents among research team members. PMID:23681256

Managing complex research datasets using electronic tools: a meta-analysis exemplar.

PubMed

Brown, Sharon A; Martin, Ellen E; Garcia, Theresa J; Winter, Mary A; García, Alexandra A; Brown, Adama; Cuevas, Heather E; Sumlin, Lisa L

2013-06-01

Meta-analyses of broad scope and complexity require investigators to organize many study documents and manage communication among several research staff. Commercially available electronic tools, for example, EndNote, Adobe Acrobat Pro, Blackboard, Excel, and IBM SPSS Statistics (SPSS), are useful for organizing and tracking the meta-analytic process as well as enhancing communication among research team members. The purpose of this article is to describe the electronic processes designed, using commercially available software, for an extensive, quantitative model-testing meta-analysis. Specific electronic tools improved the efficiency of (a) locating and screening studies, (b) screening and organizing studies and other project documents, (c) extracting data from primary studies, (d) checking data accuracy and analyses, and (e) communication among team members. The major limitation in designing and implementing a fully electronic system for meta-analysis was the requisite upfront time to decide on which electronic tools to use, determine how these tools would be used, develop clear guidelines for their use, and train members of the research team. The electronic process described here has been useful in streamlining the process of conducting this complex meta-analysis and enhancing communication and sharing documents among research team members.

Robust keyword retrieval method for OCRed text

NASA Astrophysics Data System (ADS)

Fujii, Yusaku; Takebe, Hiroaki; Tanaka, Hiroshi; Hotta, Yoshinobu

2011-01-01

Document management systems have become important because of the growing popularity of electronic filing of documents and scanning of books, magazines, manuals, etc., through a scanner or a digital camera, for storage or reading on a PC or an electronic book. Text information acquired by optical character recognition (OCR) is usually added to the electronic documents for document retrieval. Since texts generated by OCR generally include character recognition errors, robust retrieval methods have been introduced to overcome this problem. In this paper, we propose a retrieval method that is robust against both character segmentation and recognition errors. In the proposed method, the insertion of noise characters and dropping of characters in the keyword retrieval enables robustness against character segmentation errors, and character substitution in the keyword of the recognition candidate for each character in OCR or any other character enables robustness against character recognition errors. The recall rate of the proposed method was 15% higher than that of the conventional method. However, the precision rate was 64% lower.

A Digital Library in the Mid-Nineties, Ahead or On Schedule?

ERIC Educational Resources Information Center

Dijkstra, Joost

1994-01-01

Discussion of the future possibilities of digital library systems highlights digital projects developed at Tilburg University (Netherlands). Topics addressed include online access to databases; electronic document delivery; agreements between libraries and Elsevier Science publishers to provide journal articles; full text document delivery; and…

78 FR 67204 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... action to submit an information collection request to the Office of Management and Budget (OMB) and... Verification System (LVS) has been developed, providing an electronic method for fulfilling this requirement... publicly available documents, including the draft supporting statement, at the NRC's Public Document Room...

Emergency Medicine Resident Physicians’ Perceptions of Electronic Documentation and Workflow

PubMed Central

Neri, P.M.; Redden, L.; Poole, S.; Pozner, C.N.; Horsky, J.; Raja, A.S.; Poon, E.; Schiff, G.

2015-01-01

Summary Objective To understand emergency department (ED) physicians’ use of electronic documentation in order to identify usability and workflow considerations for the design of future ED information system (EDIS) physician documentation modules. Methods We invited emergency medicine resident physicians to participate in a mixed methods study using task analysis and qualitative interviews. Participants completed a simulated, standardized patient encounter in a medical simulation center while documenting in the test environment of a currently used EDIS. We recorded the time on task, type and sequence of tasks performed by the participants (including tasks performed in parallel). We then conducted semi-structured interviews with each participant. We analyzed these qualitative data using the constant comparative method to generate themes. Results Eight resident physicians participated. The simulation session averaged 17 minutes and participants spent 11 minutes on average on tasks that included electronic documentation. Participants performed tasks in parallel, such as history taking and electronic documentation. Five of the 8 participants performed a similar workflow sequence during the first part of the session while the remaining three used different workflows. Three themes characterize electronic documentation: (1) physicians report that location and timing of documentation varies based on patient acuity and workload, (2) physicians report a need for features that support improved efficiency; and (3) physicians like viewing available patient data but struggle with integration of the EDIS with other information sources. Conclusion We confirmed that physicians spend much of their time on documentation (65%) during an ED patient visit. Further, we found that resident physicians did not all use the same workflow and approach even when presented with an identical standardized patient scenario. Future EHR design should consider these varied workflows while trying to optimize efficiency, such as improving integration of clinical data. These findings should be tested quantitatively in a larger, representative study. PMID:25848411

DIRECT secure messaging as a common transport layer for reporting structured and unstructured lab results to outpatient providers.

PubMed

Sujansky, Walter; Wilson, Tom

2015-04-01

This report describes a grant-funded project to explore the use of DIRECT secure messaging for the electronic delivery of laboratory test results to outpatient physicians and electronic health record systems. The project seeks to leverage the inherent attributes of DIRECT secure messaging and electronic provider directories to overcome certain barriers to the delivery of lab test results in the outpatient setting. The described system enables laboratories that generate test results as HL7 messages to deliver these results as structured or unstructured documents attached to DIRECT secure messages. The system automatically analyzes generated HL7 messages and consults an electronic provider directory to determine the appropriate DIRECT address and delivery format for each indicated recipient. The system also enables lab results delivered to providers as structured attachments to be consumed by HL7 interface engines and incorporated into electronic health record systems. Lab results delivered as unstructured attachments may be printed or incorporated into patient records as PDF files. The system receives and logs acknowledgement messages to document the status of each transmitted lab result, and a graphical interface allows searching and review of this logged information. The described system is a fully implemented prototype that has been tested in a laboratory setting. Although this approach is promising, further work is required to pilot test the system in production settings with clinical laboratories and outpatient provider organizations. Copyright © 2015 Elsevier Inc. All rights reserved.

[Evaluation of a context sensitive system for intra-operative usage of the electronic patient record].

PubMed

Dressler, C R; Fischer, M; Burgert, O; Strauß, G

2012-06-01

This article analyzes the usage of an electronic patient record (EPR), which may be accessed intra-operatively by the surgeon. The focus lies on the automatic prioritization of documents to dramatically reduce the surgeon's interaction with the EPR system. An EPR system has been developed, which displays documents in accordance to the current procedure. The system is controlled by a foot switch and the documents are displayed on a large-scale screen in the operating room. The usage of the system by 2 surgeons has been recorded in clinical routine. 55 surgical procedures have been recorded. The EPR system has been used 2 times per procedure in average for surgeries at the middle ear, for surgeries of the paranasal sinuses, it has been used 1.3 times per procedure. The EPR-system has been used pre-operatively in 58% of cases. The surgeons did not have to interact with the EPR system for more than the half of the procedures to view the desired document. The existence of digitized documents in a clinic does not automatically lead to improved workflows. The evaluated EPR system presented the patient data in a simple and comfortable way. The extensive pre-operative usage had not been expected. Because of the low barrier to view patient data, higher patient safety may be assumed. On the other hand, the surgeon could be encouraged to skip the important preparation before the procedure. Due to the low pervasiveness of medical communication standards at this time, the integrated connection between clinic IT and an EPR system would nowadays only be possible by great efforts. © Georg Thieme Verlag KG Stuttgart · New York.

Smart roadside initiative : system requirements specifications.

DOT National Transportation Integrated Search

2015-09-01

This document describes the system requirements specifications (SyRS) for the Smart Roadside Initiative (SRI) Prototype for the delivery of capabilities related to wireless roadside inspections, electronic screening/virtual weigh stations, universal ...

Interdisciplinary collaboration and the electronic medical record.

PubMed

Green, Shayla D; Thomas, Joan D

2008-01-01

To examine interdisciplinary collaboration via electronic medical records (EMRs) with a focus on physicians' perception of nursing documentation. Quality improvement project using a survey instrument. Tertiary care pediatric hospital. Thirty-seven physicians. Physicians perceptions of nursing documentation after EMR implementation Physicians desire nursing documentation with greater clarity and additional information. Physicians indicate checklists alone for patient assessment and intervention data are insufficient for effective nurse/physician collaboration. Narrative nursing summaries are invaluable references that guide medical treatment decisions. Physicians see detailed assessments and well-described interventions of nurses' as critical to their ability to effectively practice medicine. Health care technology is called to develop EMRs that enable nurses to document detailed patient data in a swift and straightforward manner. Joint collaboration between nurses, physicians, and technology specialists is recommended to develop effective EMR systems.

Automating the business office.

PubMed

Wright, M A

1996-10-01

To measure the success of automating the business office with electronic billing and document management systems, the hospital's original goals were reviewed: Had the number of FTEs been maintained or reduced: Yes--claims volume is up 58% over 6 years with a 22% reduction in FTEs (see Exhibit 3). Was the cost of maintaining the paper filing system reduced? Yes--and the cost saving from the hospital's document imaging system will allow a 4.4 year payback. Is better customer service being provided? Yes--online access to patient demographic and financial information has improved response time. Having met all its goals, North Kansas City Hospital considers the installation of both systems to have been complete success. The facility expects to continue expansion of the document management system into accounts payable, payroll, home health, and other document-intensive areas to achieve further cost savings in the future.

Digital Avionics

NASA Technical Reports Server (NTRS)

Koelbl, Terry G.; Ponchak, Denise; Lamarche, Teresa

2003-01-01

Digital Avionics activities played an important role in the advancements made in civil aviation, military systems, and space applications. This document profiles advances made in each of these areas by the aerospace industry, NASA centers, and the U.S. military. Emerging communication technologies covered in this document include Internet connectivity onboard aircraft, wireless broadband communication for aircraft, and a mobile router for aircraft to communicate in multiple communication networks over the course of a flight. Military technologies covered in this document include avionics for unmanned combat air vehicles and microsatellites, and head-up displays. Other technologies covered in this document include an electronic flight bag for the Boeing 777, and surveillance systems for managing airport operations.

40 CFR 3.1000 - How does a state, tribe, or local government revise or modify its authorized program to allow...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false How does a state, tribe, or local... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL CROSS-MEDIA ELECTRONIC REPORTING Electronic... state, tribe, or local government that does not have an existing electronic document receiving system...

Hypersonic Vehicle Propulsion System Simplified Model Development

NASA Technical Reports Server (NTRS)

Stueber, Thomas J.; Raitano, Paul; Le, Dzu K.; Ouzts, Peter

2007-01-01

This document addresses the modeling task plan for the hypersonic GN&C GRC team members. The overall propulsion system modeling task plan is a multi-step process and the task plan identified in this document addresses the first steps (short term modeling goals). The procedures and tools produced from this effort will be useful for creating simplified dynamic models applicable to a hypersonic vehicle propulsion system. The document continues with the GRC short term modeling goal. Next, a general description of the desired simplified model is presented along with simulations that are available to varying degrees. The simulations may be available in electronic form (FORTRAN, CFD, MatLab,...) or in paper form in published documents. Finally, roadmaps outlining possible avenues towards realizing simplified model are presented.

14 CFR 11.33 - How can I track FAA's rulemaking activities?

Code of Federal Regulations, 2010 CFR

2010-01-01

... rulemaking document proceeding. Each rulemaking document FAA issues in a particular rulemaking proceeding, as... search the Federal Docket Management System (FDMS) for information on most rulemaking proceedings. You....regulations.gov. If you can't find the material in the electronic docket, contact the person listed under FOR...

14 CFR 11.33 - How can I track FAA's rulemaking activities?

Code of Federal Regulations, 2014 CFR

2014-01-01

... rulemaking document proceeding. Each rulemaking document FAA issues in a particular rulemaking proceeding, as... search the Federal Docket Management System (FDMS) for information on most rulemaking proceedings. You....regulations.gov. If you can't find the material in the electronic docket, contact the person listed under FOR...

14 CFR 11.33 - How can I track FAA's rulemaking activities?

Code of Federal Regulations, 2012 CFR

2012-01-01

... rulemaking document proceeding. Each rulemaking document FAA issues in a particular rulemaking proceeding, as... search the Federal Docket Management System (FDMS) for information on most rulemaking proceedings. You....regulations.gov. If you can't find the material in the electronic docket, contact the person listed under FOR...

14 CFR 11.33 - How can I track FAA's rulemaking activities?

Code of Federal Regulations, 2011 CFR

2011-01-01

... rulemaking document proceeding. Each rulemaking document FAA issues in a particular rulemaking proceeding, as... search the Federal Docket Management System (FDMS) for information on most rulemaking proceedings. You....regulations.gov. If you can't find the material in the electronic docket, contact the person listed under FOR...

Documentation of e-cigarette use and associations with smoking from 2012 to 2015 in an integrated healthcare delivery system.

PubMed

Young-Wolff, Kelly C; Klebaner, Daniella; Folck, Bruce; Tan, Andy S L; Fogelberg, Renee; Sarovar, Varada; Prochaska, Judith J

2018-04-01

It is unclear whether use of electronic nicotine delivery systems (ENDS) precedes cigarette smoking initiation, relapse, and/or quitting. Healthcare systems with electronic health records (EHRs) provide unique data to examine ENDS use and changes in smoking. We examined the incidence of ENDS use (2012-2015) based on clinician documentation and tested whether EHR documented ENDS use is associated with twelve-month changes in patient smoking status using a matched retrospective cohort design. The sample was Kaiser Permanente Northern California (KPNC) patients aged ≥12 with documented ENDS use (N = 7926); 57% were current smokers, 35% former smokers, and 8% never-smokers. ENDS documentation incidence peaked in 2014 for current and former smokers and in 2015 for never-smokers. We matched patients with documented ENDS use to KPNC patients without documented ENDS use (N = 7926) on age, sex, race/ethnicity, and smoking status. Documented ENDS use predicted the likelihood of smoking in the following year. Among current smokers, ENDS use was associated with greater odds of quitting smoking (OR = 1.17, 95%CI = 1.05-1.31). Among former smokers, ENDS use was associated with greater odds of smoking relapse (OR = 1.53, 95%CI = 1.22-1.92). Among never-smokers, ENDS use was associated with greater odds of initiating smoking (OR = 7.41, 95%CI = 3.14-17.5). The overall number of current smokers at 12 months was slightly higher among patients with (N = 3931) versus without (N = 3850) documented ENDS use. Results support both potential harm reduction of ENDS use (quitting combustibles among current smokers) and potential for harm (relapse to combustibles among former smokers, initiation for never-smokers). Copyright © 2018 Elsevier Inc. All rights reserved.

Modeling of outpatient prescribing process in iran: a gateway toward electronic prescribing system.

PubMed

Ahmadi, Maryam; Samadbeik, Mahnaz; Sadoughi, Farahnaz

2014-01-01

Implementation of electronic prescribing system can overcome many problems of the paper prescribing system, and provide numerous opportunities of more effective and advantageous prescribing. Successful implementation of such a system requires complete and deep understanding of work content, human force, and workflow of paper prescribing. The current study was designed in order to model the current business process of outpatient prescribing in Iran and clarify different actions during this process. In order to describe the prescribing process and the system features in Iran, the methodology of business process modeling and analysis was used in the present study. The results of the process documentation were analyzed using a conceptual model of workflow elements and the technique of modeling "As-Is" business processes. Analysis of the current (as-is) prescribing process demonstrated that Iran stood at the first levels of sophistication in graduated levels of electronic prescribing, namely electronic prescription reference, and that there were problematic areas including bottlenecks, redundant and duplicated work, concentration of decision nodes, and communicative weaknesses among stakeholders of the process. Using information technology in some activities of medication prescription in Iran has not eliminated the dependence of the stakeholders on paper-based documents and prescriptions. Therefore, it is necessary to implement proper system programming in order to support change management and solve the problems in the existing prescribing process. To this end, a suitable basis should be provided for reorganization and improvement of the prescribing process for the future electronic systems.

Personal Information Management for Nurses Returning to School.

PubMed

Bowman, Katherine

2015-12-01

Registered nurses with a diploma or an associate's degree are encouraged to return to school to earn a Bachelor of Science in Nursing degree. Until they return to school, many RNs have little need to regularly write, store, and retrieve work-related papers, but they are expected to complete the majority of assignments using a computer when in the student role. Personal information management (PIM) is a system of organizing and managing electronic information that will reduce computer clutter, while enhancing time use, task management, and productivity. This article introduces three PIM strategies for managing school work. Nesting is the creation of a system of folders to form a hierarchy for storing and retrieving electronic documents. Each folder, subfolder, and document must be given a meaningful unique name. Numbering is used to create different versions of the same paper, while preserving the original document. Copyright 2015, SLACK Incorporated.

Development and evaluation of nursing user interface screens using multiple methods.

PubMed

Hyun, Sookyung; Johnson, Stephen B; Stetson, Peter D; Bakken, Suzanne

2009-12-01

Building upon the foundation of the Structured Narrative Electronic Health Record (EHR) model, we applied theory-based (combined Technology Acceptance Model and Task-Technology Fit Model) and user-centered methods to explore nurses' perceptions of functional requirements for an electronic nursing documentation system, design user interface screens reflective of the nurses' perspectives, and assess nurses' perceptions of the usability of the prototype user interface screens. The methods resulted in user interface screens that were perceived to be easy to use, potentially useful, and well-matched to nursing documentation tasks associated with Nursing Admission Assessment, Blood Administration, and Nursing Discharge Summary. The methods applied in this research may serve as a guide for others wishing to implement user-centered processes to develop or extend EHR systems. In addition, some of the insights obtained in this study may be informative to the development of safe and efficient user interface screens for nursing document templates in EHRs.

Integration of Evidence into a Detailed Clinical Model-based Electronic Nursing Record System

PubMed Central

Park, Hyeoun-Ae; Jeon, Eunjoo; Chung, Eunja

2012-01-01

Objectives The purpose of this study was to test the feasibility of an electronic nursing record system for perinatal care that is based on detailed clinical models and clinical practice guidelines in perinatal care. Methods This study was carried out in five phases: 1) generating nursing statements using detailed clinical models; 2) identifying the relevant evidence; 3) linking nursing statements with the evidence; 4) developing a prototype electronic nursing record system based on detailed clinical models and clinical practice guidelines; and 5) evaluating the prototype system. Results We first generated 799 nursing statements describing nursing assessments, diagnoses, interventions, and outcomes using entities, attributes, and value sets of detailed clinical models for perinatal care which we developed in a previous study. We then extracted 506 recommendations from nine clinical practice guidelines and created sets of nursing statements to be used for nursing documentation by grouping nursing statements according to these recommendations. Finally, we developed and evaluated a prototype electronic nursing record system that can provide nurses with recommendations for nursing practice and sets of nursing statements based on the recommendations for guiding nursing documentation. Conclusions The prototype system was found to be sufficiently complete, relevant, useful, and applicable in terms of content, and easy to use and useful in terms of system user interface. This study has revealed the feasibility of developing such an ENR system. PMID:22844649

76 FR 16002 - Records Schedules; Availability and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

... personnel directories, and on duty and promotion date reports. 15. Department of Justice, Office of the... and system documentation of an electronic information system used to monitor staff productivity and...

Electronic health record systems in ophthalmology: impact on clinical documentation.

PubMed

Sanders, David S; Lattin, Daniel J; Read-Brown, Sarah; Tu, Daniel C; Wilson, David J; Hwang, Thomas S; Morrison, John C; Yackel, Thomas R; Chiang, Michael F

2013-09-01

To evaluate quantitative and qualitative differences in documentation of the ophthalmic examination between paper and electronic health record (EHR) systems. Comparative case series. One hundred fifty consecutive pairs of matched paper and EHR notes, documented by 3 attending ophthalmologist providers. An academic ophthalmology department implemented an EHR system in 2006. Database queries were performed to identify cases in which the same problems were documented by the same provider on different dates, using paper versus EHR methods. This was done for 50 consecutive pairs of examinations in 3 different diseases: age-related macular degeneration (AMD), glaucoma, and pigmented choroidal lesions (PCLs). Quantitative measures were used to compare completeness of documenting the complete ophthalmologic examination, as well as disease-specific critical findings using paper versus an EHR system. Qualitative differences in paper versus EHR documentation were illustrated by selecting representative paired examples. (1) Documentation score, defined as the number of examination elements recorded for the slit-lamp examination, fundus examination, and complete ophthalmologic examination and for critical clinical findings for each disease. (2) Paired comparison of qualitative differences in paper versus EHR documentation. For all 3 diseases (AMD, glaucoma, PCL), the number of complete examination findings recorded was significantly lower with paper than the EHR system (P ≤ 0.004). Among the 3 individual examination sections (general, slit lamp, fundus) for the 3 diseases, 5 of the 9 possible combinations had significantly lower mean documentation scores with paper than EHR notes. For 2 of the 3 diseases, the number of critical clinical findings recorded was significantly lower using paper versus EHR notes (P ≤ 0.022). All (150/150) paper notes relied on graphical representations using annotated hand-drawn sketches, whereas no (0/150) EHR notes contained drawings. Instead, the EHR systems documented clinical findings using textual descriptions and interpretations. There were quantitative and qualitative differences in the nature of paper versus EHR documentation of ophthalmic findings in this study. The EHR notes included more complete documentation of examination elements using structured textual descriptions and interpretations, whereas paper notes used graphical representations of findings. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Basic Hitchhiker Payload Requirements

NASA Technical Reports Server (NTRS)

Horan, Stephen

1999-01-01

This document lists the requirements for the NMSU Hitchhiker experiment payload that were developed as part of the EE 498/499 Capstone Design class during the 1999-2000 academic year. This document is used to describe the system needs as described in the mission document. The requirements listed here are those primarily used to generate the basic electronic and data processing requirements developed in the class design document. The needs of the experiment components are more fully described in the draft NASA hitchhiker customer requirements document. Many of the details for the overall payload are given in full detail in the NASA hitchhiker documentation.

Paper trails. Document management is no silver bullet, but it can patch holes as hospitals transition to paperless.

PubMed

Gamble, Kate Huvane

2009-10-01

Hospitals are leveraging content management to ease the transition from a paper-based to electronic environment. Document management is used to scan, index and archive medical records and financial documents. Even fully integrated health systems receive outside documents such as lab results and referrals that must be incorporated into the patient record. The data in scanned documents cannot be used for trending purposes without manual work. The market for natural language processing, a tool used to extract data elements from scanned documents, could ramp up significantly in the near future.

7 CFR 900.31 - Electronic submission of hearing documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Electronic submission of hearing documents. 900.31... and Marketing Orders § 900.31 Electronic submission of hearing documents. To the extent practicable..., USDA. All documents should reference the docket number of the proceeding. Instructions for electronic...

7 CFR 900.31 - Electronic submission of hearing documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Electronic submission of hearing documents. 900.31... and Marketing Orders § 900.31 Electronic submission of hearing documents. To the extent practicable..., USDA. All documents should reference the docket number of the proceeding. Instructions for electronic...

Outcomes of Computerized Physician Order Entry in an Electronic Health Record After Implementation in an Outpatient Oncology Setting

PubMed Central

Harshberger, Cara A.; Harper, Abigail J.; Carro, George W.; Spath, Wayne E.; Hui, Wendy C.; Lawton, Jessica M.; Brockstein, Bruce E.

2011-01-01

Purpose: Computerized physician order entry (CPOE) in electronic health records (EHR) has been recognized as an important tool in optimal health care provision that can reduce errors and improve safety. The objective of this study is to describe documentation completeness and user satisfaction of medical charts before and after implementation of an outpatient oncology EHR/ CPOE system in a hospital-based outpatient cancer center within three treatment sites. Methods: This study is a retrospective chart review of 90 patients who received one of the following regimens between 1999 and 2006: FOLFOX, AC, carboplatin + paclitaxel, ABVD, cisplatin + etoposide, R-CHOP, and clinical trials. Documentation completeness scores were assigned to each chart based on the number of documented data points found out of the total data points assessed. EHR/CPOE documentation completeness was compared with completeness of paper charts orders of the same regimens. A user satisfaction survey of the paper chart and EHR/CPOE system was conducted among the physicians, nurses, and pharmacists who worked with both systems. Results: The mean percentage of identified data points successfully found in the EHR/CPOE charts was 93% versus 67% in the paper charts (P < .001). Regimen complexity did not alter the number of data points found. The survey response rate was 64%, and the results showed that satisfaction was statistically significant in favor of the EHR/CPOE system. Conclusion: Using EHR/CPOE systems improves completeness of medical record and chemotherapy order documentation and improves user satisfaction with the medical record system. EHR/CPOE requires constant vigilance and maintenance to optimize patient safety. PMID:22043187

FTP: Full-Text Publishing?

ERIC Educational Resources Information Center

Jul, Erik

1992-01-01

Describes the use of file transfer protocol (FTP) on the INTERNET computer network and considers its use as an electronic publishing system. The differing electronic formats of text files are discussed; the preparation and access of documents are described; and problems are addressed, including a lack of consistency. (LRW)

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

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Data base systems in electronic design engineering

NASA Technical Reports Server (NTRS)

Williams, D.

1980-01-01

The concepts of an integrated design data base system (DBMS) as it might apply to an electronic design company are discussed. Data elements of documentation, project specifications, project tracking, firmware, software, electronic and mechanical design can be integrated and managed through a single DBMS. Combining the attributes of a DBMS data handler with specialized systems and functional data can provide users with maximum flexibility, reduced redundancy, and increased overall systems performance. Although some system overhead is lost due to redundancy in transitory data, it is believed the combination of the two data types is advisable rather than trying to do all data handling through a single DBMS.

Implementation of Improvements in an Electronic Documentation Nursing Process System Structured on NANDA-I, NOC and NIC (NNN) Classification.

PubMed

Peres, Heloísa; Cruz, Diná; Tellez, Michelle; de Cássia Gengo E Silva, Rita; Ortiz, Diley; Diogo, Regina; Ortiz, Dóris R

2016-01-01

The aim of this study was to present the experience of a teaching hospital with the implementation of improvements to an electronic documentation system of the nursing process (PROCEnf-USP®). The improvements were based on functional performance and technical quality of the system. It was adopted Scrum^™ method for version control PROCEnf-USP® by enabling agility, flexibility and possibility of integration between development and users. The PROCEnf-USP® has been used since 2009 and has professional and academic environments. The current version lets you generate reports and supports decisions about diagnoses, outcomes and interventions. It is provided the use of indicators to monitor results and registration at the point of care. The establishment of important.

Vital sign documentation in electronic records: The development of workarounds.

PubMed

Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla; Petersson, Goran; Bath, Peter A

2018-06-01

Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient's condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety.

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Officer Powers, and General Hearing Management for NRC Adjudicatory Hearings § 2.302 Filing of documents... electronic transmission when the filer performs the last act that it must perform to transmit a document, in... electronic documents. The exempt participant is permitted to file electronic documents by physically...

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Officer Powers, and General Hearing Management for NRC Adjudicatory Hearings § 2.302 Filing of documents... electronic transmission when the filer performs the last act that it must perform to transmit a document, in... electronic documents. The exempt participant is permitted to file electronic documents by physically...

Testing a Nursing-Specific Model of Electronic Patient Record documentation with regard to information completeness, comprehensiveness and consistency.

PubMed

von Krogh, Gunn; Nåden, Dagfinn; Aasland, Olaf Gjerløw

2012-10-01

To present the results from the test site application of the documentation model KPO (quality assurance, problem solving and caring) designed to impact the quality of nursing information in electronic patient record (EPR). The KPO model was developed by means of consensus group and clinical testing. Four documentation arenas and eight content categories, nursing terminologies and a decision-support system were designed to impact the completeness, comprehensiveness and consistency of nursing information. The testing was performed in a pre-test/post-test time series design, three times at a one-year interval. Content analysis of nursing documentation was accomplished through the identification, interpretation and coding of information units. Data from the pre-test and post-test 2 were subjected to statistical analyses. To estimate the differences, paired t-tests were used. At post-test 2, the information is found to be more complete, comprehensive and consistent than at pre-test. The findings indicate that documentation arenas combining work flow and content categories deduced from theories on nursing practice can influence the quality of nursing information. The KPO model can be used as guide when shifting from paper-based to electronic-based nursing documentation with the aim of obtaining complete, comprehensive and consistent nursing information. © 2012 Blackwell Publishing Ltd.

Document Concurrence System

NASA Technical Reports Server (NTRS)

Muhsin, Mansour; Walters, Ian

2004-01-01

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

Long-Term Pavement Performance Materials Characterization Program: Verification of Dynamic Test Systems with an Emphasis on Resilient Modulus

DOT National Transportation Integrated Search

2005-09-01

This document describes a procedure for verifying a dynamic testing system (closed-loop servohydraulic). The procedure is divided into three general phases: (1) electronic system performance verification, (2) calibration check and overall system perf...

Integration of scanned document management with the anatomic pathology laboratory information system: analysis of benefits.

PubMed

Schmidt, Rodney A; Simmons, Kim; Grimm, Erin E; Middlebrooks, Michael; Changchien, Rosy

2006-11-01

Electronic document management systems (EDMSs) have the potential to improve the efficiency of anatomic pathology laboratories. We implemented a novel but simple EDMS for scanned documents as part of our laboratory information system (AP-LIS) and collected cost-benefit data with the intention of discerning the value of such a system in general and whether integration with the AP-LIS is advantageous. We found that the direct financial benefits are modest but the indirect and intangible benefits are large. Benefits of time savings and access to data particularly accrued to pathologists and residents (3.8 h/d saved for 26 pathologists and residents). Integrating the scanned document management system (SDMS) into the AP-LIS has major advantages in terms of workflow and overall simplicity. This simple, integrated SDMS is an excellent value in a practice like ours, and many of the benefits likely apply in other practice settings.

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

Electronic Documentation Support Tools and Text Duplication in the Electronic Medical Record

ERIC Educational Resources Information Center

Wrenn, Jesse

2010-01-01

In order to ease the burden of electronic note entry on physicians, electronic documentation support tools have been developed to assist in note authoring. There is little evidence of the effects of these tools on attributes of clinical documentation, including document quality. Furthermore, the resultant abundance of duplicated text and…

Comparing the Efficacy of an Engineered-Based System (College Livetext) with an Off-the-Shelf General Tool (Hyperstudio) for Developing Electronic Portfolios in Teacher Education

ERIC Educational Resources Information Center

Johnson-Leslie, Natalie A.

2009-01-01

In teacher education, electronic portfolios provide an authentic form of assessment documenting students' personal and professional growth. Using the engineered-based system, College LiveText, and an off-the-shelf general tool, HyperStudio, pre-service teachers constructed e-portfolios as part of their teacher preparation requirements. This case…

Toward information management in corporations (7)

NASA Astrophysics Data System (ADS)

Yasuda, Naoyoshi

Personal computers and workstations have come into wide use. The high performance modems will be available at cheaper prices so that the bulletin-board system and electronic mail have been used by many people. This paper discusses the network system, and describes the electronic mail covering wider regions and BBS for research and development. It also describes how to handle document images by use of these measures.

Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis.

PubMed

Lacson, Ronilda; O'Connor, Stacy D; Sahni, V Anik; Roy, Christopher; Dalal, Anuj; Desai, Sonali; Khorasani, Ramin

2016-07-01

Optimal critical test result communication is a Joint Commission national patient safety goal and requires documentation of closed-loop communication among care providers in the medical record. Electronic alert notification systems can facilitate an auditable process for creating alerts for transmission and acknowledgement of critical test results. We evaluated the impact of a patient safety initiative with an alert notification system on reducing critical results lacking documented communication, and assessed potential overuse of the alerting system for communicating results. We implemented an alert notification system-Alert Notification of Critical Results (ANCR)-in January 2010. We reviewed radiology reports finalised in 2009-2014 which lacked documented communication between the radiologist and another care provider, and assessed the impact of ANCR on the proportion of such reports with critical findings, using trend analysis over 10 semiannual time periods. To evaluate potential overuse of ANCR, we assessed the proportion of reports with non-critical results among provider-communicated reports. The proportion of reports with critical results among reports without documented communication decreased significantly over 4 years (2009-2014) from 0.19 to 0.05 (p<0.0001, Cochran-Armitage trend test). The proportion of provider-communicated reports with non-critical results remained unchanged over time before and after ANCR implementation (0.20 to 0.15, p=0.45, Cochran-Armitage trend test). A patient safety initiative with an alert notification system reduced the proportion of critical results among reports lacking documented communication between care providers. We observed no change in documented communication of non-critical results, suggesting the system did not promote overuse. Future studies are needed to evaluate whether such systems prevent subsequent patient harm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The opportunities for and challenges of common integrated electronics

NASA Astrophysics Data System (ADS)

Nelson, J. R.; Retterer, Bernard L.; Cloud, Harley A.

1994-02-01

This document summarizes a portion of IDA's work concerning common integrated electronics and the potential cost savings of using common electronic hardware and software. It addresses trends in avionics costs and recent experiences in applying common electronic standards to weapon programs as a way to reduce costs. The following essential elements of a program to acquire common integrated electronics are explored: (1) integrated system architecture; (2) advanced technology programs; (3) open system standards; (4) standard common modules; and (5) associated management and policies. The principal recommendation is that OSD support and coordinate such a-program by taking a strong leadership role and setting standards policy.

Space station systems: A bibliography with indexes (supplement 6)

NASA Technical Reports Server (NTRS)

1988-01-01

This bibliography lists 1,133 reports, articles, and other documents introduced into the NASA scientific and technical information system between July 1, 1987 and December 31, 1987. Its purpose is to provide helpful information to the researcher, manager, and designer in technology development and mission design according to system, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion, and solar power satellite systems. The coverage includes documents that define major systems and subsystems, servicing and support requirements, procedures and operations, and missions for the current and future Space Station.

Space station systems: A bibliography with indexes (supplement 3)

NASA Technical Reports Server (NTRS)

1987-01-01

This bibliography lists 780 reports, articles and other documents introduced into the NASA scientific and technical information system between January 1, 1986 and June 30, 1986. Its purpose is to provide helpful information to the researcher, manager, and designer in technology development and mission design according to system, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion, and solar power satellite system. The coverage includes documents that define major systems and subsystems, servicing and support requirements, procedures and operations, and missions for the current and future space station.

Space station systems: A bibliography with indexes (supplement 2)

NASA Technical Reports Server (NTRS)

1986-01-01

This bibliography lists 904 reports, articles and other documents introduced into the NASA scientific and technical information system between July 1, 1985 and December 31, 1985. Its purpose is to provide helpful information to the researcher, manager, and designer in technology development and mission design according to system, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion, and solar power satellite systems. The coverage includes documents that define major systems and subsystems, servicing and support requirements, procedures and operations, and missions for the current and future space station.

Space station systems: A bibliography with indexes

NASA Technical Reports Server (NTRS)

1987-01-01

This bibliography lists 967 reports, articles, and other documents introduced into the NASA scientific and technical information system between January 1, 1987 and June 30, 1987. Its purpose is to provide helpful information to the researcher, manager, and designer in technology development and mission design according to system, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion, and solar power satellite systems. The coverage includes documents that define major systems and subsystems, servicing and support requirements, procedures and operations, and missions for the current and future space station.

77 FR 65206 - Privacy Act of 1974; Amendment of Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

... the Board's appellate and original jurisdiction; locate appeal documents and files, physical or... service under 5 U.S.C. 1204(a)(3), and review of regulations of the Office of Personnel Management (OPM...; b. Locate appeal documents and files, whether physical or electronic; c. Provide statistical data...

14 CFR 11.45 - Where and when do I file my comments?

Code of Federal Regulations, 2013 CFR

2013-01-01

... do I file my comments? (a) Send your comments to the location specified in the rulemaking document on which you are commenting. If you are asked to send your comments to the Federal Document Management... you do not follow the electronic filing instructions at the Federal Docket Management System Web site...

14 CFR 11.45 - Where and when do I file my comments?

Code of Federal Regulations, 2011 CFR

2011-01-01

... do I file my comments? (a) Send your comments to the location specified in the rulemaking document on which you are commenting. If you are asked to send your comments to the Federal Document Management... you do not follow the electronic filing instructions at the Federal Docket Management System Web site...

14 CFR 11.45 - Where and when do I file my comments?

Code of Federal Regulations, 2014 CFR

2014-01-01

... do I file my comments? (a) Send your comments to the location specified in the rulemaking document on which you are commenting. If you are asked to send your comments to the Federal Document Management... you do not follow the electronic filing instructions at the Federal Docket Management System Web site...

14 CFR 11.45 - Where and when do I file my comments?

Code of Federal Regulations, 2012 CFR

2012-01-01

... do I file my comments? (a) Send your comments to the location specified in the rulemaking document on which you are commenting. If you are asked to send your comments to the Federal Document Management... you do not follow the electronic filing instructions at the Federal Docket Management System Web site...

ORANGES evaluation phase I risk assessment report : phase I of the US DOT sponsored evaluation of the ORANGES electronic payment system field operational test

DOT National Transportation Integrated Search

2004-03-11

This document is the US DOT evaluation Risk Assessment report for Phase I of the ORANGES field operational test. This document consolidates working papers and incorporates an assessment of issues, risks, mitigation strategies and lessons learned look...

6 CFR 37.13 - Document verification requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... required under § 37.11 with the issuer of the document. States shall use systems for electronic validation... process is not warranted in the situation, the DMV must not issue a REAL ID driver's license or... authentic upon inspection or the data does not match and the use of an exceptions process is not warranted...

6 CFR 37.13 - Document verification requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... required under § 37.11 with the issuer of the document. States shall use systems for electronic validation... process is not warranted in the situation, the DMV must not issue a REAL ID driver's license or... authentic upon inspection or the data does not match and the use of an exceptions process is not warranted...

The New Philanthropist: Eric Schnell--Ohio State University

ERIC Educational Resources Information Center

Library Journal, 2005

2005-01-01

As head of information technology at the Prior Health Sciences Library, Eric Schnell likes to improve products that don't fully meet his library's purposes. His first major software product, the award-winning Prospero Electronic Delivery Project, is a web-based document delivery system designed to complement Ariel[R] by converting documents to a…

Automated Text Markup for Information Retrieval from an Electronic Textbook of Infectious Disease

PubMed Central

Berrios, Daniel C.; Kehler, Andrew; Kim, David K.; Yu, Victor L.; Fagan, Lawrence M.

1998-01-01

The information needs of practicing clinicians frequently require textbook or journal searches. Making these sources available in electronic form improves the speed of these searches, but precision (i.e., the fraction of relevant to total documents retrieved) remains low. Improving the traditional keyword search by transforming search terms into canonical concepts does not improve search precision greatly. Kim et al. have designed and built a prototype system (MYCIN II) for computer-based information retrieval from a forthcoming electronic textbook of infectious disease. The system requires manual indexing by experts in the form of complex text markup. However, this mark-up process is time consuming (about 3 person-hours to generate, review, and transcribe the index for each of 218 chapters). We have designed and implemented a system to semiautomate the markup process. The system, information extraction for semiautomated indexing of documents (ISAID), uses query models and existing information-extraction tools to provide support for any user, including the author of the source material, to mark up tertiary information sources quickly and accurately.

An automated electronic system for managing radiation treatment plan peer review reduces missed reviews at a large, high-volume academic center.

PubMed

Gabriel, Peter E; Woodhouse, Kristina D; Lin, Alexander; Finlay, Jarod C; Young, Richard B; Volz, Edna; Hahn, Stephen M; Metz, James M; Maity, Amit

Assuring quality in cancer care through peer review has become increasingly important in radiation oncology. In 2012, our department implemented an automated electronic system for managing radiation treatment plan peer review. The purpose of this study was to compare the overall impact of this electronic system to our previous manual, paper-based system. In an effort to improve management, an automated electronic system for case finding and documentation of review was developed and implemented. The rates of missed initial reviews, late reviews, and missed re-reviews were compared for the pre- versus postelectronic system cohorts using Pearson χ 2 test and relative risk. Major and minor changes or recommendations were documented and shared with the assigned clinical provider. The overall rate of missed reviews was 7.6% (38/500) before system implementation versus 0.4% (28/6985) under the electronic system (P < .001). In terms of relative risk, courses were 19.0 times (95% confidence interval, 11.8-30.7) more likely to be missed for initial review before the automated system. Missed re-reviews occurred in 23.1% (3/13) of courses in the preelectronic system cohort and 6.6% (10/152) of courses in the postelectronic system cohort (P = .034). Late reviews were more frequent during high travel or major holiday periods. Major changes were recommended in 2.2% and 2.8% in the pre- versus postelectronic systems, respectively. Minor changes were recommended in 5.3% of all postelectronic cases. The implementation of an automated electronic system for managing peer review in a large, complex department was effective in significantly reducing the number of missed reviews and missed re-reviews when compared to our previous manual system. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

7 CFR 735.402 - Providers of other electronic documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Providers of other electronic documents. 735.402... Electronic Providers § 735.402 Providers of other electronic documents. (a) To establish a USWA-authorized...) Records; (6) Conflict of interest requirements; (7) USDA common electronic information requirements; (8...

7 CFR 735.402 - Providers of other electronic documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Providers of other electronic documents. 735.402... Electronic Providers § 735.402 Providers of other electronic documents. (a) To establish a USWA-authorized...) Records; (6) Conflict of interest requirements; (7) USDA common electronic information requirements; (8...

Abstracts of SIG Sessions.

ERIC Educational Resources Information Center

Proceedings of the ASIS Annual Meeting, 1993

1993-01-01

Presents abstracts of 34 special interest group (SIG) sessions. Highlights include humanities scholars and electronic texts; information retrieval and indexing systems design; automated indexing; domain analysis; query expansion in document retrieval systems; thesauri; business intelligence; Americans with Disabilities Act; management;…

10 CFR 34.89 - Location of documents and records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... problems identified in daily checks of equipment as required by § 34.73(a); (5) Records of alarm system and... as pocket dosimeter and/or electronic personal dosimeters readings as required by § 34.83; (7... calibrations of alarm ratemeters and operability checks of pocket dosimeters and/or electronic personal...

10 CFR 34.89 - Location of documents and records.

Code of Federal Regulations, 2011 CFR

2011-01-01

... problems identified in daily checks of equipment as required by § 34.73(a); (5) Records of alarm system and... as pocket dosimeter and/or electronic personal dosimeters readings as required by § 34.83; (7... calibrations of alarm ratemeters and operability checks of pocket dosimeters and/or electronic personal...

47 CFR 27.20 - Digital television transition education reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... filed electronically using the Commission's Electronic Comment File System (ECFS), the “Document Type...—the licensee holding such authorization must file a report with the Commission indicating whether, in... April-June quarter of 2008, the licensee must file its first report by July 10, 2008. Each quarterly...

47 CFR 27.20 - Digital television transition education reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... filed electronically using the Commission's Electronic Comment File System (ECFS), the “Document Type...—the licensee holding such authorization must file a report with the Commission indicating whether, in... April-June quarter of 2008, the licensee must file its first report by July 10, 2008. Each quarterly...

An XML-based system for the flexible classification and retrieval of clinical practice guidelines.

PubMed Central

Ganslandt, T.; Mueller, M. L.; Krieglstein, C. F.; Senninger, N.; Prokosch, H. U.

2002-01-01

Beneficial effects of clinical practice guidelines (CPGs) have not yet reached expectations due to limited routine adoption. Electronic distribution and reminder systems have the potential to overcome implementation barriers. Existing electronic CPG repositories like the National Guideline Clearinghouse (NGC) provide individual access but lack standardized computer-readable interfaces necessary for automated guideline retrieval. The aim of this paper was to facilitate automated context-based selection and presentation of CPGs. Using attributes from the NGC classification scheme, an XML-based metadata repository was successfully implemented, providing document storage, classification and retrieval functionality. Semi-automated extraction of attributes was implemented for the import of XML guideline documents using XPath. A hospital information system interface was exemplarily implemented for diagnosis-based guideline invocation. Limitations of the implemented system are discussed and possible future work is outlined. Integration of standardized computer-readable search interfaces into existing CPG repositories is proposed. PMID:12463831

Definition, structure, content, use and impacts of electronic health records: a review of the research literature.

PubMed

Häyrinen, Kristiina; Saranto, Kaija; Nykänen, Pirkko

2008-05-01

This paper reviews the research literature on electronic health record (EHR) systems. The aim is to find out (1) how electronic health records are defined, (2) how the structure of these records is described, (3) in what contexts EHRs are used, (4) who has access to EHRs, (5) which data components of the EHRs are used and studied, (6) what is the purpose of research in this field, (7) what methods of data collection have been used in the studies reviewed and (8) what are the results of these studies. A systematic review was carried out of the research dealing with the content of EHRs. A literature search was conducted on four electronic databases: Pubmed/Medline, Cinalh, Eval and Cochrane. The concept of EHR comprised a wide range of information systems, from files compiled in single departments to longitudinal collections of patient data. Only very few papers offered descriptions of the structure of EHRs or the terminologies used. EHRs were used in primary, secondary and tertiary care. Data were recorded in EHRs by different groups of health care professionals. Secretarial staff also recorded data from dictation or nurses' or physicians' manual notes. Some information was also recorded by patients themselves; this information is validated by physicians. It is important that the needs and requirements of different users are taken into account in the future development of information systems. Several data components were documented in EHRs: daily charting, medication administration, physical assessment, admission nursing note, nursing care plan, referral, present complaint (e.g. symptoms), past medical history, life style, physical examination, diagnoses, tests, procedures, treatment, medication, discharge, history, diaries, problems, findings and immunization. In the future it will be necessary to incorporate different kinds of standardized instruments, electronic interviews and nursing documentation systems in EHR systems. The aspects of information quality most often explored in the studies reviewed were the completeness and accuracy of different data components. It has been shown in several studies that the use of an information system was conducive to more complete and accurate documentation by health care professionals. The quality of information is particularly important in patient care, but EHRs also provide important information for secondary purposes, such as health policy planning. Studies focusing on the content of EHRs are needed, especially studies of nursing documentation or patient self-documentation. One future research area is to compare the documentation of different health care professionals with the core information about EHRs which has been determined in national health projects. The challenge for ongoing national health record projects around the world is to take into account all the different types of EHRs and the needs and requirements of different health care professionals and consumers in the development of EHRs. A further challenge is the use of international terminologies in order to achieve semantic interoperability.

An Investigation of Nonuniform Dose Deposition From an Electron Beam

DTIC Science & Technology

1994-08-01

to electron - beam pulse. Ceramic package HIPEC Lid Electron beam Die Bond wires TLD TLD Silver epoxy 6 package cavity die TLD’s 21 3 4 5 Figure 2...these apertures was documented in a previous experiment relating to HIFX electron -beam dosimetry .2 The hardware required for this setup was a 60-cm...impurity serves 2Gregory K. Ovrebo, Steven M. Blomquist, and Steven R. Murrill, A HIFX Electron -Beam Dosimetry System, Army Research Laboratory, ARL-TR

Use of the QR Reader to Provide Real-Time Evaluation of Residents' Skills Following Surgical Procedures.

PubMed

Reynolds, Kellin; Barnhill, Danny; Sias, Jamie; Young, Amy; Polite, Florencia Greer

2014-12-01

A portable electronic method of providing instructional feedback and recording an evaluation of resident competency immediately following surgical procedures has not previously been documented in obstetrics and gynecology. This report presents a unique electronic format that documents resident competency and encourages verbal communication between faculty and residents immediately following operative procedures. The Microsoft Tag system and SurveyMonkey platform were linked by a 2-D QR code using Microsoft QR code generator. Each resident was given a unique code (TAG) embedded onto an ID card. An evaluation form was attached to each resident's file in SurveyMonkey. Postoperatively, supervising faculty scanned the resident's TAG with a smartphone and completed the brief evaluation using the phone's screen. The evaluation was reviewed with the resident and automatically submitted to the resident's educational file. The evaluation system was quickly accepted by residents and faculty. Of 43 residents and faculty in the study, 38 (88%) responded to a survey 8 weeks after institution of the electronic evaluation system. Thirty (79%) of the 38 indicated it was superior to the previously used handwritten format. The electronic system demonstrated improved utilization compared with paper evaluations, with a mean of 23 electronic evaluations submitted per resident during a 6-month period versus 14 paper assessments per resident during an earlier period of 6 months. This streamlined portable electronic evaluation is an effective tool for direct, formative feedback for residents, and it creates a longitudinal record of resident progress. Satisfaction with, and use of, this evaluation system was high.

Use of the QR Reader to Provide Real-Time Evaluation of Residents' Skills Following Surgical Procedures

PubMed Central

Reynolds, Kellin; Barnhill, Danny; Sias, Jamie; Young, Amy; Polite, Florencia Greer

2014-01-01

Background A portable electronic method of providing instructional feedback and recording an evaluation of resident competency immediately following surgical procedures has not previously been documented in obstetrics and gynecology. Objective This report presents a unique electronic format that documents resident competency and encourages verbal communication between faculty and residents immediately following operative procedures. Methods The Microsoft Tag system and SurveyMonkey platform were linked by a 2-D QR code using Microsoft QR code generator. Each resident was given a unique code (TAG) embedded onto an ID card. An evaluation form was attached to each resident's file in SurveyMonkey. Postoperatively, supervising faculty scanned the resident's TAG with a smartphone and completed the brief evaluation using the phone's screen. The evaluation was reviewed with the resident and automatically submitted to the resident's educational file. Results The evaluation system was quickly accepted by residents and faculty. Of 43 residents and faculty in the study, 38 (88%) responded to a survey 8 weeks after institution of the electronic evaluation system. Thirty (79%) of the 38 indicated it was superior to the previously used handwritten format. The electronic system demonstrated improved utilization compared with paper evaluations, with a mean of 23 electronic evaluations submitted per resident during a 6-month period versus 14 paper assessments per resident during an earlier period of 6 months. Conclusions This streamlined portable electronic evaluation is an effective tool for direct, formative feedback for residents, and it creates a longitudinal record of resident progress. Satisfaction with, and use of, this evaluation system was high. PMID:26140128

Facilitating NASA's Use of GEIA-STD-0005-1, Performance Standard for Aerospace and High Performance Electronic Systems Containing Lead-Free Solder

NASA Technical Reports Server (NTRS)

Plante, Jeannete

2010-01-01

GEIA-STD-0005-1 defines the objectives of, and requirements for, documenting processes that assure customers and regulatory agencies that AHP electronic systems containing lead-free solder, piece parts, and boards will satisfy the applicable requirements for performance, reliability, airworthiness, safety, and certify-ability throughout the specified life of performance. It communicates requirements for a Lead-Free Control Plan (LFCP) to assist suppliers in the development of their own Plans. The Plan documents the Plan Owner's (supplier's) processes, that assure their customer, and all other stakeholders that the Plan owner's products will continue to meet their requirements. The presentation reviews quality assurance requirements traceability and LFCP template instructions.

Integration of clinical research documentation in electronic health records.

PubMed

Broach, Debra

2015-04-01

Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

Metrics for Electronic-Nursing-Record-Based Narratives: Cross-sectional Analysis

PubMed Central

Kim, Kidong; Jeong, Suyeon; Lee, Kyogu; Park, Hyeoun-Ae; Min, Yul Ha; Lee, Joo Yun; Kim, Yekyung; Yoo, Sooyoung; Doh, Gippeum

2016-01-01

Summary Objectives We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. Methods We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system. The standardized number of nursing narratives (i.e., the total number of nursing narratives divided by the length of the hospital stay) was suggested to integrate the frequency and quantity of nursing documentation. Results The standardized number of nursing narratives was higher for patients aged 70 years (median = 30.2 narratives/day, interquartile range [IQR] = 24.0–39.4 narratives/day), long (8 days) hospital stays (median = 34.6 narratives/day, IQR = 27.2–43.5 narratives/day), and hospital deaths (median = 59.1 narratives/day, IQR = 47.0–74.8 narratives/day). The standardized number of narratives was higher in “pregnancy, childbirth, and puerperium” (median = 46.5, IQR = 39.0–54.7) and “diseases of the circulatory system” admissions (median = 35.7, IQR = 29.0–43.4). Conclusions Diverse hospital admissions can be consistently described with nursing-document-derived metrics for similar hospital admissions and diagnoses. Some areas of hospital admissions may have consistently increasing volumes of nursing documentation across years. Usability of electronic nursing document metrics for evaluating healthcare requires multiple aspects of hospital admissions to be considered. PMID:27901174

An electronic specimen collection protocol schema (eSCPS). Document architecture for specimen management and the exchange of specimen collection protocols between biobanking information systems.

PubMed

Eminaga, O; Semjonow, A; Oezguer, E; Herden, J; Akbarov, I; Tok, A; Engelmann, U; Wille, S

2014-01-01

The integrity of collection protocols in biobanking is essential for a high-quality sample preparation process. However, there is not currently a well-defined universal method for integrating collection protocols in the biobanking information system (BIMS). Therefore, an electronic schema of the collection protocol that is based on Extensible Markup Language (XML) is required to maintain the integrity and enable the exchange of collection protocols. The development and implementation of an electronic specimen collection protocol schema (eSCPS) was performed at two institutions (Muenster and Cologne) in three stages. First, we analyzed the infrastructure that was already established at both the biorepository and the hospital information systems of these institutions and determined the requirements for the sufficient preparation of specimens and documentation. Second, we designed an eSCPS according to these requirements. Finally, a prospective study was conducted to implement and evaluate the novel schema in the current BIMS. We designed an eSCPS that provides all of the relevant information about collection protocols. Ten electronic collection protocols were generated using the supplementary Protocol Editor tool, and these protocols were successfully implemented in the existing BIMS. Moreover, an electronic list of collection protocols for the current studies being performed at each institution was included, new collection protocols were added, and the existing protocols were redesigned to be modifiable. The documentation time was significantly reduced after implementing the eSCPS (5 ± 2 min vs. 7 ± 3 min; p = 0.0002). The eSCPS improves the integrity and facilitates the exchange of specimen collection protocols in the existing open-source BIMS.

Electrical, Electronic, and Electromechanical (EEE) parts management and control requirements for NASA space flight programs

NASA Technical Reports Server (NTRS)

1989-01-01

This document establishes electrical, electronic, and electromechanical (EEE) parts management and control requirements for contractors providing and maintaining space flight and mission-essential or critical ground support equipment for NASA space flight programs. Although the text is worded 'the contractor shall,' the requirements are also to be used by NASA Headquarters and field installations for developing program/project parts management and control requirements for in-house and contracted efforts. This document places increased emphasis on parts programs to ensure that reliability and quality are considered through adequate consideration of the selection, control, and application of parts. It is the intent of this document to identify disciplines that can be implemented to obtain reliable parts which meet mission needs. The parts management and control requirements described in this document are to be selectively applied, based on equipment class and mission needs. Individual equipment needs should be evaluated to determine the extent to which each requirement should be implemented on a procurement. Utilization of this document does not preclude the usage of other documents. The entire process of developing and implementing requirements is referred to as 'tailoring' the program for a specific project. Some factors that should be considered in this tailoring process include program phase, equipment category and criticality, equipment complexity, and mission requirements. Parts management and control requirements advocated by this document directly support the concept of 'reliability by design' and are an integral part of system reliability and maintainability. Achieving the required availability and mission success objectives during operation depends on the attention given reliability and maintainability in the design phase. Consequently, it is intended that the requirements described in this document are consistent with those of NASA publications, 'Reliability Program Requirements for Aeronautical and Space System Contractors,' NHB 5300.4(1A-l); 'Maintainability Program Requirements for Space Systems,' NHB 5300.4(1E); and 'Quality Program Provisions for Aeronautical and Space System Contractors,' NHB 5300.4(1B).

45 CFR 307.5 - Mandatory computerized support enforcement systems.

Code of Federal Regulations, 2013 CFR

2013-10-01

... hardware, operational system software, and electronic linkages with the separate components of an... plans to use and how they will interface with the base system; (3) Provide documentation that the... and for operating costs including hardware, operational software and applications software of a...

45 CFR 307.5 - Mandatory computerized support enforcement systems.

Code of Federal Regulations, 2014 CFR

2014-10-01

... hardware, operational system software, and electronic linkages with the separate components of an... plans to use and how they will interface with the base system; (3) Provide documentation that the... and for operating costs including hardware, operational software and applications software of a...

45 CFR 307.5 - Mandatory computerized support enforcement systems.

Code of Federal Regulations, 2012 CFR

2012-10-01

... hardware, operational system software, and electronic linkages with the separate components of an... plans to use and how they will interface with the base system; (3) Provide documentation that the... and for operating costs including hardware, operational software and applications software of a...

TES: A Text Extraction System.

ERIC Educational Resources Information Center

Goh, A.; Hui, S. C.

1996-01-01

Describes how TES, a text extraction system, is able to electronically retrieve a set of sentences from a document to form an indicative abstract. Discusses various text abstraction techniques and related work in the area, provides an overview of the TES system, and compares system results against manually produced abstracts. (LAM)

Complexity in Indexing Systems--Abandonment and Failure: Implications for Organizing the Internet.

ERIC Educational Resources Information Center

Weinberg, Bella Hass

1996-01-01

Discusses detailed classification systems, sophisticated alphabetical indexing systems and reasons for the abandonment of complex indexing systems. The suggested structure for indexing the Internet or other large electronic collections of documents is based on that of book indexes: specific headings with coined modifications. (Author/AEF)

What big size you have! Using effect sizes to determine the impact of public health nursing interventions.

PubMed

Johnson, K E; McMorris, B J; Raynor, L A; Monsen, K A

2013-01-01

The Omaha System is a standardized interface terminology that is used extensively by public health nurses in community settings to document interventions and client outcomes. Researchers using Omaha System data to analyze the effectiveness of interventions have typically calculated p-values to determine whether significant client changes occurred between admission and discharge. However, p-values are highly dependent on sample size, making it difficult to distinguish statistically significant changes from clinically meaningful changes. Effect sizes can help identify practical differences but have not yet been applied to Omaha System data. We compared p-values and effect sizes (Cohen's d) for mean differences between admission and discharge for 13 client problems documented in the electronic health records of 1,016 young low-income parents. Client problems were documented anywhere from 6 (Health Care Supervision) to 906 (Caretaking/parenting) times. On a scale from 1 to 5, the mean change needed to yield a large effect size (Cohen's d ≥ 0.80) was approximately 0.60 (range = 0.50 - 1.03) regardless of p-value or sample size (i.e., the number of times a client problem was documented in the electronic health record). Researchers using the Omaha System should report effect sizes to help readers determine which differences are practical and meaningful. Such disclosures will allow for increased recognition of effective interventions.

PACS and electronic health records

NASA Astrophysics Data System (ADS)

Cohen, Simona; Gilboa, Flora; Shani, Uri

2002-05-01

Electronic Health Record (EHR) is a major component of the health informatics domain. An important part of the EHR is the medical images obtained over a patient's lifetime and stored in diverse PACS. The vision presented in this paper is that future medical information systems will convert data from various medical sources -- including diverse modalities, PACS, HIS, CIS, RIS, and proprietary systems -- to HL7 standard XML documents. Then, the various documents are indexed and compiled to EHRs, upon which complex queries can be posed. We describe the conversion of data retrieved from PACS systems through DICOM to HL7 standard XML documents. This enables the EHR system to answer queries such as 'Get all chest images of patients at the age of 20-30, that have blood type 'A' and are allergic to pine trees', which a single PACS cannot answer. The integration of data from multiple sources makes our approach capable of delivering such answers. It enables the correlation of medical, demographic, clinical, and even genetic information. In addition, by fully indexing all the tagged data in DICOM objects, it becomes possible to offer access to huge amounts of valuable data, which can be better exploited in the specific radiology domain.

Space environmental effects on spacecraft: LEO materials selection guide, part 2

NASA Astrophysics Data System (ADS)

Silverman, Edward M.

1995-08-01

This document provides performance properties on major spacecraft materials and subsystems that have been exposed to the low-Earth orbit (LEO) space environment. Spacecraft materials include metals, polymers, composites, white and black paints, thermal-control blankets, adhesives, and lubricants. Spacecraft subsystems include optical components, solar cells, and electronics. Information has been compiled from LEO short-term spaceflight experiments (e.g., space shuttle) and from retrieved satellites of longer mission durations (e.g., Long Duration Exposure Facility). Major space environment effects include atomic oxygen (AO), ultraviolet radiation, micrometeoroids and debris, contamination, and particle radiation. The main objective of this document is to provide a decision tool to designers for designing spacecraft and structures. This document identifies the space environments that will affect the performance of materials and components, e.g., thermal-optical property changes of paints due to UV exposures, AO-induced surface erosion of composites, dimensional changes due to thermal cycling, vacuum-induced moisture outgassing, and surface optical changes due to AO/UV exposures. Where appropriate, relationships between the space environment and the attendant material/system effects are identified. Part 2 covers thermal control systems, power systems, optical components, electronic systems, and applications.

Space environmental effects on spacecraft: LEO materials selection guide, part 2

NASA Technical Reports Server (NTRS)

Silverman, Edward M.

1995-01-01

This document provides performance properties on major spacecraft materials and subsystems that have been exposed to the low-Earth orbit (LEO) space environment. Spacecraft materials include metals, polymers, composites, white and black paints, thermal-control blankets, adhesives, and lubricants. Spacecraft subsystems include optical components, solar cells, and electronics. Information has been compiled from LEO short-term spaceflight experiments (e.g., space shuttle) and from retrieved satellites of longer mission durations (e.g., Long Duration Exposure Facility). Major space environment effects include atomic oxygen (AO), ultraviolet radiation, micrometeoroids and debris, contamination, and particle radiation. The main objective of this document is to provide a decision tool to designers for designing spacecraft and structures. This document identifies the space environments that will affect the performance of materials and components, e.g., thermal-optical property changes of paints due to UV exposures, AO-induced surface erosion of composites, dimensional changes due to thermal cycling, vacuum-induced moisture outgassing, and surface optical changes due to AO/UV exposures. Where appropriate, relationships between the space environment and the attendant material/system effects are identified. Part 2 covers thermal control systems, power systems, optical components, electronic systems, and applications.

Critical Infrastructure References: Documented Literature Search

DTIC Science & Technology

2012-10-01

the literature search document can be a resource for DRDC and external partners. Future plans: At present, the electronic copies of the reference...Personal Information Protection and Electronic Documents Act (S.C. 2000, c. 5) Title: Personal Information Protection and Electronic Documents Act (S.C...2011 Overview: • "An Act to support and promote electronic commerce by protecting personal information that is collected, used or disclosed in

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2014 CFR

2014-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

29 CFR 2520.104b-1 - Disclosure.

Code of Federal Regulations, 2013 CFR

2013-07-01

... documents furnished in electronic form at any location where the participant is reasonably expected to... or non-electronic form, to receiving documents through electronic media and has not withdrawn such consent; (B) In the case of documents to be furnished through the Internet or other electronic...

Space station systems: A bibliography with indexes (supplement 7)

NASA Technical Reports Server (NTRS)

1988-01-01

This bibliography lists 1,158 reports, articles, and other documents introduced into the NASA scientific and technical information system between January 1, 1988 and June 30, 1988. Its purpose is to provide helpful information to researchers, designers and managers engaged in Space Station technology development and mission design. Coverage includes documents that define major systems and subsystems related to structures and dynamic control, electronics and power supplies, propulsion, and payload integration. In addition, orbital construction methods, servicing and support requirements, procedures and operations, and missions for the current and future Space Station are included.

Space station systems: A bibliography with indexes (supplement 10)

NASA Technical Reports Server (NTRS)

1990-01-01

This bibliography lists 1,422 reports, articles, and other documents introduced into the NASA scientific and technical information system between July 1, 1989 and December 31, 1989. Its purpose is to provide helpful information to researchers, designers and managers engaged in Space Station technology development and mission design. Coverage includes documents that define major systems and subsystems related to structures and dynamic control, electronics and power supplies, propulsion, and payload integration. In addition, orbital construction methods, servicing and support requirements, procedures and operations, and missions for the current and future Space Station are included.

Space Station Systems: a Bibliography with Indexes (Supplement 8)

NASA Technical Reports Server (NTRS)

1988-01-01

This bibliography lists 950 reports, articles, and other documents introduced into the NASA scientific and technical information system between July 1, 1989 and December 31, 1989. Its purpose is to provide helpful information to researchers, designers and managers engaged in Space Station technology development and mission design. Coverage includes documents that define major systems and subsystems related to structures and dynamic control, electronics and power supplies, propulsion, and payload integration. In addition, orbital construction methods, servicing and support requirements, procedures and operations, and missions for the current and future Space Station are included.

Space station systems: A bibliography with indexes (supplement 9)

NASA Technical Reports Server (NTRS)

1989-01-01

This bibliography lists 1,313 reports, articles, and other documents introduced into the NASA scientific and technical information system between January 1, 1989 and June 30, 1989. Its purpose is to provide helpful information to researchers, designers and managers engaged in Space Station technology development and mission design. Coverage includes documents that define major systems and subsystems related to structures and dynamic control, electronics and power supplies, propulsion, and payload integration. In addition, orbital construction methods, servicing and support requirements, procedures and operations, and missions for the current and future Space Station are included.

Visualization of CDA laboratory reports and long term trends as a possible EHR application for patients and physicians.

PubMed

Obenaus, Manuel; Burgsteiner, Harald

2014-01-01

To increase the patient's acceptance of electronic health records and understanding for their laboratory findings a web application was developed which presents all parameters and possible deviations of standard values in a clear way and visualizes the time based trend of all recorded parameters graphically. Documents corresponding to the Clinical document architecture (CDA) R2 laboratory reports standard and a rapid prototyping framework called Groovy on Grails were used. This work shows, that it is possible to create a useful, standards based tool for patients and physicians with comparatively few resources - an application that could be in similar form a part of an electronic Health Record (EHR) system like the Austrian electronic Health Record (ELGA).

The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

PubMed

Rodriguez Torres, Yasaira; Huang, Jordan; Mihlstin, Melanie; Juzych, Mark S; Kromrei, Heidi; Hwang, Frank S

2017-01-01

This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p < 0.0005). Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

A First Standardized Swiss Electronic Maternity Record.

PubMed

Murbach, Michel; Martin, Sabine; Denecke, Kerstin; Nüssli, Stephan

2017-01-01

During the nine months of pregnancy, women have to regularly visit several physicians for continuous monitoring of the health and development of the fetus and mother. Comprehensive examination results of different types are generated in this process; documentation and data transmission standards are still unavailable or not in use. Relevant information is collected in a paper-based maternity record carried by the pregnant women. To improve availability and transmission of data, we aim at developing a first prototype for an electronic maternity record for Switzerland. By analyzing the documentation workflow during pregnancy, we determined a maternity record data set. Further, we collected requirements towards a digital maternity record. As data exchange format, the Swiss specific exchange format SMEEX (swiss medical data exchange) was exploited. Feedback from 27 potential users was collected to identify further improvements. The relevant data is extracted from the primary care information system as SMEEX file, stored in a database and made available in a web and a mobile application, developed as prototypes of an electronic maternity record. The user confirmed the usefulness of the system and provided multiple suggestions for an extension. An electronical maternity record as developed in this work could be in future linked to the electronic patient record.

Semantic Clinical Guideline Documents

PubMed Central

Eriksson, Henrik; Tu, Samson W.; Musen, Mark

2005-01-01

Decision-support systems based on clinical practice guidelines can support physicians and other health-care personnel in the process of following best practice consistently. A knowledge-based approach to represent guidelines makes it possible to encode computer-interpretable guidelines in a formal manner, perform consistency checks, and use the guidelines directly in decision-support systems. Decision-support authors and guideline users require guidelines in human-readable formats in addition to computer-interpretable ones (e.g., for guideline review and quality assurance). We propose a new document-oriented information architecture that combines knowledge-representation models with electronic and paper documents. The approach integrates decision-support modes with standard document formats to create a combined clinical-guideline model that supports on-line viewing, printing, and decision support. PMID:16779037

Automatic Word Sense Disambiguation of Acronyms and Abbreviations in Clinical Texts

ERIC Educational Resources Information Center

Moon, Sungrim

2012-01-01

The use of acronyms and abbreviations is increasing profoundly in the clinical domain in large part due to the greater adoption of electronic health record (EHR) systems and increased electronic documentation within healthcare. A single acronym or abbreviation may have multiple different meanings or senses. Comprehending the proper meaning of an…

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 8 2012-01-01 2012-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 8 2011-01-01 2011-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 8 2014-01-01 2014-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

7 CFR 900.41 - Electronic document submission standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 8 2013-01-01 2013-01-01 false Electronic document submission standards. 900.41... Agreements and Marketing Orders § 900.41 Electronic document submission standards. To the extent practicable.... Instructions for electronic filing shall be provided at the amendatory formal rulemaking hearing and in each...

Desktop Access to Full-Text NACA and NASA Reports: Systems Developed by NASA Langley Technical Library

NASA Technical Reports Server (NTRS)

Ambur, Manjula Y.; Adams, David L.; Trinidad, P. Paul

1997-01-01

NASA Langley Technical Library has been involved in developing systems for full-text information delivery of NACA/NASA technical reports since 1991. This paper will describe the two prototypes it has developed and the present production system configuration. The prototype systems are a NACA CD-ROM of thirty-three classic paper NACA reports and a network-based Full-text Electronic Reports Documents System (FEDS) constructed from both paper and electronic formats of NACA and NASA reports. The production system is the DigiDoc System (DIGItal Documents) presently being developed based on the experiences gained from the two prototypes. DigiDoc configuration integrates the on-line catalog database World Wide Web interface and PDF technology to provide a powerful and flexible search and retrieval system. It describes in detail significant achievements and lessons learned in terms of data conversion, storage technologies, full-text searching and retrieval, and image databases. The conclusions from the experiences of digitization and full- text access and future plans for DigiDoc system implementation are discussed.

Project #8, Task 2 - Travel Information Services (TIS), Definition Of Goals For The I-95 Corridor

DOT National Transportation Integrated Search

1995-01-23

CONTINUED FROM DOCUMENT NUMBER 6303 : RESEARCH AND DEVELOPMENT OR R&D, ELECTRONIC PAYMENT SYSTEMS, AUTOMATED FARE COLLECTION, EMERGENCY MANAGEMENT SERVICES OR EMS, FREEWAY MANAGEMENT SYSTEMS, INCIDENT MANAGEMENT/INCIDENT DETECTION : THE L-95 CORRI...

The 3-axis Dynamic Motion Simulator (DMS) system

NASA Technical Reports Server (NTRS)

1975-01-01

A three-axis dynamic motion simulator (DMS) consisting of a test table with three degrees of freedom and an electronics control system was designed, constructed, delivered, and tested. Documentation, as required in the Data Requirements List (DRL), was also provided.

An observational study of the accuracy and completeness of an anesthesia information management system: recommendations for documentation system changes.

PubMed

Wilbanks, Bryan A; Moss, Jacqueline A; Berner, Eta S

2013-08-01

Anesthesia information management systems must often be tailored to fit the environment in which they are implemented. Extensive customization necessitates that systems be analyzed for both accuracy and completeness of documentation design to ensure that the final record is a true representation of practice. The purpose of this study was to determine the accuracy of a recently installed system in the capture of key perianesthesia data. This study used an observational design and was conducted using a convenience sample of nurse anesthetists. Observational data of the nurse anesthetists'delivery of anesthesia care were collected using a touch-screen tablet computer utilizing an Access database customized observational data collection tool. A questionnaire was also administered to these nurse anesthetists to assess perceived accuracy, completeness, and satisfaction with the electronic documentation system. The major sources of data not documented in the system were anesthesiologist presence (20%) and placement of intravenous lines (20%). The major sources of inaccuracies in documentation were gas flow rates (45%), medication administration times (30%), and documentation of neuromuscular function testing (20%)-all of the sources of inaccuracies were related to the use of charting templates that were not altered to reflect the actual interventions performed.

[Automated anesthesia record systems].

PubMed

Heinrichs, W; Mönk, S; Eberle, B

1997-07-01

The introduction of electronic anaesthesia documentation systems was attempted as early as in 1979, although their efficient application has become reality only in the past few years. The advantages of the electronic protocol are apparent: Continuous high quality documentation, comparability of data due to the availability of a data bank, reduction in the workload of the anaesthetist and availability of additional data. Disadvantages of the electronic protocol have also been discussed in the literature. By going through the process of entering data on the course of the anaesthetic procedure on the protocol sheet, the information is mentally absorbed and evaluated by the anaesthetist. This information may, however, be lost when the data are recorded fully automatically-without active involvement on the part of the anaesthetist. Recent publications state that by using intelligent alarms and/or integrated displays manual record keeping is no longer necessary for anaesthesia vigilance. The technical design of automated anaesthesia records depends on an integration of network technology into the hospital. It will be appropriate to connect the systems to the internet, but safety requirements have to be followed strictly. Concerning the database, client server architecture as well as language standards like SQL should be used. Object oriented databases will be available in the near future. Another future goal of automated anaesthesia record systems will be using knowledge based technologies within these systems. Drug interactions, disease related anaesthetic techniques and other information sources can be integrated. At this time, almost none of the commercially available systems has matured to a point where their purchase can be recommended without reservation. There is still a lack of standards for the subsequent exchange of data and a solution to a number of ergonomic problems still remains to be found. Nevertheless, electronic anaesthesia protocols will be required in the near future. The advantages of accurate documentation and quality control in the presence of careful planning outweight cost considerations by far.

25 CFR 559.7 - May a tribe submit documents required by this part electronically?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false May a tribe submit documents required by this part... NOTIFICATIONS AND SUBMISSIONS § 559.7 May a tribe submit documents required by this part electronically? Yes. Tribes wishing to submit documents electronically should contact the Commission for guidance on...

25 CFR 559.7 - May a tribe submit documents required by this part electronically?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false May a tribe submit documents required by this part... NOTIFICATIONS AND SUBMISSIONS § 559.7 May a tribe submit documents required by this part electronically? Yes. Tribes wishing to submit documents electronically should contact the Commission for guidance on...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

17 CFR 232.401 - XBRL-Related Document submissions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REGULATION S-T-GENERAL RULES AND REGULATIONS FOR ELECTRONIC FILINGS Xbrl-Related Documents § 232.401 XBRL-Related Document submissions. (a) Only an electronic filer that is an investment company registered under... XBRL-Related Documents relate; or, if the electronic filer is eligible to file a Form 8-K (§ 249.308 of...

Design of the SGML-based electronic patient record system with the use of object-oriented analysis methods.

PubMed

Kuikka, E; Eerola, A; Porrasmaa, J; Miettinen, A; Komulainen, J

1999-01-01

Since a patient record is typically a document updated by many users, required to be represented in many different layouts, and transferred from place to place, it is a good candidate to be represented structured and coded using the SGML document standard. The use of the SGML requires that the structure of the document is defined in advance by a Document Type Definition (DTD) and the document follows it. This paper represents a method which derives an SGML DTD by starting from the description of the usage of the patient record in medical care and nursing.

The application of intelligent process control to space based systems

NASA Technical Reports Server (NTRS)

Wakefield, G. Steve

1990-01-01

The application of Artificial Intelligence to electronic and process control can help attain the autonomy and safety requirements of manned space systems. An overview of documented applications within various industries is presented. The development process is discussed along with associated issues for implementing an intelligence process control system.

Using Adaptive Turnaround Documents to Electronically Acquire Structured Data in Clinical Settings

PubMed Central

Biondich, Paul G.; Anand, Vibha; Downs, Stephen M.; McDonald, Clement J.

2003-01-01

We developed adaptive turnaround documents (ATDs) to address longstanding challenges inherent in acquiring structured data at the point of care. These computer-generated paper forms both request and receive patient tailored information specifically for electronic storage. In our pilot, we evaluated the usability, accuracy, and user acceptance of an ATD designed to enrich a pediatric preventative care decision support system. The system had an overall digit recognition rate of 98.6% (95% CI: 98.3 to 98.9) and a marksense accuracy of 99.2% (95% CI: 99.1 to 99.3). More importantly, the system reliably extracted all data from 56.6% (95% CI: 53.3 to 59.9) of our pilot forms without the need for a verification step. These results translate to a minimal workflow burden to end users. This suggests that ATDs can serve as an inexpensive, workflow-sensitive means of structured data acquisition in the clinical setting. PMID:14728139

42 CFR 93.512 - Discovery.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., accounts, papers, tangible items, and other data and documentary evidence. This subpart does not require the creation of any document. However, requested data stored in an electronic data storage system must...

42 CFR 93.512 - Discovery.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., accounts, papers, tangible items, and other data and documentary evidence. This subpart does not require the creation of any document. However, requested data stored in an electronic data storage system must...

42 CFR 93.512 - Discovery.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., accounts, papers, tangible items, and other data and documentary evidence. This subpart does not require the creation of any document. However, requested data stored in an electronic data storage system must...

42 CFR 93.512 - Discovery.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., accounts, papers, tangible items, and other data and documentary evidence. This subpart does not require the creation of any document. However, requested data stored in an electronic data storage system must...

From a paper-based to an electronic registry in physiotherapy.

PubMed

Buyl, Ronald; Nyssen, Marc

2008-01-01

During the past decade the healthcare industry has evolved from paper-based storage of clinical data into the digital era. Electronic healthcare records play a crucial role to meet the growing need for integrated data-storage and data communication. In this context a new law was issued in Belgium on December 7th, 2005, which requires physiotherapists (but also nurses and speech therapists) to keep an electronic version of the registry. This (electronic) registry contains all physiotherapeutic acts, starting from January 1, 2007. Up until that day, a paper version of the registry had to be created every month.This article describes the development of an electronic version of the registry that not only meets all legal constraints, but also enables to verify the traceability and inalterability of the generated documents, by means of SHA-256 codes. One of the major concerns of the process was that the rationale behind the electronic registry would conform well to the common practice of the physiotherapist. Therefore we opted for a periodic recording of a standardized "image" of the controllable data, in the patient database of the software-system, into the XML registry messages. The proposed XSLT schema can also form a basis for the development of tools that can be used by the controlling authorities. Hopefully the electronic registry for physiotherapists will be a first step towards the future development of a fully integrated electronic physiotherapy record.By means of a certification procedure for the software systems, we succeeded in developing a user friendly system that enables end-users that use a quality labeled software package, to automatically produce all the legally necessary documents concerning the registry. Moreover, we hope that this development will be an incentive for non-users to start working in an electronic way.

ORANGES evaluation test plans : analysis of before data collected for the US DOT sponsored evaluation of the ORANGES electronic payment systems field operational test

DOT National Transportation Integrated Search

2003-10-02

This document is one of a series of working papers that report on progress for the US DOT evaluation for Phase I of the ORANGES field operational test. Each working paper corresponds to a Phase I task. At the conclusion of Phase I, these documents wi...

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

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-01-01

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

48 CFR 4.302 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Technology for large space systems: A bibliography with indexes (supplement 07)

NASA Technical Reports Server (NTRS)

1983-01-01

This bibliography lists 366 reports, articles and other documents introduced into the NASA scientific and technical information system between January 1, 1982 and June 30, 1982. Subject matter is grouped according to systems, interactive analysis and design, structural concepts, control systems, electronics, advanced materials, assembly concepts, propulsion, solar power satellite systems, and flight experiments.

Evaluating the usability of speech recognition to create clinical documentation using a commercial electronic health record.

PubMed

Hodgson, Tobias; Magrabi, Farah; Coiera, Enrico

2018-05-01

To conduct a usability study exploring the value of using speech recognition (SR) for clinical documentation tasks within an electronic health record (EHR) system. Thirty-five emergency department clinicians completed a system usability scale (SUS) questionnaire. The study was undertaken after participants undertook randomly allocated clinical documentation tasks using keyboard and mouse (KBM) or SR. SUS scores were analyzed and the results with KBM were compared to SR results. Significant difference in SUS scores between EHR system use with and without SR were observed (KBM 67, SR 61; P = 0.045; CI, 0.1 to 12.0). Nineteen of 35 participants scored higher for EHR with KBM, 11 higher for EHR with SR and 5 gave the same score for both. Factor analysis showed no significant difference in scores for the sub-element of usability (EHR with KBM 65, EHR with SR 62; P = 0.255; CI, -2.6 to 9.5). Scores for the sub-element of learnability were significantly different (KBM 72, SR 55; P < 0.001; CI, 9.8 to 23.5). A significant correlation was found between the perceived usability of the two system configurations (EHR with KBM or SR) and the efficiency of documentation (time to document) (P = 0.002; CI, 10.5 to -0.1) but not with safety (number of errors) (P = 0.90; CI, -2.3 to 2.6). SR was associated with significantly reduced overall usability scores, even though it is often positioned as ease of use technology. SR was perceived to impose larger costs in terms of learnability via training and support requirements for EHR based documentation when compared to using KBM. Lower usability scores were significantly associated with longer documentation times. The usability of EHR systems with any input modality is an area that requires continued development. The addition of an SR component to an EHR system may cause a significant reduction in terms of perceived usability by clinicians. Copyright © 2018 Elsevier B.V. All rights reserved.

Space Act Agreement Maker (SAAM) With Electronic Routing System (ERouter) Developed

NASA Technical Reports Server (NTRS)

Stauber, Laurel J.

2003-01-01

Members of the Commercial Technology Office at the NASA Glenn Research Center have developed an exciting new tool that greatly reduces the lead time in creating and routing Space Act Agreements. The Space Act Agreement Maker (SAAM) is an e-government Web-based system that automates the initial drafting of Space Act Agreements by technical and program personnel. SAAM also is used for editing and will be used later for maintaining electronic copies of all Space Act Agreements. During the initial drafting, the software prompts NASA personnel proposing an agreement to answer questions regarding the agreement. On the basis of the answers, the software selects from a matrix of NASA standard clauses to produce a first draft of the agreement. The draft agreement and information submitted by the NASA personnel are electronically routed to Glenn s Commercial Technology Office for review and, where necessary, editing. The final version of the agreement, along with any supporting documentation, is then routed for electronic concurrence/approval to the necessary internal review participants using the electronic routing system (e-router). SAAM was developed cooperatively by Glenn s Commercial Technology Office and Glenn s Office of Chief Counsel. Currently, SAAM is being evaluated by the NASA Headquarters General Counsel Office for use at all NASA centers. This system allows for the effective processing of Space Act Agreements for NASA s internal and external customers. Document control is maintained by a database. With SAAM s electronic routing, review times can be reduced significantly, allowing Glenn to more rapidly establish partnerships with industry. Prior to the creation of SAAM, it took several hours to draft a Space Act Agreement. With SAAM in place, the document can be written in about 30 min. Using the e-router also saves time in determining where the agreement is in the routing process. The document can be tracked easily, and delays can be avoided. Important research with industry partners can commence quickly after preliminary discussions have been held. The development of these products is in line with the expanding e-government initiative that is part of the Presidential Management Agenda. By using this product, NASA researchers can secure greater support from industry and academia partners. The Space Act Agreement Maker has been very well received at NASA Headquarters and at some of the other NASA centers as well. We anticipate that the NASA Ames Research Center will have the system in place very soon, and that some of the other centers will use SAAM in the near future. The General Counsel s office at NASA Headquarters has encouraged the Glenn team to develop a similar system for processing patent licenses. Find out more about Glenn's Technology Transfer & Partnership Office http://technology.grc.nasa.gov/.

Standardized exchange of clinical documents--towards a shared care paradigm in glaucoma treatment.

PubMed

Gerdsen, F; Müller, S; Jablonski, S; Prokosch, H-U

2006-01-01

The exchange of medical data from research and clinical routine across institutional borders is essential to establish an integrated healthcare platform. In this project we want to realize the standardized exchange of medical data between different healthcare institutions to implement an integrated and interoperable information system supporting clinical treatment and research of glaucoma. The central point of our concept is a standardized communication model based on the Clinical Document Architecture (CDA). Further, a communication concept between different health care institutions applying the developed document model has been defined. With our project we have been able to prove that standardized communication between an Electronic Medical Record (EMR), an Electronic Health Record (EHR) and the Erlanger Glaucoma Register (EGR) based on the established conceptual models, which rely on CDA rel.1 level 1 and SCIPHOX, could be implemented. The HL7-tool-based deduction of a suitable CDA rel.2 compliant schema showed significant differences when compared with the manually created schema. Finally fundamental requirements, which have to be implemented for an integrated health care platform, have been identified. An interoperable information system can enhance both clinical treatment and research projects. By automatically transferring screening findings from a glaucoma research project to the electronic medical record of our ophthalmology clinic, clinicians could benefit from the availability of a longitudinal patient record. The CDA as a standard for exchanging clinical documents has demonstrated its potential to enhance interoperability within a future shared care paradigm.

Xyce Parallel Electronic Simulator Reference Guide Version 6.7.

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

Keiter, Eric R.; Aadithya, Karthik Venkatraman; Mei, Ting

This document is a reference guide to the Xyce Parallel Electronic Simulator, and is a companion document to the Xyce Users' Guide [1] . The focus of this document is (to the extent possible) exhaustively list device parameters, solver options, parser options, and other usage details of Xyce . This document is not intended to be a tutorial. Users who are new to circuit simulation are better served by the Xyce Users' Guide [1] . The information herein is subject to change without notice. Copyright c 2002-2017 Sandia Corporation. All rights reserved. Trademarks Xyce TM Electronic Simulator and Xyce TMmore » are trademarks of Sandia Corporation. Orcad, Orcad Capture, PSpice and Probe are registered trademarks of Cadence Design Systems, Inc. Microsoft, Windows and Windows 7 are registered trademarks of Microsoft Corporation. Medici, DaVinci and Taurus are registered trademarks of Synopsys Corporation. Amtec and TecPlot are trademarks of Amtec Engineering, Inc. All other trademarks are property of their respective owners. Contacts World Wide Web http://xyce.sandia.gov https://info.sandia.gov/xyce (Sandia only) Email xyce@sandia.gov (outside Sandia) xyce-sandia@sandia.gov (Sandia only) Bug Reports (Sandia only) http://joseki-vm.sandia.gov/bugzilla http://morannon.sandia.gov/bugzilla« less

Electronic Procedures for Medical Operations

NASA Technical Reports Server (NTRS)

2015-01-01

Electronic procedures are replacing text-based documents for recording the steps in performing medical operations aboard the International Space Station. S&K Aerospace, LLC, has developed a content-based electronic system-based on the Extensible Markup Language (XML) standard-that separates text from formatting standards and tags items contained in procedures so they can be recognized by other electronic systems. For example, to change a standard format, electronic procedures are changed in a single batch process, and the entire body of procedures will have the new format. Procedures can be quickly searched to determine which are affected by software and hardware changes. Similarly, procedures are easily shared with other electronic systems. The system also enables real-time data capture and automatic bookmarking of current procedure steps. In Phase II of the project, S&K Aerospace developed a Procedure Representation Language (PRL) and tools to support the creation and maintenance of electronic procedures for medical operations. The goal is to develop these tools in such a way that new advances can be inserted easily, leading to an eventual medical decision support system.

The Heinz Electronic Library Interactive Online System (HELIOS): Building a Digital Archive Using Imaging, OCR, and Natural Language Processing Technologies.

ERIC Educational Resources Information Center

Galloway, Edward A.; Michalek, Gabrielle V.

1995-01-01

Discusses the conversion project of the congressional papers of Senator John Heinz into digital format and the provision of electronic access to these papers by Carnegie Mellon University. Topics include collection background, project team structure, document processing, scanning, use of optical character recognition software, verification…

JPRS Report, Science & Technology, Europe & Latin America

DTIC Science & Technology

1987-08-12

there is significant international interest in this today. Going beyond the original applications the thermoluminescent dosimeters ( TLD ) developed...manufacturing; --Applications in the health and teaching sectors; —Correspondence management; -- Electronic mail. The competitive advantages of the multimedia...objective of the MOSES project is to make the multimedia electronic documentation system much more powerful than its paper counterpart. To achieve

Uniforming information management in Finnish Social Welfare.

PubMed

Laaksonen, Maarit; Kärki, Jarmo; Ailio, Erja

2012-01-01

This paper describes the phases and methods used in the National project for IT in Social Services in Finland (Tikesos). The main goals of Tikesos were to unify the client information systems in social services, to develop electronic documentation and to produce specifications for nationally organized electronic archive. The method of Enterprise Architecture was largely used in the project.

SGML and HTML: The Merging of Document Management and Electronic Document Publishing.

ERIC Educational Resources Information Center

Dixon, Ross

1996-01-01

Document control is an issue for organizations that use SGML/HTML. The prevalent approach is to apply the same techniques to document elements that are applied to full documents, a practice that has led to an overlap of electronic publishing and document management. Lists requirements for the management of SGML/HTML documents. (PEN)

76 FR 411 - Regulatory Guidance Concerning Electronic Signatures and Documents

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Concerning Electronic Signatures and Documents AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION: Notice of regulatory guidance. SUMMARY: FMCSA issues regulatory guidance concerning the... regulatory guidance concerning the use of electronic signatures and documents to comply with FMCSA...

Using computers in the exam room.

PubMed

McGrath, Debra

2009-01-01

Purchasing an electronic health records system is the first step to assimilation of the new system into the fabric of a practice. The next hurdle is use of the electronic health record as close to the point of patient care as possible, which requires the clinician to use a computer. This article presents some of the unique challenges of using computers to document patient encounters and some practical advice and considerations for improving the use of computers at the bedside.

SU-F-T-234: Quality Improvements in the Electronic Medical Record of Patients Treated with High Dose-Rate Brachytherapy

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

Diener, T; Wilkinson, D

Purpose: To improve workflow efficiency and patient safety by assessing the quality control documentation for HDR brachytherapy within our Electronic Medical Record System (Mosaiq). Methods: A list of parameters based on NRC regulations, our quality management program (QMP), recommendations of the ACR and the American Brachytherapy Society, and HDR treatment planning risks identified in our previous FMEA study was made. Next, the parameter entries were classified according to the type of data input—manual, electronic, or both. Manual entry included the electronic Brachytherapy Treatment Record (BTR) and pre-treatment Mosaiq Assessments list. Oncentra Treatment Reports (OTR) from the Oncentra Treatment Control Systemmore » constituted the electronic data. The OTR includes a Pre-treatment Report for each fraction, and a Treatment Summary Report at the completion of treatment. Each entry was then examined for appropriateness and completeness of data; adjustments and additions as necessary were then made. Results: Ten out of twenty-one recorded treatment parameters were identified to be documented within both the BTR and OTR. Of these ten redundancies, eight were changed from recorded values to a simple checklist in the BTR to avoid recording errors. The other redundancies were kept in both documents due to their value to ensuring patient safety. An edit was made to the current BTR quality assessment; this change revises the definition of a medical event in accordance with ODH Regulation 3701:1-58-101. One addition was made to the current QMP documents regarding HDR. This addition requires a physician to be present through the duration of HDR treatment in accordance with ODH Regulation 3701:1-58-59; Paragraph (F); Section (2); Subsection (a). Conclusion: Careful examination of HDR documentation that originates from different sources can help to improve the accuracy and reliability of the documents. In addition, there may be a small improvement in efficiency due to elimination of unnecessary redundancies.« less

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 4 Accounts 1 2011-01-01 2011-01-01 false Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web sit...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 4 Accounts 1 2012-01-01 2012-01-01 false Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web sit...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 4 Accounts 1 2013-01-01 2013-01-01 false Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web sit...

4 CFR 201.3 - Publicly available documents and electronic reading room.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 4 Accounts 1 2014-01-01 2013-01-01 true Publicly available documents and electronic reading room. 201.3 Section 201.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PUBLIC INFORMATION AND REQUESTS § 201.3 Publicly available documents and electronic reading room. (a) Many Board records are available electronically at the Board's Web site...

Self-Powered Human-Interactive Transparent Nanopaper Systems.

PubMed

Zhong, Junwen; Zhu, Hongli; Zhong, Qize; Dai, Jiaqi; Li, Wenbo; Jang, Soo-Hwan; Yao, Yonggang; Henderson, Doug; Hu, Qiyi; Hu, Liangbing; Zhou, Jun

2015-07-28

Self-powered human-interactive but invisible electronics have many applications in anti-theft and anti-fake systems for human society. In this work, for the first time, we demonstrate a transparent paper-based, self-powered, and human-interactive flexible system. The system is based on an electrostatic induction mechanism with no extra power system appended. The self-powered, transparent paper device can be used for a transparent paper-based art anti-theft system in museums or for a smart mapping anti-fake system in precious packaging and documents, by virtue of the advantages of adding/removing freely, having no impairment on the appearance of the protected objects, and being easily mass manufactured. This initial study bridges the transparent nanopaper with a self-powered and human-interactive electronic system, paving the way for the development of smart transparent paper electronics.

Design of a modular digital computer system, CDRL no. D001, final design plan

NASA Technical Reports Server (NTRS)

Easton, R. A.

1975-01-01

The engineering breadboard implementation for the CDRL no. D001 modular digital computer system developed during design of the logic system was documented. This effort followed the architecture study completed and documented previously, and was intended to verify the concepts of a fault tolerant, automatically reconfigurable, modular version of the computer system conceived during the architecture study. The system has a microprogrammed 32 bit word length, general register architecture and an instruction set consisting of a subset of the IBM System 360 instruction set plus additional fault tolerance firmware. The following areas were covered: breadboard packaging, central control element, central processing element, memory, input/output processor, and maintenance/status panel and electronics.

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2012 CFR

2012-01-01

... electronic documents. The exempt participant is permitted to file electronic documents by physically... 10 Energy 1 2012-01-01 2012-01-01 false Filing of documents. 2.302 Section 2.302 Energy NUCLEAR... General Applicability: Hearing Requests, Petitions To Intervene, Availability of Documents, Selection of...

10 CFR 2.302 - Filing of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... electronic documents. The exempt participant is permitted to file electronic documents by physically... 10 Energy 1 2011-01-01 2011-01-01 false Filing of documents. 2.302 Section 2.302 Energy NUCLEAR... General Applicability: Hearing Requests, Petitions To Intervene, Availability of Documents, Selection of...

Review of Developments in Electronic, Clinical Data Collection, and Documentation Systems over the Last Decade - Are We Ready for Big Data in Routine Health Care?

PubMed

Kessel, Kerstin A; Combs, Stephanie E

2016-01-01

Recently, information availability has become more elaborate and widespread, and treatment decisions are based on a multitude of factors, including imaging, molecular or pathological markers, surgical results, and patient's preference. In this context, the term "Big Data" evolved also in health care. The "hype" is heavily discussed in literature. In interdisciplinary medical specialties, such as radiation oncology, not only heterogeneous and voluminous amount of data must be evaluated but also spread in different styles across various information systems. Exactly this problem is also referred to in many ongoing discussions about Big Data - the "three V's": volume, velocity, and variety. We reviewed 895 articles extracted from the NCBI databases about current developments in electronic clinical data management systems and their further analysis or postprocessing procedures. Few articles show first ideas and ways to immediately make use of collected data, particularly imaging data. Many developments can be noticed in the field of clinical trial or analysis documentation, mobile devices for documentation, and genomics research. Using Big Data to advance medical research is definitely on the rise. Health care is perhaps the most comprehensive, important, and economically viable field of application.

Digitization, Integration and Preservation of Technical and Historical Information: The Case of INTA, the National Institute for Aerospace Technique of Spain

NASA Astrophysics Data System (ADS)

Merida Martín, F.; Paz Otero, S.

2007-10-01

During the last two years the INTA -- National Institute for Aerospace Technique -- library has been improving different areas related to the information management processes, such as those related to cataloguing, dissemination of technical information, centralization at the Library of all relevant documents and information applicable to scientific research within our organization, implementation of library web services, etc. As part of these processes of modernization of services that the INTA Library is carrying out, a project of digitization of both technical documentation and historical records of the Institute has been defined. The goal is to achieve the total digitization of technical documents and historical papers through the year 2006, and provide access for the resulting electronic collection to the Spanish aerospace community. For the development of the project a deep study of the state of the art in digitization and preservation matters has been conducted. That study covers the different aspects of such a project that could be experienced, such as the risk of data loss, the bandwidth needed to guarantee access to this huge quantity of electronic documentation, the fragility of the digital media, the rapid obsolescence of hardware and software, etc. Also the project is going to assume the new reality of documents that are not originating in paper format, but are digital-born, and how to integrate all the electronic documents in one system, fulfilling the same standards and using the same available technology.

78 FR 22876 - Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... developed an electronic disbursement approval processing system for guaranteed lenders with Credit Guarantee Facilities. After a Credit Guarantee Facility (CGF) has been authorized by Ex-Im Bank and legal documentation...

Intelligent Transportation Systems/Commercial Vehicle Operations Project Plan For Commercial Vehicle Information Systems And Networks Electronic Data Interchange Standards Development And Deployment

DOT National Transportation Integrated Search

1996-12-02

THE PURPOSE OF THIS DOCUMENT IS TO PROVIDE INFORMATION ON THE PLANNING FOR THE DEVELOPMENT AND DEPLOYMENT OF EDI STANDARDS FOR COMMERCIAL VEHICLE INFORMATION SYSTEMS AND NETWORKS (CVISN). THE STATUS, PRIORITIES, AND SCHEDULES FOR THIS EFFORT ARE CONT...

Informed Consent: Does Anyone Really Understand What Is Contained In The Medical Record?

PubMed

Fenton, S H; Manion, F; Hsieh, K; Harris, M

2015-01-01

Despite efforts to provide standard definitions of terms such as "medical record", "computer-based patient record", "electronic medical record" and "electronic health record", the terms are still used interchangeably. Initiatives like data and information governance, research biorepositories, and learning health systems require availability and reuse of data, as well as common understandings of the scope for specific purposes. Lacking widely shared definitions, utilization of the afore-mentioned terms in research informed consent documents calls to question whether all participants in the research process - patients, information technology and regulatory staff, and the investigative team - fully understand what data and information they are asking to obtain and agreeing to share. This descriptive study explored the terminology used in research informed consent documents when describing patient data and information, asking the question "Does the use of the term "medical record" in the context of a research informed consent document accurately represent the scope of the data involved?" Informed consent document templates found on 17 Institutional Review Board (IRB) websites with Clinical and Translational Science Awards (CTSA) were searched for terms that appeared to be describing the data resources to be accessed. The National Library of Medicine's (NLM) Terminology Services was searched for definitions provided by key standards groups that deposit terminologies with the NLM. The results suggest research consent documents are using outdated terms to describe patient information, health care terminology systems need to consider the context of research for use cases, and that there is significant work to be done to assure the HIPAA Omnibus Rule is applied to contemporary activities such as biorepositories and learning health systems. "Medical record", a term used extensively in research informed consent documents, is ambiguous and does not serve us well in the context of contemporary information management and governance.

Development and Implementation of a Curricular-wide Electronic Portfolio System in a School of Pharmacy

PubMed Central

Lopez, Tina C.; Trang, David D.; Farrell, Nicole C.; De Leon, Melissa A.; Villarreal, Cynthia C.; Maize, David F.

2011-01-01

The Feik School of Pharmacy collaborated with a commercial software development company to create a Web-based e-portfolio system to document student achievement of curricular outcomes and performance in pharmacy practice experiences. The multi-functional system also could be used for experiential site selection and assignment and continuing pharmacy education. The pharmacy school trained students, faculty members, and pharmacist preceptors to use the e-portfolio system. All pharmacy students uploaded the required number of documents and assessments to the program as evidence of achievement of each of the school's curricular outcomes and completion of pharmacy practice experiences. PMID:21829263

Implementation of a closed-loop reporting system for critical values and clinical communication in compliance with goals of the joint commission.

PubMed

Parl, Fritz F; O'Leary, Mandy F; Kaiser, Allen B; Paulett, John M; Statnikova, Kristina; Shultz, Edward K

2010-03-01

Current practices of reporting critical laboratory values make it challenging to measure and assess the timeliness of receipt by the treating physician as required by The Joint Commission's 2008 National Patient Safety Goals. A multidisciplinary team of laboratorians, clinicians, and information technology experts developed an electronic ALERTS system that reports critical values via the laboratory and hospital information systems to alphanumeric pagers of clinicians and ensures failsafe notification, instant documentation, automatic tracking, escalation, and reporting of critical value alerts. A method for automated acknowledgment of message receipt was incorporated into the system design. The ALERTS system has been applied to inpatients and eliminated approximately 9000 phone calls a year made by medical technologists. Although a small number of phone calls were still made as a result of pages not acknowledged by clinicians within 10 min, they were made by telephone operators, who either contacted the same physician who was initially paged by the automated system or identified and contacted alternate physicians or the patient's nurse. Overall, documentation of physician acknowledgment of receipt in the electronic medical record increased to 95% of critical values over 9 months, while the median time decreased to <3 min. We improved laboratory efficiency and physician communication by developing an electronic system for reporting of critical values that is in compliance with The Joint Commission's goals.

Tin Whiskers: A History of Documented Electrical System Failures

NASA Technical Reports Server (NTRS)

Leidecker, Henning; Brusse, Jay

2006-01-01

This viewgraph presentation reviews the history of tin and other metal whiskers, and the damage they have caused equipment. There are pictures of whiskers on various pieces of electronic equipment, and microscopic views of whiskers. There is also a chart with information on the documented failures associated with metal whiskers. There are also examples of on-orbit failures believed to be caused by whiskers.

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

PubMed

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

2017-06-01

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

Computer-Based Medical System

NASA Technical Reports Server (NTRS)

1998-01-01

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

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

PubMed

Gardner, Carrie Lee; Pearce, Patricia F

2013-03-01

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

An Electronic Nursing Patient Care Plan Helps in Clinical Decision Support.

PubMed

Wong, C M; Wu, S Y; Ting, W H; Ho, K H; Tong, L H; Cheung, N T

2015-01-01

Information technology can help to improve health care delivery. The utilisation of informatics principle enhances the quality of nursing practices through improved communication, documentation and efficiency. The Nursing Profession constitutes 34% of the total workforce in the Hong Kong Hospital Authority (HA) and includes 21,000 nurses in 2012. To enhance the quality of care and patient safety in both hospitals and community care setting, it is essential that an integrated electronic decision support system for nurses is designed to track documentation and support care or service including observations, decisions, actions and outcomes throughout the care process at each point-of-care. The Patient Care Plan project was set up to achieve these objectives. The Project adheres to strict documentation information architecture to ensure data sharing is freely available. Preliminary results showed very promising improvement in clinical care.

Examining database persistence of ISO/EN 13606 standardized electronic health record extracts: relational vs. NoSQL approaches.

PubMed

Sánchez-de-Madariaga, Ricardo; Muñoz, Adolfo; Lozano-Rubí, Raimundo; Serrano-Balazote, Pablo; Castro, Antonio L; Moreno, Oscar; Pascual, Mario

2017-08-18

The objective of this research is to compare the relational and non-relational (NoSQL) database systems approaches in order to store, recover, query and persist standardized medical information in the form of ISO/EN 13606 normalized Electronic Health Record XML extracts, both in isolation and concurrently. NoSQL database systems have recently attracted much attention, but few studies in the literature address their direct comparison with relational databases when applied to build the persistence layer of a standardized medical information system. One relational and two NoSQL databases (one document-based and one native XML database) of three different sizes have been created in order to evaluate and compare the response times (algorithmic complexity) of six different complexity growing queries, which have been performed on them. Similar appropriate results available in the literature have also been considered. Relational and non-relational NoSQL database systems show almost linear algorithmic complexity query execution. However, they show very different linear slopes, the former being much steeper than the two latter. Document-based NoSQL databases perform better in concurrency than in isolation, and also better than relational databases in concurrency. Non-relational NoSQL databases seem to be more appropriate than standard relational SQL databases when database size is extremely high (secondary use, research applications). Document-based NoSQL databases perform in general better than native XML NoSQL databases. EHR extracts visualization and edition are also document-based tasks more appropriate to NoSQL database systems. However, the appropriate database solution much depends on each particular situation and specific problem.

Evaluation of Electronic Health Record Implementation in Ophthalmology at an Academic Medical Center (An American Ophthalmological Society Thesis)

PubMed Central

Chiang, Michael F.; Read-Brown, Sarah; Tu, Daniel C.; Choi, Dongseok; Sanders, David S.; Hwang, Thomas S.; Bailey, Steven; Karr, Daniel J.; Cottle, Elizabeth; Morrison, John C.; Wilson, David J.; Yackel, Thomas R.

2013-01-01

Purpose: To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. Methods: An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Results: Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. Conclusion: This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation. PMID:24167326

Script identification from images using cluster-based templates

DOEpatents

Hochberg, J.G.; Kelly, P.M.; Thomas, T.R.

1998-12-01

A computer-implemented method identifies a script used to create a document. A set of training documents for each script to be identified is scanned into the computer to store a series of exemplary images representing each script. Pixels forming the exemplary images are electronically processed to define a set of textual symbols corresponding to the exemplary images. Each textual symbol is assigned to a cluster of textual symbols that most closely represents the textual symbol. The cluster of textual symbols is processed to form a representative electronic template for each cluster. A document having a script to be identified is scanned into the computer to form one or more document images representing the script to be identified. Pixels forming the document images are electronically processed to define a set of document textual symbols corresponding to the document images. The set of document textual symbols is compared to the electronic templates to identify the script. 17 figs.

Script identification from images using cluster-based templates

DOEpatents

Hochberg, Judith G.; Kelly, Patrick M.; Thomas, Timothy R.

1998-01-01

A computer-implemented method identifies a script used to create a document. A set of training documents for each script to be identified is scanned into the computer to store a series of exemplary images representing each script. Pixels forming the exemplary images are electronically processed to define a set of textual symbols corresponding to the exemplary images. Each textual symbol is assigned to a cluster of textual symbols that most closely represents the textual symbol. The cluster of textual symbols is processed to form a representative electronic template for each cluster. A document having a script to be identified is scanned into the computer to form one or more document images representing the script to be identified. Pixels forming the document images are electronically processed to define a set of document textual symbols corresponding to the document images. The set of document textual symbols is compared to the electronic templates to identify the script.

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

Not Available

This report contains papers on the following topics: NREN Security Issues: Policies and Technologies; Layer Wars: Protect the Internet with Network Layer Security; Electronic Commission Management; Workflow 2000 - Electronic Document Authorization in Practice; Security Issues of a UNIX PEM Implementation; Implementing Privacy Enhanced Mail on VMS; Distributed Public Key Certificate Management; Protecting the Integrity of Privacy-enhanced Electronic Mail; Practical Authorization in Large Heterogeneous Distributed Systems; Security Issues in the Truffles File System; Issues surrounding the use of Cryptographic Algorithms and Smart Card Applications; Smart Card Augmentation of Kerberos; and An Overview of the Advanced Smart Card Access Control System.more » Selected papers were processed separately for inclusion in the Energy Science and Technology Database.« less

Lesson 5: Defining Valid Electronic Signatures

EPA Pesticide Factsheets

A valid electronic signature on an electronic document is one that is created with an electronic signature device that is uniquely entitled to a signatory, not compromised, and used by a signatory who is authorized to sign the electronic document.

Implementation of Medical Information Exchange System Based on EHR Standard

PubMed Central

Han, Soon Hwa; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

2010-01-01

Objectives To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. Methods To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. Results The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. Conclusions This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information. PMID:21818447

Implementation of Medical Information Exchange System Based on EHR Standard.

PubMed

Han, Soon Hwa; Lee, Min Ho; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

2010-12-01

To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.

Issues and approaches for electronic document approval and transmittal using digital signatures and text authentication: Prototype documentation

NASA Astrophysics Data System (ADS)

Boling, M. E.

1989-09-01

Prototypes were assembled pursuant to recommendations made in report K/DSRD-96, Issues and Approaches for Electronic Document Approval and Transmittal Using Digital Signatures and Text Authentication, and to examine and discover the possibilities for integrating available hardware and software to provide cost effective systems for digital signatures and text authentication. These prototypes show that on a LAN, a multitasking, windowed, mouse/keyboard menu-driven interface can be assembled to provide easy and quick access to bit-mapped images of documents, electronic forms and electronic mail messages with a means to sign, encrypt, deliver, receive or retrieve and authenticate text and signatures. In addition they show that some of this same software may be used in a classified environment using host to terminal transactions to accomplish these same operations. Finally, a prototype was developed demonstrating that binary files may be signed electronically and sent by point to point communication and over ARPANET to remote locations where the authenticity of the code and signature may be verified. Related studies on the subject of electronic signatures and text authentication using public key encryption were done within the Department of Energy. These studies include timing studies of public key encryption software and hardware and testing of experimental user-generated host resident software for public key encryption. This software used commercially available command-line source code. These studies are responsive to an initiative within the Office of the Secretary of Defense (OSD) for the protection of unclassified but sensitive data. It is notable that these related studies are all built around the same commercially available public key encryption products from the private sector and that the software selection was made independently by each study group.

Project #8, Task 1 - Travel Information Services (TIS), Inventory Of Traveler Information Services And Commercial Opportunities In The I-95 Corridor

DOT National Transportation Integrated Search

1995-12-01

CONTINUED FROM DOCUMENT NUMBER 6303 : RESEARCH AND DEVELOPMENT OR R&D, ELECTRONIC PAYMENT SYSTEMS, AUTOMATED FARE COLLECTION, EMERGENCY MANAGEMENT SERVICES OR EMS, FREEWAY MANAGEMENT SYSTEMS, INCIDENT MANAGEMENT/INCIDENT DETECTION : THE L-95 CORRI...

NLC Injector Systems

Science.gov Websites

text only NLC Home Page NLC Technical SLAC Sources Damping Rings S & L Band Linacs Engineering ; Presentations Injector System Documentation Talks and Presentations The NLC ZDR ISG Reports Sources Lasers Photocathodes Electron Source Laser Maintenance Facility Positron Source Sources Technical Notes Sources Meeting

Crossing the "digital divide:" implementing an electronic medical record system in a rural Kenyan health center to support clinical care and research.

PubMed

Tierney, William M; Rotich, Joseph K; Smith, Faye E; Bii, John; Einterz, Robert M; Hannan, Terry J

2002-01-01

To improve care, one must measure it. In the US, electronic medical record systems have been installed in many institutions to support health care management, quality improvement, and research. Developing countries lack such systems and thus have difficulties managing scarce resources and investigating means of improving health care delivery and outcomes. We describe the implementation and use of the first documented electronic medical record system in ambulatory care in sub-Saharan Africa. After one year, it has captured data for more than 13,000 patients making more than 26,000 visits. We present lessons learned and modifications made to this system to improve its capture of data and ability to support a comprehensive clinical care and research agenda.

Accuracy of outpatient service data for activity-based funding in New South Wales, Australia.

PubMed

Munyisia, Esther N; Reid, David; Yu, Ping

2017-05-01

Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. An audit was carried out on healthcare workers' (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system. Of the 6919 data entries in the electronic documentation system, 7.5% (518) had errors, 68.7% of the errors were related to a wrong primary activity, 14.5% were due to a wrong activity category, 14.5% were as a result of a wrong combination of primary activity and modality of care, 1.9% were due to inaccurate information on a client's presence during service delivery and 0.4% were related to a wrong modality of care. Data entry errors may affect the amount of funding received by a healthcare organisation, which in turn may affect the quality of treatment provided to clients due to the possibility of underfunding the organisation. To reduce errors or achieve an error-free environment, there is a need to improve the naming convention of data elements, their descriptions and alignment with the national standard classification of outpatient services. It is also important to support healthcare workers in their data entry by embedding safeguards in the electronic documentation system such as flags for inaccurate data elements.

Association Between Real-time Electronic Injury Surveillance Applications and Clinical Documentation and Data Acquisition in a South African Trauma Center.

PubMed

Zargaran, Eiman; Spence, Richard; Adolph, Lauren; Nicol, Andrew; Schuurman, Nadine; Navsaria, Pradeep; Ramsey, Damon; Hameed, S Morad

2018-03-14

Collection and analysis of up-to-date and accurate injury surveillance data are a key step in the maturation of trauma systems. Trauma registries have proven to be difficult to establish in low- and middle-income countries owing to the burden of trauma volume, cost, and complexity. To determine whether an electronic trauma health record (eTHR) used by physicians can serve as simultaneous clinical documentation and data acquisition tools. This 2-part quality improvement study included (1) preimplementation and postimplementation eTHR study with assessments of satisfaction by 41 trauma physicians, time to completion, and quality of data collected comparing paper and electronic charting; and (2) prospective ecologic study describing the burden of trauma seen at a Level I trauma center, using real-time data collected by the eTHR on consecutive patients during a 12-month study period. The study was conducted from October 1, 2010, to September 30, 2011, at Groote Schuur Hospital, Cape Town, South Africa. Data analysis was performed from October 15, 2011, to January 15, 2013. The primary outcome of part 1 was data field competition rates of pertinent trauma registry items obtained through electronic or paper documentation. The main measures of part 2 were to identify risk factors to trauma in Cape Town and quality indicators recommended for trauma system evaluation at Groote Schuur Hospital. The 41 physicians included in the study found the electronic patient documentation to be more efficient and preferable. A total of 11 612 trauma presentations were accurately documented and promptly analyzed. Fields relevant to injury surveillance in the eTHR (n = 11 612) had statistically significant higher completion rates compared with paper records (n = 9236) (for all comparisons, P < .001). The eTHR successfully captured quality indicators recommended for trauma system evaluation which were previously challenging to collect in a timely and accurate manner. Of the 11 612 patient admissions over the study period, injury location was captured 11 075 times (95.4%), injury mechanism 11 135 times (95.9%), systolic blood pressure 11 106 times (95.6%), and Glasgow Coma Scale 11 140 times (95.9%). These fields were successfully captured with statistically higher rates than previous paper documentation. Epidemiologic analysis confirmed a heavy burden of violence-related injury (51.8% of all injuries) and motor vehicle crash injuries (14.3% of all injuries). Mapping analysis demonstrated clusters of injuries originating mainly from vulnerable and low-income neighborhoods and their respective referring trauma facilities, Mitchell's Plain Hospital (734 [10.1%]), Guguletu Community Health Center (654 [9.0%]), and New Somerset Hospital (400 [5.5%]). Accurate capture and simultaneous analysis of trauma data in low-resource trauma settings are feasible through the integration of surveillance into clinical workflow and the timely analysis of electronic data.

Secure content objects

DOEpatents

Evans, William D [Cupertino, CA

2009-02-24

A secure content object protects electronic documents from unauthorized use. The secure content object includes an encrypted electronic document, a multi-key encryption table having at least one multi-key component, an encrypted header and a user interface device. The encrypted document is encrypted using a document encryption key associated with a multi-key encryption method. The encrypted header includes an encryption marker formed by a random number followed by a derivable variation of the same random number. The user interface device enables a user to input a user authorization. The user authorization is combined with each of the multi-key components in the multi-key encryption key table and used to try to decrypt the encrypted header. If the encryption marker is successfully decrypted, the electronic document may be decrypted. Multiple electronic documents or a document and annotations may be protected by the secure content object.

Helping the Visually Impaired Student with Electronic Video Visual Aids.

ERIC Educational Resources Information Center

Visualtek, Inc., Santa Monica, CA.

THE FOLLOWING IS THE FULL TEXT OF THIS DOCUMENT: Video visual aids are Closed Circuit TV systems (CCTV's) which magnify print and enlarge it electronically upon a screen so partially sighted persons with some residual vision can read and write normal size print. These devices are in use around the world in homes, schools, industries and libraries,…

Design of a graphical user interface for an intelligent multimedia information system for radiology research

NASA Astrophysics Data System (ADS)

Taira, Ricky K.; Wong, Clement; Johnson, David; Bhushan, Vikas; Rivera, Monica; Huang, Lu J.; Aberle, Denise R.; Cardenas, Alfonso F.; Chu, Wesley W.

1995-05-01

With the increase in the volume and distribution of images and text available in PACS and medical electronic health-care environments it becomes increasingly important to maintain indexes that summarize the content of these multi-media documents. Such indices are necessary to quickly locate relevant patient cases for research, patient management, and teaching. The goal of this project is to develop an intelligent document retrieval system that allows researchers to request for patient cases based on document content. Thus we wish to retrieve patient cases from electronic information archives that could include a combined specification of patient demographics, low level radiologic findings (size, shape, number), intermediate-level radiologic findings (e.g., atelectasis, infiltrates, etc.) and/or high-level pathology constraints (e.g., well-differentiated small cell carcinoma). The cases could be distributed among multiple heterogeneous databases such as PACS, RIS, and HIS. Content- based retrieval systems go beyond the capabilities of simple key-word or string-based retrieval matching systems. These systems require a knowledge base to comprehend the generality/specificity of a concept (thus knowing the subclasses or related concepts to a given concept) and knowledge of the various string representations for each concept (i.e., synonyms, lexical variants, etc.). We have previously reported on a data integration mediation layer that allows transparent access to multiple heterogeneous distributed medical databases (HIS, RIS, and PACS). The data access layer of our architecture currently has limited query processing capabilities. Given a patient hospital identification number, the access mediation layer collects all documents in RIS and HIS and returns this information to a specified workstation location. In this paper we report on our efforts to extend the query processing capabilities of the system by creation of custom query interfaces, an intelligent query processing engine, and a document-content index that can be generated automatically (i.e., no manual authoring or changes to the normal clinical protocols).

Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest.

PubMed

Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla C; Petersson, Göran I; Bath, Peter A

2016-03-01

Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. © The Author(s) 2014.

78 FR 22877 - Agency Information Collection Activities; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-17

... Bank has developed an electronic disbursement approval processing system for guaranteed lenders with... authorized by Ex-Im Bank and legal documentation has been completed, the lender will obtain and review the... application system (ExIm Online). Ex-Im Bank's action (approved or declined) will be posted on the lender's...

78 FR 10169 - Agency Information Collection Activities: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... Bank has developed an electronic disbursement approval processing system for guaranteed lenders with... authorized by Ex-Im Bank and legal documentation has been completed, the lender will obtain and review the... application system (ExIm Online). Ex-Im Bank's action (approved or declined) will be posted on the lender's...

Context as a Factor in Personal Information Management Systems.

ERIC Educational Resources Information Center

Barreau, Deborah K.

1995-01-01

Examines context as a factor in personal information management systems to suggest how it may influence classification decisions and ultimately retrieval. A study of seven managers is described that explored the factors that influence the way individuals manage electronic documents, and results are compared with an earlier study of physical…

10 CFR 2.305 - Service of documents; methods; proof.

Code of Federal Regulations, 2010 CFR

2010-01-01

... E-Filing system. Upon an order from the Commission or presiding officer permitting alternative... service not accompanying a filing. Service of demonstrative evidence, e.g., maps and other physical... area, service on the Secretary may be accomplished electronically to the E-Filing system, as well as by...

GRIN-Global: An International Project to Develop a Global Plant Genebank and Information Management System

USDA-ARS?s Scientific Manuscript database

Many of the world's national genebanks, responsible for the safeguarding and availability of their country's Plant Genetic Resource (PGR) collections, have lacked access to high quality IT needed to document and manage their collections electronically. The Germplasm Resource Information System (GRI...

Educational Technology Program. Quarterly Technical Summary Report, 1 December 1971-29 February 1972.

ERIC Educational Resources Information Center

Frick, Frederick C.

The Lincoln Training System (LTS-3) is a computer-assisted instructional system for training Air Traffic Controllers and Basic Electronic students in the United States Air Force. This document describes the components of the system prior to its initial field trial in mid-April 1972 at Kessler Air Force Base. The system is made up of 14 Basic…

Solid waste information and tracking system client-server conversion project management plan

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

May, D.L.

1998-04-15

This Project Management Plan is the lead planning document governing the proposed conversion of the Solid Waste Information and Tracking System (SWITS) to a client-server architecture. This plan presents the content specified by American National Standards Institute (ANSI)/Institute of Electrical and Electronics Engineers (IEEE) standards for software development, with additional information categories deemed to be necessary to describe the conversion fully. This plan is a living document that will be reviewed on a periodic basis and revised when necessary to reflect changes in baseline design concepts and schedules. This PMP describes the background, planning and management of the SWITS conversion.more » It does not constitute a statement of product requirements. Requirements and specification documentation needed for the SWITS conversion will be released as supporting documents.« less

Mediagraphy: Print and Nonprint Resources.

ERIC Educational Resources Information Center

Educational Media and Technology Yearbook, 1999

1999-01-01

Provides annotated listings for current journals, books, ERIC documents, articles, and nonprint resources in the following categories: artificial intelligence/robotics/electronic performance support systems; computer-assisted instruction; distance education; educational research; educational technology; information science and technology;…

76 FR 1173 - Draft Guidance for Industry on Electronic Source Documentation in Clinical Investigations...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-07

...] Draft Guidance for Industry on Electronic Source Documentation in Clinical Investigations; Availability... Documentation in Clinical Investigations.'' This document provides guidance to sponsors, contract research organizations (CROs), data management centers, and clinical investigators on capturing, using, and archiving...

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

Palomar, J.; Wyman, R.

This document provides recommendations to guide reviewers in the application of Programmable Logic Controllers (PLCS) to the control, monitoring and protection of nuclear reactors. The first topics addressed are system-level design issues, specifically including safety. The document then discusses concerns about the PLC manufacturing organization and the protection system engineering organization. Supplementing this document are two appendices. Appendix A summarizes PLC characteristics. Specifically addressed are those characteristics that make the PLC more suitable for emergency shutdown systems than other electrical/electronic-based systems, as well as characteristics that improve reliability of a system. Also covered are PLC characteristics that may create anmore » unsafe operating environment. Appendix B provides an overview of the use of programmable logic controllers in emergency shutdown systems. The intent is to familiarize the reader with the design, development, test, and maintenance phases of applying a PLC to an ESD system. Each phase is described in detail and information pertinent to the application of a PLC is pointed out.« less

Using a Recommender System and Hyperwave Attributes To Augment an Electronic Resource Library.

ERIC Educational Resources Information Center

Fenn, B.; Lennon, J.

There has been increasing interest over the past few years in systems that help users exchange recommendations about World Wide Web documents. Programs have ranged from those that rely totally on user pre-selection, to others that are based on artificial intelligence. This paper proposes a system that falls between these two extremes, providing…

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

PubMed

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

2015-11-03

Clinical documentation has undergone a change due to the usage of electronic health records. The core element is to capture clinical findings and document therapy electronically. Health care personnel spend a significant portion of their time on the computer. Alternatives to self-typing, such as speech recognition, are currently believed to increase documentation efficiency and quality, as well as satisfaction of health professionals while accomplishing clinical documentation, but few studies in this area have been published to date. This study describes the effects of using a Web-based medical speech recognition system for clinical documentation in a university hospital on (1) documentation speed, (2) document length, and (3) physician satisfaction. Reports of 28 physicians were randomized to be created with (intervention) or without (control) the assistance of a Web-based system of medical automatic speech recognition (ASR) in the German language. The documentation was entered into a browser's text area and the time to complete the documentation including all necessary corrections, correction effort, number of characters, and mood of participant were stored in a database. The underlying time comprised text entering, text correction, and finalization of the documentation event. Participants self-assessed their moods on a scale of 1-3 (1=good, 2=moderate, 3=bad). Statistical analysis was done using permutation tests. The number of clinical reports eligible for further analysis stood at 1455. Out of 1455 reports, 718 (49.35%) were assisted by ASR and 737 (50.65%) were not assisted by ASR. Average documentation speed without ASR was 173 (SD 101) characters per minute, while it was 217 (SD 120) characters per minute using ASR. The overall increase in documentation speed through Web-based ASR assistance was 26% (P=.04). Participants documented an average of 356 (SD 388) characters per report when not assisted by ASR and 649 (SD 561) characters per report when assisted by ASR. Participants' average mood rating was 1.3 (SD 0.6) using ASR assistance compared to 1.6 (SD 0.7) without ASR assistance (P<.001). We conclude that medical documentation with the assistance of Web-based speech recognition leads to an increase in documentation speed, document length, and participant mood when compared to self-typing. Speech recognition is a meaningful and effective tool for the clinical documentation process.

75 FR 32984 - Policy on the Retention of Supporting Documents and the Use of Electronic Mobile Communication...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-10

...-0168] Policy on the Retention of Supporting Documents and the Use of Electronic Mobile Communication/Tracking Technology in Assessing Motor Carriers' and Commercial Motor Vehicle Drivers' Compliance With the... changes regarding the retention of supporting documents and the use of electronic mobile communication...

Digital Libraries and the Problem of Purpose [and] On DigiPaper and the Dissemination of Electronic Documents [and] DFAS: The Distributed Finding Aid Search System [and] Best Practices for Digital Archiving: An Information Life Cycle Approach [and] Mapping and Converting Essential Federal Geographic Data Committee (FGDC) Metadata into MARC21 and Dublin Core: Towards an Alternative to the FGDC Clearinghouse [and] Evaluating Website Modifications at the National Library of Medicine through Search Log analysis.

ERIC Educational Resources Information Center

Levy, David M.; Huttenlocher, Dan; Moll, Angela; Smith, MacKenzie; Hodge, Gail M.; Chandler, Adam; Foley, Dan; Hafez, Alaaeldin M.; Redalen, Aaron; Miller, Naomi

2000-01-01

Includes six articles focusing on the purpose of digital public libraries; encoding electronic documents through compression techniques; a distributed finding aid server; digital archiving practices in the framework of information life cycle management; converting metadata into MARC format and Dublin Core formats; and evaluating Web sites through…

ISS and STS Commercial Off-the-Shelf Router Testing

NASA Technical Reports Server (NTRS)

Ivancie, William D.; Bell, Terry L.; Shell, Dan

2002-01-01

This report documents the results of testing performed with commercial off-the-shelf (COTS) routers and Internet Protocols (IPs) to determine if COTS equipment and IP could be utilized to upgrade NASA's current Space Transportation System (STS), the Shuttle, and the International Space Station communication infrastructure. Testing was performed by NASA Glenn Research Center (GRC) personnel within the Electronic Systems Test Laboratory (ESTE) with cooperation from the Mission Operations Directorate (MOD) Qualification and Utilization of Electronic System Technology (QUEST) personnel. The ESTE testing occurred between November 1 and 9, 2000. Additional testing was performed at NASA Glenn Research Center in a laboratory environment with equipment configured to emulate the STS. This report documents those tests and includes detailed test procedures, equipment interface requirements, test configurations and test results. The tests showed that a COTS router and standard Transmission Control Protocols and Internet Protocols (TCP/IP) could be used for both the Shuttle and the Space Station if near-error-free radio links are provided.

Development of a Hand Held Thromboelastograph

DTIC Science & Technology

2015-01-01

documents will be referenced during the Entegrion PCM System design, verification and validation activities. EN 61010 -1:2010 (Edition3.0) Safety...requirements for electrical equipment for measurement, control, and laboratory use – Part 1: General requirements. EN 61010 -2-101:2002 Safety...IPC-A-610E Acceptability of Electronic Assemblies IPC 7711/21B Rework, Modification and Repair of Electronic Assemblies. IEC 62304:2006/AC:2008

Educators' Use of Electronic Networks: An E-Mail Survey of Account-Holders on a Statewide Telecomputing System.

ERIC Educational Resources Information Center

Anderson, Susan E.; Harris, Judith B.

This study investigated educators' use of TENET, a statewide educational telecomputing network in Texas. It also documented the development and testing of a lengthy theory-based questionnaire and verified the efficacy of a method for administering surveys via electronic mail. The 70-item survey was sent to a random sample of 300 TENET users with a…

Index to NASA Tech Briefs, 1974

NASA Technical Reports Server (NTRS)

1975-01-01

The following information was given for 1974: (1) abstracts of reports dealing with new technology derived from the research and development activities of NASA or the U.S. Atomic Energy Commission, arranged by subjects: electronics/electrical, electronics/electrical systems, physical sciences, materials/chemistry, life sciences, mechanics, machines, equipment and tools, fabrication technology, and computer programs, (2) indexes for the above documents: subject, personal author, originating center.

Joint Services Electronics Program.

DTIC Science & Technology

1988-02-29

REPORT DOCUMENTATION PAG6E I a lb. RESTRICTIVE MARKINGS ~CI~LAI U4ll- iL --- ’ ,, J,,-.,, , 3 DISTRIBUTION / AVAILABILITY OF REPORT Approved for public...Proximity Gettering with Mega-Electron-Volt-Carbon Implantation 4 GaAs Probing: Surface Properties to 3 -D Field Mapping 8 Miniaturized of Josephson Logic...Materials Studies 21 HFD. 3 . Basic Techniques for Electromagnetic Scattering and Radiation 23 Transmission Line Systems for Millimeter/Submillimeter

Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

PubMed

Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

2015-08-01

This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

27 CFR 73.33 - Am I legally bound by a form I sign electronically?

Code of Federal Regulations, 2010 CFR

2010-04-01

... TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURES AND PRACTICES ELECTRONIC SIGNATURES; ELECTRONIC SUBMISSION OF FORMS Electronic Filing of Documents with TTB § 73.33 Am I legally bound... paper document submitted to satisfy the same reporting requirement. Persons using electronic signatures...

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

PubMed

Young, Wendy; Klima, George; Isaac, Winston

2011-01-01

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

The Storied Experiences of Registered Nurses' Transition from Paper to Electronic Nursing Documentation

ERIC Educational Resources Information Center

Smith, Jeff S.

2010-01-01

This narrative inquiry was designed to bring to life the storied experiences of registered nurses who have transitioned from paper to electronic nursing documentation and to provide a foundation for others who may be preparing to implement electronic documentation and wish to consider the significance of these nurses' stories of change in their…

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 4 2011-07-01 2011-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 41 Public Contracts and Property Management 4 2014-07-01 2014-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

41 CFR 301-71.3 - May we use electronic signatures on travel documents?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May we use electronic signatures on travel documents? 301-71.3 Section 301-71.3 Public Contracts and Property Management Federal... ACCOUNTABILITY REQUIREMENTS General § 301-71.3 May we use electronic signatures on travel documents? Yes, if you...

10 CFR 2.1013 - Use of the electronic docket during the proceeding.

Code of Federal Regulations, 2010 CFR

2010-01-01

... bi-tonal documents. (v) Electronic submissions must be generated in the appropriate PDF output format by using: (A) PDF—Formatted Text and Graphics for textual documents converted from native applications; (B) PDF—Searchable Image (Exact) for textual documents converted from scanned documents; and (C...

5 CFR 850.303 - Return of personal documents.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS (CONTINUED) ELECTRONIC RETIREMENT PROCESSING Records § 850.303 Return of personal documents. An..., OPM may provide the individual with a copy of the document that is derived from electronic records. ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Return of personal documents. 850.303...

IHE profiles applied to regional PACS.

PubMed

Fernandez-Bayó, Josep

2011-05-01

PACS has been widely adopted as an image storage solution that perfectly fits the radiology department workflow and that can be easily extended to other hospital departments. Integrations with other hospital systems, like the Radiology Information System, the Hospital Information System and the Electronic Patient Record are fully achieved but still challenging aims. PACS also creates the perfect environment for teleradiology and teleworking setups. One step further is the regional PACS concept where different hospitals or health care enterprises share the images in an integrated Electronic Patient Record. Among the different solutions available to share images between different hospitals IHE (Integrating the Healthcare Enterprise) organization presents the Cross Enterprise Document Sharing profile (XDS) which allows sharing images from different hospitals even if they have different PACS vendors. Adopting XDS has multiple advantages, images do not need to be duplicated in a central archive to be shared among the different healthcare enterprises, they only need to be indexed and published in a central document registry. In the XDS profile IHE defines the mechanisms to publish and index the images in the central document registry. It also defines the mechanisms that each hospital will use to retrieve those images regardless on the Hospital PACS they are stored. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2014 CFR

2014-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2013 CFR

2013-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2011 CFR

2011-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

17 CFR 232.105 - Limitation on use of HTML documents and hypertext links.

Code of Federal Regulations, 2012 CFR

2012-04-01

... submit the following documents in ASCII: Form N-SAR (§ 274.101 of this chapter) and Form 13F (§ 249.325... exhibits to Form N-SAR in HTML. (b) Electronic filers may not include in any HTML document hypertext links... documents within the current submission and to documents previously filed electronically and located in the...

Achieving Interoperability Through Base Registries for Governmental Services and Document Management

NASA Astrophysics Data System (ADS)

Charalabidis, Yannis; Lampathaki, Fenareti; Askounis, Dimitris

As digital infrastructures increase their presence worldwide, following the efforts of governments to provide citizens and businesses with high-quality one-stop services, there is a growing need for the systematic management of those newly defined and constantly transforming processes and electronic documents. E-government Interoperability Frameworks usually cater to the technical standards of e-government systems interconnection, but do not address service composition and use by citizens, businesses, or other administrations.

Implementation of a cloud-based electronic medical record exchange system in compliance with the integrating healthcare enterprise's cross-enterprise document sharing integration profile.

PubMed

Wu, Chien Hua; Chiu, Ruey Kei; Yeh, Hong Mo; Wang, Da Wei

2017-11-01

In 2011, the Ministry of Health and Welfare of Taiwan established the National Electronic Medical Record Exchange Center (EEC) to permit the sharing of medical resources among hospitals. This system can presently exchange electronic medical records (EMRs) among hospitals, in the form of medical imaging reports, laboratory test reports, discharge summaries, outpatient records, and outpatient medication records. Hospitals can send or retrieve EMRs over the virtual private network by connecting to the EEC through a gateway. International standards should be adopted in the EEC to allow users with those standards to take advantage of this exchange service. In this study, a cloud-based EMR-exchange prototyping system was implemented on the basis of the Integrating the Healthcare Enterprise's Cross-Enterprise Document Sharing integration profile and the existing EMR exchange system. RESTful services were used to implement the proposed prototyping system on the Microsoft Azure cloud-computing platform. Four scenarios were created in Microsoft Azure to determine the feasibility and effectiveness of the proposed system. The experimental results demonstrated that the proposed system successfully completed EMR exchange under the four scenarios created in Microsoft Azure. Additional experiments were conducted to compare the efficiency of the EMR-exchanging mechanisms of the proposed system with those of the existing EEC system. The experimental results suggest that the proposed RESTful service approach is superior to the Simple Object Access Protocol method currently implemented in the EEC system, according to the irrespective response times under the four experimental scenarios. Copyright © 2017 Elsevier B.V. All rights reserved.

Implementation of Imaging Technology for Recordkeeping at the World Bank.

ERIC Educational Resources Information Center

Smith, Clive D.

1997-01-01

Describes the evolution of an electronic document management system for the World Bank, including record-keeping components, and how the Pittsburgh requirements for evidence in record keeping were used to evaluate it. Discusses imaging technology for scanning paper records, metadata for retrieval and record keeping, and extending the system to…

Development of TOPS

NASA Astrophysics Data System (ADS)

Tanaka, Yoshiyuki; Tsugiishi, Shigemi

The off-line patent and utility model information management system at Teijin Ltd. had been developed and operated since 1980. To achieve efficient business management through office automation and to get ready for easy access to electronic document delivery so-called Paperless project being developed by Japan Patent Office, the system was reviewed and new online system was constructed in 1985. The paper describes its details.

Bridging the Gap between HL7 CDA and HL7 FHIR: A JSON Based Mapping.

PubMed

Rinner, Christoph; Duftschmid, Georg

2016-01-01

The Austrian electronic health record (EHR) system ELGA went live in December 2016. It is a document oriented EHR system and is based on the HL7 Clinical Document Architecture (CDA). The HL7 Fast Healthcare Interoperability Resources (FHIR) is a relatively new standard that combines the advantages of HL7 messages and CDA Documents. In order to offer easier access to information stored in ELGA we present a method based on adapted FHIR resources to map CDA documents to FHIR resources. A proof-of-concept tool using Java, the open-source FHIR framework HAPI-FHIR and publicly available FHIR servers was created to evaluate the presented mapping. In contrast to other approaches the close resemblance of the mapping file to the FHIR specification allows existing FHIR infrastructure to be reused. In order to reduce information overload and facilitate the access to CDA documents, FHIR could offer a standardized way to query CDA data on a fine granular base in Austria.

Secure scalable disaster electronic medical record and tracking system.

PubMed

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

2013-10-01

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

27 CFR 73.35 - Do I need to keep paper copies of forms I submit to TTB electronically?

Code of Federal Regulations, 2010 CFR

2010-04-01

... Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY (CONTINUED) PROCEDURES AND PRACTICES ELECTRONIC SIGNATURES; ELECTRONIC SUBMISSION OF FORMS Electronic Filing of Documents with TTB § 73... unless TTB otherwise authorizes you to maintain electronic copies of these documents through a general...

Defining and incorporating basic nursing care actions into the electronic health record.

PubMed

Englebright, Jane; Aldrich, Kelly; Taylor, Cathy R

2014-01-01

To develop a definition of basic nursing care for the hospitalized adult patient and drive uptake of that definition through the implementation of an electronic health record. A team of direct care nurses, assisted by subject matter experts, analyzed nursing theory and regulatory requirements related to basic nursing care. The resulting list of activities was coded using the Clinical Care Classification (CCC) system and incorporated into the electronic health record system of a 170-bed community hospital. Nine basic nursing care activities were identified as a result of analyzing nursing theory and regulatory requirements in the framework of a hypothetical "well" patient. One additional basic nursing care activity was identified following the pilot implementation in the electronic health record. The pilot hospital has successfully passed a post-implementation regulatory review with no recommendations related to the documentation of basic patient care. This project demonstrated that it is possible to define the concept of basic nursing care and to distinguish it from the interdisciplinary, problem-focused plan of care. The use of the electronic health record can help clarify, document, and communicate basic care elements and improve uptake among nurses. This project to define basic nursing care activities and incorporate into the electronic health record represents a first step in capturing meaningful data elements. When fully implemented, these data could be translated into knowledge for improving care outcomes and collaborative processes. © 2013 Sigma Theta Tau International.

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2014 CFR

2014-07-01

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

Electrical actuation technology bridging, volume 1

NASA Astrophysics Data System (ADS)

Hammond, Monica S.; Doane, George B., III

1993-01-01

This document contains the proceedings from the conference. The workshop addressed key technologies bridging the entire field of electrical actuation including systems methodology, control electronics, power source systems, reliability, maintainability, and vehicle health management with special emphasis on thrust vector control (TVC) applications on NASA launch vehicles. Speakers were drawn primarily from industry with participation from universities and government. In addition, prototype hardware demonstrations were held at the MSFC Propulsion Laboratory each afternoon. Splinter sessions held on the final day afforded the opportunity to discuss key issues and to provide overall recommendations. Presentations are included in this document.

26 CFR 1.6050W-2 - Electronic furnishing of information statements for payments made in settlement of payment card...

Code of Federal Regulations, 2014 CFR

2014-04-01

... statements required by section 6050W(f) electronically on a website instead of in a paper format. The letter... website, downloading the consent document, completing the consent document, and e-mailing the completed consent back to F. The consent document posted on the website uses the same electronic format that F uses...

26 CFR 1.6050W-2 - Electronic furnishing of information statements for payments made in settlement of payment card...

Code of Federal Regulations, 2012 CFR

2012-04-01

... statements required by section 6050W(f) electronically on a website instead of in a paper format. The letter... website, downloading the consent document, completing the consent document, and e-mailing the completed consent back to F. The consent document posted on the website uses the same electronic format that F uses...

26 CFR 1.6050W-2 - Electronic furnishing of information statements for payments made in settlement of payment card...

Code of Federal Regulations, 2013 CFR

2013-04-01

... statements required by section 6050W(f) electronically on a website instead of in a paper format. The letter... website, downloading the consent document, completing the consent document, and e-mailing the completed consent back to F. The consent document posted on the website uses the same electronic format that F uses...

Implementation of the common phrase index method on the phrase query for information retrieval

NASA Astrophysics Data System (ADS)

Fatmawati, Triyah; Zaman, Badrus; Werdiningsih, Indah

2017-08-01

As the development of technology, the process of finding information on the news text is easy, because the text of the news is not only distributed in print media, such as newspapers, but also in electronic media that can be accessed using the search engine. In the process of finding relevant documents on the search engine, a phrase often used as a query. The number of words that make up the phrase query and their position obviously affect the relevance of the document produced. As a result, the accuracy of the information obtained will be affected. Based on the outlined problem, the purpose of this research was to analyze the implementation of the common phrase index method on information retrieval. This research will be conducted in English news text and implemented on a prototype to determine the relevance level of the documents produced. The system is built with the stages of pre-processing, indexing, term weighting calculation, and cosine similarity calculation. Then the system will display the document search results in a sequence, based on the cosine similarity. Furthermore, system testing will be conducted using 100 documents and 20 queries. That result is then used for the evaluation stage. First, determine the relevant documents using kappa statistic calculation. Second, determine the system success rate using precision, recall, and F-measure calculation. In this research, the result of kappa statistic calculation was 0.71, so that the relevant documents are eligible for the system evaluation. Then the calculation of precision, recall, and F-measure produces precision of 0.37, recall of 0.50, and F-measure of 0.43. From this result can be said that the success rate of the system to produce relevant documents is low.

Association Between Real-time Electronic Injury Surveillance Applications and Clinical Documentation and Data Acquisition in a South African Trauma Center

PubMed Central

Zargaran, Eiman; Spence, Richard; Adolph, Lauren; Nicol, Andrew; Schuurman, Nadine; Navsaria, Pradeep; Ramsey, Damon

2018-01-01

Importance Collection and analysis of up-to-date and accurate injury surveillance data are a key step in the maturation of trauma systems. Trauma registries have proven to be difficult to establish in low- and middle-income countries owing to the burden of trauma volume, cost, and complexity. Objective To determine whether an electronic trauma health record (eTHR) used by physicians can serve as simultaneous clinical documentation and data acquisition tools. Design, Setting, and Participants This 2-part quality improvement study included (1) preimplementation and postimplementation eTHR study with assessments of satisfaction by 41 trauma physicians, time to completion, and quality of data collected comparing paper and electronic charting; and (2) prospective ecologic study describing the burden of trauma seen at a Level I trauma center, using real-time data collected by the eTHR on consecutive patients during a 12-month study period. The study was conducted from October 1, 2010, to September 30, 2011, at Groote Schuur Hospital, Cape Town, South Africa. Data analysis was performed from October 15, 2011, to January 15, 2013. Main Outcomes and Measures The primary outcome of part 1 was data field competition rates of pertinent trauma registry items obtained through electronic or paper documentation. The main measures of part 2 were to identify risk factors to trauma in Cape Town and quality indicators recommended for trauma system evaluation at Groote Schuur Hospital. Results The 41 physicians included in the study found the electronic patient documentation to be more efficient and preferable. A total of 11 612 trauma presentations were accurately documented and promptly analyzed. Fields relevant to injury surveillance in the eTHR (n = 11 612) had statistically significant higher completion rates compared with paper records (n = 9236) (for all comparisons, P < .001). The eTHR successfully captured quality indicators recommended for trauma system evaluation which were previously challenging to collect in a timely and accurate manner. Of the 11 612 patient admissions over the study period, injury location was captured 11 075 times (95.4%), injury mechanism 11 135 times (95.9%), systolic blood pressure 11 106 times (95.6%), and Glasgow Coma Scale 11 140 times (95.9%). These fields were successfully captured with statistically higher rates than previous paper documentation. Epidemiologic analysis confirmed a heavy burden of violence-related injury (51.8% of all injuries) and motor vehicle crash injuries (14.3% of all injuries). Mapping analysis demonstrated clusters of injuries originating mainly from vulnerable and low-income neighborhoods and their respective referring trauma facilities, Mitchell’s Plain Hospital (734 [10.1%]), Guguletu Community Health Center (654 [9.0%]), and New Somerset Hospital (400 [5.5%]). Conclusions and Relevance Accurate capture and simultaneous analysis of trauma data in low-resource trauma settings are feasible through the integration of surveillance into clinical workflow and the timely analysis of electronic data. PMID:29541765

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., and General Hearing Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., and General Hearing Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents; signatures; acceptance... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

10 CFR 2.304 - Formal requirements for documents; signatures; acceptance for filing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Management for NRC Adjudicatory Hearings § 2.304 Formal requirements for documents; signatures; acceptance... section, it may be struck. (1) An electronic document must be signed using a participant's or a... paragraph (d) of this section. (i) When signing an electronic document using a digital ID certificate, the...

Survey of Computer-Based Message Systems; COM/PortaCOM Conference System: Design Goals and Principles; Computer Conferencing Is More Than Electronic Mail; Effects of the COM Computer Conference System.

ERIC Educational Resources Information Center

Palme, Jacob

The four papers contained in this document provide: (1) a survey of computer based mail and conference systems; (2) an evaluation of systems for both individually addressed mail and group addressing through conferences and distribution lists; (3) a discussion of various methods of structuring the text data in existing systems; and (4) a…

Functionality Research

DTIC Science & Technology

1993-07-01

PERIOD. 1.1 Naval Research Laboratory (NRL): The CM5, with 128 nodes, was installed at NRL in November of 1992. In late December, the upgrade to 256...Details on their approach to spectral to grid conversion have been DTIC QUALITY INSPECTED 8 documented in a paper submitted for a special issue of...interactions between electrons in certain rare earth and actinide compounds called heavy electron systems, and in the high temperature superconductors and

High-G Verification of Lithium-Polymer (Li-Po) Pouch Cells

DTIC Science & Technology

2016-05-19

should not be construed as an official Department of the Army position, policy, or decision, unless so designated by other documentation. The...telemetry systems supporting the design , development, and testing of smart and precision mortar and artillery projectiles. 15. SUBJECT TERMS Telemetry...electronics have enabled smaller and more powerful electronic devices to be developed as designers are able to package more capability in smaller spaces. At

STS-53 Discovery, OV-103, DOD Hercules digital electronic imagery equipment

NASA Technical Reports Server (NTRS)

1992-01-01

STS-53 Discovery, Orbiter Vehicle (OV) 103, Department of Defense (DOD) mission Hand-held Earth-oriented Real-time Cooperative, User-friendly, Location, targeting, and Environmental System (Hercules) spaceborne experiment equipment is documented in this table top view. HERCULES is a joint NAVY-NASA-ARMY payload designed to provide real-time high resolution digital electronic imagery and geolocation (latitude and longitude determination) of earth surface targets of interest. HERCULES system consists of (from left to right): a specially modified GRID Systems portable computer mounted atop NASA developed Playback-Downlink Unit (PDU) and the Naval Research Laboratory (NRL) developed HERCULES Attitude Processor (HAP); the NASA-developed Electronic Still Camera (ESC) Electronics Box (ESCEB) including removable imagery data storage disks and various connecting cables; the ESC (a NASA modified Nikon F-4 camera) mounted atop the NRL HERCULES Inertial Measurement Unit (HIMU) containing the three

STS-53 Discovery, OV-103, DOD Hercules digital electronic imagery equipment

NASA Image and Video Library

1992-04-22

STS-53 Discovery, Orbiter Vehicle (OV) 103, Department of Defense (DOD) mission Hand-held Earth-oriented Real-time Cooperative, User-friendly, Location, targeting, and Environmental System (Hercules) spaceborne experiment equipment is documented in this table top view. HERCULES is a joint NAVY-NASA-ARMY payload designed to provide real-time high resolution digital electronic imagery and geolocation (latitude and longitude determination) of earth surface targets of interest. HERCULES system consists of (from left to right): a specially modified GRID Systems portable computer mounted atop NASA developed Playback-Downlink Unit (PDU) and the Naval Research Laboratory (NRL) developed HERCULES Attitude Processor (HAP); the NASA-developed Electronic Still Camera (ESC) Electronics Box (ESCEB) including removable imagery data storage disks and various connecting cables; the ESC (a NASA modified Nikon F-4 camera) mounted atop the NRL HERCULES Inertial Measurement Unit (HIMU) containing the three-axis ring-laser gyro.

Evaluation of Evidence-Based Nursing Pain Management Practice

PubMed Central

Song, Wenjia; Eaton, Linda H.; Gordon, Debra B.; Hoyle, Christine; Doorenbos, Ardith Z.

2014-01-01

Background It is important to ensure that cancer pain management is based on the best evidence. Nursing evidence-based pain management can be examined through an evaluation of pain documentation. Aims This study aimed to (a) modify and test an evaluation tool for nursing cancer pain documentation, and (b) describe the frequency and quality of nursing pain documentation in one oncology unit via electronic medical system. Design and Setting A descriptive cross-sectional design was used for this study at an oncology unit of an academic medical center in the Pacific Northwest. Methods Medical records were examined for 37 adults hospitalized during April and May of 2013. Nursing pain documentations (N = 230) were reviewed using an evaluation tool modified from the Cancer Pain Practice Index to consist of 13 evidence-based pain management indicators, including pain assessment, care plan, pharmacologic and nonpharmacologic interventions, monitoring and treatment of analgesic side effects, communication with physicians, and patient education. Individual nursing documentation was assigned a score from 0 (worst possible) to 13 (best possible), to reflect the delivery of evidence-based pain management. Results The participating nurses documented 90% of the recommended evidence-based pain management indicators. Documentation was suboptimal for pain reassessment, pharmacologic interventions, and bowel regimen. Conclusions The study results provide implications for enhancing electronic medical record design and highlight a need for future research to understand the reasons for suboptimal nursing documentation of cancer pain management. For the future use of the data evaluation tool, we recommend additional modifications according to study settings. PMID:26256215

Design and development of an IBM/VM menu system

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

Cazzola, D.J.

1992-10-01

This report describes a full screen menu system developed using IBM's Interactive System Productivity Facility (ISPF) and the REXX programming language. The software was developed for the 2800 IBM/VM Electrical Computer Aided Design (ECAD) system. The system was developed to deliver electronic drawing definitions to a corporate drawing release system. Although this report documents the status of the menu system when it was retired, the methodologies used and the requirements defined are very applicable to replacement systems.

78 FR 77354 - Procedural Rules To Permit Parties To File and Serve Documents Electronically

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... by handwriting his or her signature. For documents filed by electronic transmission, a party may sign... transmission. A party or representative of the party shall sign a document by handwriting his signature. (2...

Transforming to a computerized system for nursing care: organizational success within Magnet idealism.

PubMed

Lindgren, Carolyn L; Elie, Leslie G; Vidal, Elizabeth C; Vasserman, Alex

2010-01-01

In reaching the goal for standardized, quality care, a not-for-profit healthcare system consisting of seven institutional entities is transforming nursing practice guidelines, patient care workflow, and patient documents into electronic, online, real-time modalities for use across departments and all healthcare delivery entities of the system. Organizational structure and a strategic plan were developed for the 2-year Clinical Transformation Project. The Siemens Patient Care Document System was adopted and adapted to the hospitals' documentation and information needs. Two fast-track sessions of more than 100 nurses and representatives from other health disciplines were held to standardize assessments, histories, care protocols, and interdisciplinary plans of care for the top 10 diagnostic regulatory groups. Education needs of the users were addressed. After the first year, a productive, functional system is evidenced. For example, the bar-coded Medication Administration Check System is in full use on the clinical units of one of the hospitals, and the other institutional entities are at substantial stages of implementation of Patient Care Documentation System. The project requires significant allocation of personnel and financial resources for a highly functional informatics system that will transform clinical care. The project exemplifies four of the Magnet ideals and serves as a model for others who may be deciding about launching a similar endeavor.

[Electronic data records in primary health care and aspects of their development in Bosnia and Herzegovina].

PubMed

Novo, Ahmed; Masić, Izet; Toromanović, Selim; Karić, Mediha; Zunić, Lejla

2004-01-01

In Medical Informatics medical documentation and evidention are most probably the key areas. Also, in primary health care it is very important and part of daily activity of medical staff. Bosnia and Herzegovina is trying to be close to developed countries and to modernize and computerize current systems of documentation and to cross over from manual and semi manual methods to computerized medical data analysis. The most of European countries have developed standards and classification systems in primary health care for collecting, examination, analysis and interpretation of medical data assessed. One of possibilities as well as dilemma, which data carrier should be used for storage and manipulation of patient data in primary health care, is use of electronic medical record. Most of the South East European countries use chip or smart card and some of countries in neighborhood (Italy) choose laser card as patient data carrier. Both technologies have the advantages and disadvantages what was comprehensively colaborated by the authors in this paper, with intention to help experts who make decisions in this segment to create and to correctly influence on improvement of quality, correctness and accuracy of medical documentation in primary health care.

Instant replay.

PubMed

Rosenthal, David I

2013-06-01

With widespread adoption of electronic health records (EHRs) and electronic clinical documentation, health care organizations now have greater faculty to review clinical data and evaluate the efficacy of quality improvement efforts. Unfortunately, I believe there is a fundamental gap between actual health care delivery and what we document in the current EHR systems. This process of capturing the patient encounter, which I'll refer to as transcription, is prone to significant data loss due to inadequate methods of data capture, multiple points of view, and bias and subjectivity in the transcriptional process. Our current EHR, text-based clinical documentation systems are lossy abstractions - one sided accounts of what take place between patients and providers. Our clinical notes contain the breadcrumbs of relationships, conversations, physical exams, and procedures but often lack the ability to capture the form, the emotions, the images, the nonverbal communication, and the actual narrative of interactions between human beings. I believe that a video record, in conjunction with objective transcriptional services and other forms of data capture, may provide a closer approximation to the truth of health care delivery and may be a valuable tool for healthcare improvement. Copyright © 2013 Elsevier Inc. All rights reserved.

Electronic Flight Bag (EFB) 2015 Industry Survey.

DOT National Transportation Integrated Search

2015-10-01

This document provides an overview of Electronic Flight Bag (EFB) hardware and software capabilities, including portable electronic devices (PEDs) used as EFBs, as of July 2015. This document updates and replaces the Volpe Centers previous EFB ind...

Analysis And Control System For Automated Welding

NASA Technical Reports Server (NTRS)

Powell, Bradley W.; Burroughs, Ivan A.; Kennedy, Larry Z.; Rodgers, Michael H.; Goode, K. Wayne

1994-01-01

Automated variable-polarity plasma arc (VPPA) welding apparatus operates under electronic supervision by welding analysis and control system. System performs all major monitoring and controlling functions. It acquires, analyzes, and displays weld-quality data in real time and adjusts process parameters accordingly. Also records pertinent data for use in post-weld analysis and documentation of quality. System includes optoelectronic sensors and data processors that provide feedback control of welding process.

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

PubMed

Kossman, Susan P; Scheidenhelm, Sandra L

2008-01-01

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

Onboard shuttle on-line software requirements system: Prototype

NASA Technical Reports Server (NTRS)

Kolkhorst, Barbara; Ogletree, Barry

1989-01-01

The prototype discussed here was developed as proof of a concept for a system which could support high volumes of requirements documents with integrated text and graphics; the solution proposed here could be extended to other projects whose goal is to place paper documents in an electronic system for viewing and printing purposes. The technical problems (such as conversion of documentation between word processors, management of a variety of graphics file formats, and difficulties involved in scanning integrated text and graphics) would be very similar for other systems of this type. Indeed, technological advances in areas such as scanning hardware and software and display terminals insure that some of the problems encountered here will be solved in the near-term (less than five years). Examples of these solvable problems include automated input of integrated text and graphics, errors in the recognition process, and the loss of image information which results from the digitization process. The solution developed for the Online Software Requirements System is modular and allows hardware and software components to be upgraded or replaced as industry solutions mature. The extensive commercial software content allows the NASA customer to apply resources to solving the problem and maintaining documents.

A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems.

PubMed

Simpao, Allan F; Tan, Jonathan M; Lingappan, Arul M; Gálvez, Jorge A; Morgan, Sherry E; Krall, Michael A

2017-10-01

Anesthesia information management systems (AIMS) are sophisticated hardware and software technology solutions that can provide electronic feedback to anesthesia providers. This feedback can be tailored to provide clinical decision support (CDS) to aid clinicians with patient care processes, documentation compliance, and resource utilization. We conducted a systematic review of peer-reviewed articles on near real-time and point-of-care CDS within AIMS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Studies were identified by searches of the electronic databases Medline and EMBASE. Two reviewers screened studies based on title, abstract, and full text. Studies that were similar in intervention and desired outcome were grouped into CDS categories. Three reviewers graded the evidence within each category. The final analysis included 25 articles on CDS as implemented within AIMS. CDS categories included perioperative antibiotic prophylaxis, post-operative nausea and vomiting prophylaxis, vital sign monitors and alarms, glucose management, blood pressure management, ventilator management, clinical documentation, and resource utilization. Of these categories, the reviewers graded perioperative antibiotic prophylaxis and clinical documentation as having strong evidence per the peer reviewed literature. There is strong evidence for the inclusion of near real-time and point-of-care CDS in AIMS to enhance compliance with perioperative antibiotic prophylaxis and clinical documentation. Additional research is needed in many other areas of AIMS-based CDS.

Electronic implementation of national nursing standards--NANDA, NOC and NIC as an effective teaching tool.

PubMed

Allred, Sharon K; Smith, Kevin F; Flowers, Laura

2004-01-01

With the increased interest in evidence-based medicine, Internet access and the growing emphasis on national standards, there is an increased challenge for teaching institutions and nursing services to teach and implement standards. At the same time, electronic clinical documentation tools have started to become a common format for recording nursing notes. The major aim of this paper is to ascertain and assess the availability of clinical nursing tools based on the NANDA, NOC and NIC standards. Faculty at 20 large nursing schools and directors of nursing at 20 hospitals were interviewed regarding the use of nursing standards in clinical documentation packages, not only for teaching purposes but also for use in hospital-based systems to ensure patient safety. A survey tool was utilized that covered questions regarding what nursing standards are being taught in the nursing schools, what standards are encouraged by the hospitals, and teaching initiatives that include clinical documentation tools. Information was collected on how utilizing these standards in a clinical or hospital setting can improve the overall quality of care. Analysis included univariate and bivariate analysis. The consensus between both groups was that the NANDA, NOC and NIC national standards are the most widely taught and utilized. In addition, a training initiative was identified within a large university where a clinical documentation system based on these standards was developed utilizing handheld devices.

North Carolina: Statewide Automation and Connectivity Efforts.

ERIC Educational Resources Information Center

Christian, Elaine J., Ed.

1996-01-01

Describes statewide information automation and connectivity efforts in North Carolina. Highlights include Triangle Research Libraries Network Document Delivery System; cooperative networking projects; public library connectivity to the state library; rural access projects; community college automation; K-12 technology plans; electronic government…

Performance Support on the Shop Floor.

ERIC Educational Resources Information Center

Kasvi, Jyrki J. J.; Vartiainen, Matti

2000-01-01

Discussion of performance support on the shop floor highlights four support systems for assembly lines that incorporate personal computer workstations in local area networks and use multimedia documents. Considers new customer-focused production paradigms; organizational learning; knowledge development; and electronic performance support systems…

Method of estimation of scanning system quality

NASA Astrophysics Data System (ADS)

Larkin, Eugene; Kotov, Vladislav; Kotova, Natalya; Privalov, Alexander

2018-04-01

Estimation of scanner parameters is an important part in developing electronic document management system. This paper suggests considering the scanner as a system that contains two main channels: a photoelectric conversion channel and a channel for measuring spatial coordinates of objects. Although both of channels consist of the same elements, the testing of their parameters should be executed separately. The special structure of the two-dimensional reference signal is offered for this purpose. In this structure, the fields for testing various parameters of the scanner are sp atially separated. Characteristics of the scanner are associated with the loss of information when a document is digitized. The methods to test grayscale transmitting ability, resolution and aberrations level are offered.

Final Report: MaRSPlus Sensor System Electrical Cable Management and Distributed Motor Control Computer Interface

NASA Technical Reports Server (NTRS)

Reil, Robin

2011-01-01

The success of JPL's Next Generation Imaging Spectrometer (NGIS) in Earth remote sensing has inspired a follow-on instrument project, the MaRSPlus Sensor System (MSS). One of JPL's responsibilities in the MSS project involves updating the documentation from the previous JPL airborne imagers to provide all the information necessary for an outside customer to operate the instrument independently. As part of this documentation update, I created detailed electrical cabling diagrams to provide JPL technicians with clear and concise build instructions and a database to track the status of cables from order to build to delivery. Simultaneously, a distributed motor control system is being developed for potential use on the proposed 2018 Mars rover mission. This system would significantly reduce the mass necessary for rover motor control, making more mass space available to other important spacecraft systems. The current stage of the project consists of a desktop computer talking to a single "cold box" unit containing the electronics to drive a motor. In order to test the electronics, I developed a graphical user interface (GUI) using MATLAB to allow a user to send simple commands to the cold box and display the responses received in a user-friendly format.

Large space structures and systems in the space station era: A bibliography with indexes (supplement 05)

NASA Technical Reports Server (NTRS)

1993-01-01

Bibliographies and abstracts are listed for 1363 reports, articles, and other documents introduced into the NASA scientific and technical information system between January 1, 1991 and July 31, 1992. Topics covered include technology development and mission design according to system, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion and solar power satellite systems.

Large space structures and systems in the space station era: A bibliography with indexes (supplement 05)

NASA Astrophysics Data System (ADS)

1993-03-01

Bibliographies and abstracts are listed for 1363 reports, articles, and other documents introduced into the NASA scientific and technical information system between January 1, 1991 and July 31, 1992. Topics covered include technology development and mission design according to system, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion and solar power satellite systems.

Development of electronic medical record charting for hospital-based transfusion and apheresis medicine services: Early adoption perspectives

PubMed Central

Levy, Rebecca; Pantanowitz, Liron; Cloutier, Darlene; Provencher, Jean; McGirr, Joan; Stebbins, Jennifer; Cronin, Suzanne; Wherry, Josh; Fenton, Joseph; Donelan, Eileen; Johari, Vandita; Andrzejewski, Chester

2010-01-01

Background: Electronic medical records (EMRs) provide universal access to health care information across multidisciplinary lines. In pathology departments, transfusion and apheresis medicine services (TAMS) involved in direct patient care activities produce data and documentation that typically do not enter the EMR. Taking advantage of our institution's initiative for implementation of a paperless medical record, our TAMS division set out to develop an electronic charting (e-charting) strategy within the EMR. Methods: A focus group of our hospital's transfusion committee consisting of transfusion medicine specialists, pathologists, residents, nurses, hemapheresis specialists, and information technologists was constituted and charged with the project. The group met periodically to implement e-charting TAMS workflow and produced electronic documents within the EMR (Cerner Millenium) for various service line functions. Results: The interdisciplinary working group developed and implemented electronic versions of various paper-based clinical documentation used by these services. All electronic notes collectively gather and reside within a unique Transfusion Medicine Folder tab in the EMR, available to staff with access to patient charts. E-charting eliminated illegible handwritten notes, resulted in more consistent clinical documentation among staff, and provided greater realered. However, minor updates and corrections to documents as well as select work re-designs were required for optimal use of e-charting-time review/access of hemotherapy practices. No major impediments to workflow or inefficiencies have been encount by these services. Conclusion: Documentation of pathology subspecialty activities such as TAMS can be successfully incorporated into the EMR. E-charting by staff enhances communication and helps promote standardized documentation of patient care within and across service lines. Well-constructed electronic documents in the EMR may also enhance data mining, quality improvement, and biovigilance monitoring activities. PMID:20805955

Second Line of Defense: Electronic Maintenance Reports, Local Maintenance Provider User Guide, Rev. 3

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

Leigh, Richard J.

2012-09-01

The Electronic Maintenance Report forms allow Local Maintenance Providers (LMP) and other program staff to enter maintenance information into a simple and secure system. This document describes the features and information required to complete the Maintenance Report forms. It is expected that all Corrective Maintenance Reports from LMPs will be submitted electronically into the SLD Portal. As an exception (e.g., when access to the SLD Portal is unavailable), Maintenance Reports can be submitted via a secure Adobe PDF form available through the Sustainability Manager assigned to each country.

78 FR 55292 - Certain Optical Disc Drives, Components Thereof, and Products Containing the Same; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-10

...; Toshiba America Information Systems, Inc. of CA; MediaTek, Inc. of Taiwan; and MediaTek USA Inc. of CA... FURTHER INFORMATION CONTACT: Lisa R. Barton, Acting Secretary to the Commission, U.S. International Trade... complaint can be accessed on the Commission's Electronic Document Information System (EDIS) at EDIS \\1\\, and...

Document analysis with neural net circuits

NASA Technical Reports Server (NTRS)

Graf, Hans Peter

1994-01-01

Document analysis is one of the main applications of machine vision today and offers great opportunities for neural net circuits. Despite more and more data processing with computers, the number of paper documents is still increasing rapidly. A fast translation of data from paper into electronic format is needed almost everywhere, and when done manually, this is a time consuming process. Markets range from small scanners for personal use to high-volume document analysis systems, such as address readers for the postal service or check processing systems for banks. A major concern with present systems is the accuracy of the automatic interpretation. Today's algorithms fail miserably when noise is present, when print quality is poor, or when the layout is complex. A common approach to circumvent these problems is to restrict the variations of the documents handled by a system. In our laboratory, we had the best luck with circuits implementing basic functions, such as convolutions, that can be used in many different algorithms. To illustrate the flexibility of this approach, three applications of the NET32K circuit are described in this short viewgraph presentation: locating address blocks, cleaning document images by removing noise, and locating areas of interest in personal checks to improve image compression. Several of the ideas realized in this circuit that were inspired by neural nets, such as analog computation with a low resolution, resulted in a chip that is well suited for real-world document analysis applications and that compares favorably with alternative, 'conventional' circuits.

Document Delivery: An Annotated Selective Bibliography.

ERIC Educational Resources Information Center

Khalil, Mounir A.; Katz, Suzanne R.

1992-01-01

Presents a selective annotated bibliography of 61 items that deal with topics related to document delivery, including networks; hypertext; interlibrary loan; computer security; electronic publishing; copyright; online catalogs; resource sharing; electronic mail; electronic libraries; optical character recognition; microcomputers; liability issues;…

Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

PubMed Central

Gibbons, John P.; Antolak, John A.; Followill, David S.; Huq, M. Saiful; Klein, Eric E.; Lam, Kwok L.; Palta, Jatinder R.; Roback, Donald M.; Reid, Mark; Khan, Faiz M.

2014-01-01

A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′ = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′ ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of dm, with \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′ = 1 cGy/MU, although both systems are acceptable within the current protocol. For photon beams, the formalism includes the use of blocked fields, physical or dynamic wedges, and (static) multileaf collimation. No formalism is provided for intensity modulated radiation therapy calculations, although some general considerations and a review of current calculation techniques are included. For electron beams, the formalism provides for calculations at the standard and extended SSDs using either an effective SSD or an air-gap correction factor. Example tables and problems are included to illustrate the basic concepts within the presented formalism. PMID:24593704

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

NASA Astrophysics Data System (ADS)

Beaser, R.; Wagner, E.

1999-12-01

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

Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research.

PubMed

Meißner, Anne; Schnepp, Wilfried

2014-06-20

Since the introduction of electronic nursing documentation systems, its implementation in recent years has increased rapidly in Germany. The objectives of such systems are to save time, to improve information handling and to improve quality. To integrate IT in the daily working processes, the employee is the pivotal element. Therefore it is important to understand nurses' experience with IT implementation. At present the literature shows a lack of understanding exploring staff experiences within the implementation process. A systematic review and meta-ethnographic synthesis of primary studies using qualitative methods was conducted in PubMed, CINAHL, and Cochrane. It adheres to the principles of the PRISMA statement. The studies were original, peer-reviewed articles from 2000 to 2013, focusing on computer-based nursing documentation in Residential Aged Care Facilities. The use of IT requires a different form of information processing. Some experience this new form of information processing as a benefit while others do not. The latter find it more difficult to enter data and this result in poor clinical documentation. Improvement in the quality of residents' records leads to an overall improvement in the quality of care. However, if the quality of those records is poor, some residents do not receive the necessary care. Furthermore, the length of time necessary to complete the documentation is a prominent theme within that process. Those who are more efficient with the electronic documentation demonstrate improved time management. For those who are less efficient with electronic documentation the information processing is perceived as time consuming. Normally, it is possible to experience benefits when using IT, but this depends on either promoting or hindering factors, e.g. ease of use and ability to use it, equipment availability and technical functionality, as well as attitude. In summary, the findings showed that members of staff experience IT as a benefit when it simplifies their daily working routines and as a burden when it complicates their working processes. Whether IT complicates or simplifies their routines depends on influencing factors. The line between benefit and burden is semipermeable. The experiences differ according to duties and responsibilities.

Nurses' perceptions of e-portfolio use for on-the-job training in Taiwan.

PubMed

Tsai, Pei-Rong; Lee, Ting-Ting; Lin, Hung-Ru; Lee-Hsieh, Jane; Mills, Mary Etta

2015-01-01

Electronic portfolios can be used to record user performance and achievements. Currently, clinical learning systems and in-service education systems lack integration of nurses' clinical performance records with their education or training outcomes. For nurses with less than 2 years' work experience (nursing postgraduate year), use of an electronic portfolio is essential. This study aimed to assess the requirements of using electronic portfolios in continuing nursing education for clinical practices. Fifteen nurses were recruited using a qualitative purposive sampling approach between April 2013 and May 2013. After obtaining participants' consent, data were collected in a conference room of the study hospital by one-on-one semistructured in-depth interviews. Through data analyses, the following five main themes related to electronic learning portfolios were identified: instant access to in-service education information, computerized nursing postgraduate year training manual, diversity of system functions and interface designs, need for sufficient computers, and protection of personal documents. Because electronic portfolios are beginning to be used in clinical settings, a well-designed education information system not only can meet the needs of nurses but also can facilitate their learning progress.

Modern Corneal Eye-Banking Using a Software-Based IT Management Solution.

PubMed

Kern, C; Kortuem, K; Wertheimer, C; Nilmayer, O; Dirisamer, M; Priglinger, S; Mayer, W J

2018-01-01

Increasing government legislation and regulations in manufacturing have led to additional documentation regarding the pharmaceutical product requirements of corneal grafts in the European Union. The aim of this project was to develop a software within a hospital information system (HIS) to support the documentation process, to improve the management of the patient waiting list and to increase informational flow between the clinic and eye bank. After an analysis of the current documentation process, a new workflow and software were implemented in our electronic health record (EHR) system. The software takes over most of the documentation and reduces the time required for record keeping. It guarantees real-time tracing of all steps during human corneal tissue processing from the start of production until allocation during surgery and includes follow-up within the HIS. Moreover, listing of the patient for surgery as well as waiting list management takes place in the same system. The new software for corneal eye banking supports the whole process chain by taking over both most of the required documentation and the management of the transplant waiting list. It may provide a standardized IT-based solution for German eye banks working within the same HIS.

Technology for large space systems: A bibliography with indexes (supplement 08)

NASA Technical Reports Server (NTRS)

1983-01-01

This bibliography lists 414 reports, articles and other documents introduced into the NASA scientific and technical information system. It provides helpful information to the researcher, manager, and designer in technology development and mission design in the area of Large Space System Technology. Subject matter is grouped according to systems, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion, and solar power satellite systems.

Technology for large space systems: A bibliography with indexes (supplement 09)

NASA Technical Reports Server (NTRS)

1983-01-01

This bibliography lists 414 reports, articles and other documents introduced into the NASA scientific and technical information system between January 1, 1983 and June 30, 1983. Information on technology development and mission design in the area of Large Space System Technology is provided. Subject matter is grouped according to systems, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics. advanced materials, assembly concepts, propulsion, and solar power satellite systems.

Technology for large space systems: A bibliography with indexes (supplement 10)

NASA Technical Reports Server (NTRS)

1984-01-01

The bibliography lists 408 reports, articles and other documents introduced into the NASA scientific and technical information system to provide helpful information to the researcher, manager, and designer in technology development and mission design in the area of large space system technology. Subject matter is grouped according to systems, interactive analysis and design, structural and thermal analysis and design, structural concepts and control systems, electronics, advanced materials, assembly concepts, propulsion, and solar power satellite systems.

Automatic public access to documents and maps stored on and internal secure system.

NASA Astrophysics Data System (ADS)

Trench, James; Carter, Mary

2013-04-01

The Geological Survey of Ireland operates a Document Management System for providing documents and maps stored internally in high resolution and in a high level secure environment, to an external service where the documents are automatically presented in a lower resolution to members of the public. Security is devised through roles and Individual Users where role level and folder level can be set. The application is an electronic document/data management (EDM) system which has a Geographical Information System (GIS) component integrated to allow users to query an interactive map of Ireland for data that relates to a particular area of interest. The data stored in the database consists of Bedrock Field Sheets, Bedrock Notebooks, Bedrock Maps, Geophysical Surveys, Geotechnical Maps & Reports, Groundwater, GSI Publications, Marine, Mine Records, Mineral Localities, Open File, Quaternary and Unpublished Reports. The Konfig application Tool is both an internal and public facing application. It acts as a tool for high resolution data entry which are stored in a high resolution vault. The public facing application is a mirror of the internal application and differs only in that the application furnishes high resolution data into low resolution format which is stored in a low resolution vault thus, making the data web friendly to the end user for download.

Electronics Teacher's Guide. Science and Technology Document Series No. 40.

ERIC Educational Resources Information Center

Lewis, John

This is the second document on the teaching of electronics to appear as part of UNESCO's science and technology education program. An introductory section describes the role that electronics plays as part of the physics curriculum. The following section outlines the content of the electronics course. The outline includes guidelines for determining…

Creating a Living Portfolio: Documenting Student Growth with Electronic Portfolios.

ERIC Educational Resources Information Center

Siegle, Del

2002-01-01

This article explains how teachers can use electronic portfolios of students' work to document learner progress. It considers different file formats for storing student work, describes steps to creating an electronic portfolio, and discusses an art and literature electronic magazine created by one school featuring work from student portfolios. (CR)