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Sample records for internet medical document

  1. A model for enhancing Internet medical document retrieval with "medical core metadata".

    PubMed

    Malet, G; Munoz, F; Appleyard, R; Hersh, W

    1999-01-01

    Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and MEDLINE-type content descriptions. The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines.

  2. A Model for Enhancing Internet Medical Document Retrieval with “Medical Core Metadata”

    PubMed Central

    Malet, Gary; Munoz, Felix; Appleyard, Richard; Hersh, William

    1999-01-01

    Objective: Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. Design: The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and Medline-type content descriptions. Results: The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. Conclusions: The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines. PMID:10094069

  3. Document Delivery over the Internet.

    ERIC Educational Resources Information Center

    Jackson, Mary E.

    1993-01-01

    Discusses three innovative Internet-based electronic document delivery systems: Ariel, developed by the Research Libraries Group; Digitized Document Transmission Project, developed by North Carolina State University; and Network Fax Project, developed by Ohio State University. System are compared in terms of equipment, operation, advantages and…

  4. Verifiable and Redactable Medical Documents

    PubMed Central

    Brown, Jordan; Blough, Douglas M.

    2012-01-01

    This paper considers how to verify provenance and integrity of data in medical documents that are exchanged in a distributed system of health IT services. Provenance refers to the sources of health information within the document and integrity means that the information was not modified after generation by the source. Our approach allows intermediate parties to redact the document by removing information that they do not wish to reveal. For example, patients can store verifiable health information and provide subsets of it to third parties, while redacting sensitive information that they do not wish employers, insurers, or others to receive. Our method uses a cryptographic primitive known as a redactable signature. We study practical issues and performance impacts of building, redacting, and verifying Continuity of Care Documents (CCDs) that are protected with redactable signatures. Results show that manipulating redactable CCDs provides superior security and privacy with little computational overhead. PMID:23304391

  5. Verifiable and redactable medical documents.

    PubMed

    Brown, Jordan; Blough, Douglas M

    2012-01-01

    This paper considers how to verify provenance and integrity of data in medical documents that are exchanged in a distributed system of health IT services. Provenance refers to the sources of health information within the document and integrity means that the information was not modified after generation by the source. Our approach allows intermediate parties to redact the document by removing information that they do not wish to reveal. For example, patients can store verifiable health information and provide subsets of it to third parties, while redacting sensitive information that they do not wish employers, insurers, or others to receive. Our method uses a cryptographic primitive known as a redactable signature. We study practical issues and performance impacts of building, redacting, and verifying Continuity of Care Documents (CCDs) that are protected with redactable signatures. Results show that manipulating redactable CCDs provides superior security and privacy with little computational overhead.

  6. Internet Search Engines - Fluctuations in Document Accessibility.

    ERIC Educational Resources Information Center

    Mettrop, Wouter; Nieuwenhuysen, Paul

    2001-01-01

    Reports an empirical investigation of the consistency of retrieval through Internet search engines. Evaluates 13 engines: AltaVista, EuroFerret, Excite, HotBot, InfoSeek, Lycos, MSN, NorthernLight, Snap, WebCrawler, and three national Dutch engines: Ilse, Search.nl and Vindex. The focus is on a characteristic related to size: the degree of…

  7. Internet Search Engines - Fluctuations in Document Accessibility.

    ERIC Educational Resources Information Center

    Mettrop, Wouter; Nieuwenhuysen, Paul

    2001-01-01

    Reports an empirical investigation of the consistency of retrieval through Internet search engines. Evaluates 13 engines: AltaVista, EuroFerret, Excite, HotBot, InfoSeek, Lycos, MSN, NorthernLight, Snap, WebCrawler, and three national Dutch engines: Ilse, Search.nl and Vindex. The focus is on a characteristic related to size: the degree of…

  8. Podiatric medical resources on the Internet.

    PubMed

    Fikar, C R; Tran, M Q

    1997-02-01

    The authors discuss Internet sites that provide information on podiatric medicine relevant to practitioners and students. Before going online, the podiatric health professional should be aware that the information located at these sites may vary in quality, reliability, and level of sophistication. A brief introduction to the history of the Internet is presented, along with useful sites and general medical resources.

  9. Medical Internet exchange project in Japan.

    PubMed

    Mizushima, H; Uchiyama, E; Akiyama, M; Yamamoto, R; Tatsumi, H

    1998-01-01

    The Internet has been widely used by medical institutes and hospitals around the world, however; its use for telemedicine is still low. The main reason for this is the availability of bandwidth and poor security through the net. Meanwhile, we have established and have been operating 'Cancer Information Network' among 11 Cancer Centers in Japan, mainly for Multipoint TV Conference using HDTV image. There are also similar projects among 9 cardiovascular centers in Japan. By March, all 240 national hospitals will have been connected by an IP network using an ATM backbone. The above network projects are operated independently, and have an 'Intranet' characteristics within them. There are also many hospitals and clinics connected to the Internet by commercial internet providers. To make a secure and efficient network between these medical networks and medical sites, we started the Medical Internet eXchange project (MDX project) constructing a Medical Network Operation Center to create a link between them. To provide the administrative policy of this project, we established the Medical Internet eXchange Association. We are planning to expand this project to Asian-Pacific countries using the Asian-Pacific Advanced Network (APAN), and also expand it to worldwide connections in the future. For this purpose, we are currently asking other countries to form a structure similar to MDX-Japan. The concept, hardware system, software system, firewall configuration, and routing policy will be also discussed.

  10. Medical internet ethics: a field in evolution.

    PubMed

    Dyer, K A; Thompson, C D

    2001-01-01

    As in any new field, the merger of medicine, e-commerce and the Internet raises many questions pertaining to ethical conduct. Key issues include defining the essence of the patient-provider relationship, establishing guidelines and training for practicing online medicine and therapy, setting standards for ethical online research, determining guidelines for providing quality healthcare information and requiring ethical conduct for medical and health websites. Physicians who follow their professional code of ethics are obligated not to exploit the relationship they have with patients, nor allow anyone else working with them to do so. Physicians and therapists are obligated to serve those who place trust in them for treatment, whether in face-to-face or online Internet encounters with patients or clients. This ethical responsibility to patients and clients is often in direct conflict with the business model of generating profits. Healthcare professionals involved in Medical Internet Ethics need to define the scope of competent medical and healthcare on the Internet. The emerging ethical issues facing medicine on the Internet, the current state of medical ethics on the Internet and questions for future directions of study in this evolving field are reviewed in this paper.

  11. Creating your own medical Internet library

    PubMed Central

    Stewart, A

    1999-01-01

    Many physicians struggle to keep up with new developments in their fields. The internet can provide a solution to this problem by allowing rapid access to a broad spectrum of reliable information. Becoming familiar with a few clinically relevant and freely available medical resources on the World Wide Web may enhance a physician's efforts to provide evidence-based care on a daily basis. This article outlines a simple strategy for physicians to make the internet a useful tool. PMID:10569106

  12. Profiling characteristics of internet medical information users.

    PubMed

    Weaver, James B; Mays, Darren; Lindner, Gregg; Eroglu, Dogan; Fridinger, Frederick; Bernhardt, Jay M

    2009-01-01

    The Internet's potential to bolster health promotion and disease prevention efforts has attracted considerable attention. Existing research leaves two things unclear, however: the prevalence of online health and medical information seeking and the distinguishing characteristics of individuals who seek that information. This study seeks to clarify and extend the knowledge base concerning health and medical information use online by profiling adults using Internet medical information (IMI). Secondary analysis of survey data from a large sample (n = 6,119) representative of the Atlanta, GA, area informed this investigation. Five survey questions were used to assess IMI use and general computer and Internet use during the 30 days before the survey was administered. Five questions were also used to assess respondents' health care system use. Several demographic characteristics were measured. RESULTS Contrary to most prior research, this study found relatively low prevalence of IMI-seeking behavior. Specifically, IMI use was reported by 13.2% of all respondents (n = 6,119) and by 21.1% of respondents with Internet access (n = 3,829). Logistic regression models conducted among respondents accessing the Internet in the previous 30 days revealed that, when controlling for several sociodemographic characteristics, home computer ownership, online time per week, and health care system use are all positively linked with IMI-seeking behavior. The data suggest it may be premature to embrace unilaterally the Internet as an effective asset for health promotion and disease prevention efforts that target the public.

  13. Medical Documentation: An English Composition Professor's Perspective.

    ERIC Educational Resources Information Center

    Freeman, Mary G.

    Nursing textbooks which address the subject of medical documentation tend to equate good documentation of a patient's behavior and state with strong interpersonal skills on the part of the nurse. Rarely do they point out the importance of developing a deep concentrated attention to the sensory world around oneself in order to be a good medical…

  14. [Medical research using Internet questionnaire in Japan].

    PubMed

    Yasunaga, Hideo; Ide, Hiroo; Imamura, Tomoaki; Ohe, Kazuhiko

    2006-01-01

    As the method for questionnaire studies, mail survey and interview survey are frequently used. The utility and validity of applying the Internet method to medical studies have yet to be fully evaluated. For the present investigation, we reviewed 36 Japanese original articles using Internet questionnaire reported through to April 2005. Although original papers using the Internet method have been increasing in recent years, they are still limited in number. There is comparatively much research on disease with many patients in youth and early manhood, such as allergic ailments (allergic rhinitis, atopic dermatitis, and hives). As compared with conventional methods, the advantages of the Internet approach are convenience for both investigators and respondents and the ability to quickly collect data. The disadvantage is that the user's age range is more concentrated. Since samples are extracted from individuals who are registered as monitors, a greater sampling error may occur as compared with a random sampling method. However, it is to be expected that continued explosive growth of the Internet would decrease the limitation in user's age. If more elderly people participate in questionnaire studies using the web, research into more illnesses should be facilitated. Considering the inherent advantage, it is thought that Internet method can become the leading tool for sociomedical and clinical research in the near future.

  15. Use of Internet resources by German medical professionals.

    PubMed Central

    Obst, O

    1998-01-01

    A survey of German medical professionals, students, and librarians was performed in 1995 to examine how they used the Internet. The great majority used e-mail, the Web, and Internet sources based in the United States. Respondents claimed various advantages from Internet use. There was a clearly expressed need for Internet courses as well as evaluation and presentation of Internet sources. A majority of respondents wanted the librarians to provide Internet related services. A follow-up survey in 1996 suggested a trend towards a more realistic view among medical Internet users that incorporated expected benefits and advantages from the Internet. PMID:9803296

  16. Indexing medical WWW documents by morphemes.

    PubMed

    Schulz, S; Honeck, M; Hahn, U

    2001-01-01

    Assisting users to search medical information on the WWW is here considered from two perspectives--the linguistic complexity of medical terms, nominal compounds in particular, and cross-lingual relationships between monolingual medical terminologies. In order to solve the first problem, we present an approach to automatic indexing in which medically plausible morphological units are used. Semantic value is added to these index terms by a compact domain-specific thesaurus. We further discuss tools for morphological segmentation and morphosemantic normalization of HTML documents, as well as an adaptation of a standard WWW search engine for morpheme-based retrieval. The second problem, cross-lingual medical document retrieval, is dealt with by defining cross-lingual equivalence relations on the emerging morpheme sets.

  17. Computer Assisted Medical Record Documentation-Hyperalimentation

    PubMed Central

    Guritz, Gary A.; Brier, Kenneth Leo; Buth, Jonathan A.

    1985-01-01

    A microcomputer total parenteral nutrition (TPN) (hyperalimentation) program was developed to provide individualized intravenous nutritional support. The microcomputer TPN program assisted in preliminary nutritional assessment and enabled the pharmacist to manipulate different solutions in achieving a final product. Computerized calculations are based on caloric needs, nitrogen requirements and solutions available. The resultant program allowed greater clinical involvement by the pharmacist and enabled complete medical record documentation of the nutritional regimen.

  18. Internet addiction and its determinants among medical students

    PubMed Central

    Chaudhari, Bhushan; Menon, Preethi; Saldanha, Daniel; Tewari, Abhinav; Bhattacharya, Labhanya

    2015-01-01

    Background: Exponential use of internet has resulted in internet addiction in recent times. Students are particularly at risk because of their unique personal, social, and academic needs. Objectives: The study was designed to evaluate the prevalence of internet addiction and its determinants among medical students. Materials and Methods: A cross-sectional study was conducted in 282 medical students with the help of semi-structured questionnaire consisting of questions related to demographic information, information related to internet use, and Young's internet addiction test. Results: We found prevalence of internet addiction among medical students to be 58.87% (mild – 51.42%, moderate –7.45%) and significantly associated factors with internet addiction being male gender, staying in private accommodation, lesser age of first internet use, using mobile for internet access, higher expenditure on internet, staying online for longer time, and using internet for social networking, online videos, and watching website with sexual content. Conclusion: Medical students are vulnerable for internet addiction and efforts should be taken to increase awareness and prevent the problem of internet addiction in them. PMID:27212820

  19. Internet addiction and its determinants among medical students.

    PubMed

    Chaudhari, Bhushan; Menon, Preethi; Saldanha, Daniel; Tewari, Abhinav; Bhattacharya, Labhanya

    2015-01-01

    Exponential use of internet has resulted in internet addiction in recent times. Students are particularly at risk because of their unique personal, social, and academic needs. The study was designed to evaluate the prevalence of internet addiction and its determinants among medical students. A cross-sectional study was conducted in 282 medical students with the help of semi-structured questionnaire consisting of questions related to demographic information, information related to internet use, and Young's internet addiction test. We found prevalence of internet addiction among medical students to be 58.87% (mild - 51.42%, moderate -7.45%) and significantly associated factors with internet addiction being male gender, staying in private accommodation, lesser age of first internet use, using mobile for internet access, higher expenditure on internet, staying online for longer time, and using internet for social networking, online videos, and watching website with sexual content. Medical students are vulnerable for internet addiction and efforts should be taken to increase awareness and prevent the problem of internet addiction in them.

  20. Distributed medical informatics education using internet2.

    PubMed

    Tidmarsh, Patrica J; Cummings, Joseph; Hersh, William R; Freidman, Charles P

    2002-01-01

    The curricula of most medical informatics training programs are incomplete. We used Internet2-based videoconferencing to expand the educational opportunities of medical informatics students at Oregon Health & Science University and the University of Pittsburgh. Students and faculty in both programs shared extra-curricular research conferences and journal club meetings. A course in Information Retrieval was made available to students in both programs. The conferences, meetings and class were well accepted by participants. A few problems were experienced with the technology, some of which were resolved, and some non-technical challenges to distributing academic conferences, meetings and coursework were also uncovered. We plan to continue our efforts with expanded course and extra-curricular offerings and a more comprehensive evaluation strategy.

  1. Distributed medical informatics education using internet2.

    PubMed Central

    Tidmarsh, Patrica J.; Cummings, Joseph; Hersh, William R.; Freidman, Charles P.

    2002-01-01

    The curricula of most medical informatics training programs are incomplete. We used Internet2-based videoconferencing to expand the educational opportunities of medical informatics students at Oregon Health & Science University and the University of Pittsburgh. Students and faculty in both programs shared extra-curricular research conferences and journal club meetings. A course in Information Retrieval was made available to students in both programs. The conferences, meetings and class were well accepted by participants. A few problems were experienced with the technology, some of which were resolved, and some non-technical challenges to distributing academic conferences, meetings and coursework were also uncovered. We plan to continue our efforts with expanded course and extra-curricular offerings and a more comprehensive evaluation strategy. PMID:12463932

  2. Problematic internet use and internet searches for medical information: the role of health anxiety.

    PubMed

    Fergus, Thomas A; Dolan, Sara L

    2014-12-01

    Individuals frequently use the Internet to search for medical information. For some individuals, repeated searches for medical information on the Internet exacerbate health anxiety. Researchers have termed this phenomenon "cyberchondria" and have suggested that cyberchondria might relate to the excessive use of the Internet for other purposes as well. The present study examined associations among Internet searches for medical information, health anxiety, and problematic Internet use (PIU) using a large sample of medically healthy community adults located in the United States (N=430). As predicted, respondents who experienced increased health anxiety following Internet searches for medical information reported significantly greater PIU than respondents for whom such searches either had no impact on or decreased their health anxiety. This effect was not attributable to the frequency of health-related online searching behavior or negative affect. Conceptual and therapeutic implications are discussed.

  3. Internet-Based Reference Services in Medical Libraries: A Perspective.

    ERIC Educational Resources Information Center

    Bandyopadhyay, Aditi

    1997-01-01

    This study examines different applications of Internet (e-mail, Telnet, File Transfer Protocol, Gopher, World Wide Web) in medical library settings, emphasizing reference services. Discusses the role of the Internet in fulfilling National Network of Libraries of Medicine's objectives and analyzes the merits of using the Internet as a reference…

  4. Reducing medical errors through better documentation.

    PubMed

    Edwards, Marie; Moczygemba, Jackie

    2004-01-01

    Preventable medical errors occur with alarming frequency in US hospitals. Questions to address include what is a medical error, what errors occur most often, and what solutions can health information technologies offer with better documentation. Preventable injuries caused by mismanagement of treatment happen in all areas of care. Some result from human fallibility and some from system failures. Most errors stem from a combination of the two. Examples of combination errors include wrong-site surgeries, scrambled laboratory results, medication mishaps, misidentification of patients, and equipment failures. Unavailable patient information and illegible handwriting lead to diagnosing and ordering errors. Recent technology offers viable solutions to many of these medical errors. Computer-based medical records, integration with the pharmacy, decision support software, Computerized Physician Order Entry Systems, and bar coding all offer ways to avoid tragic treatment outcomes. Persuading and training hospital staff to use the technology poses a problem, as does budgeting for the new equipment. However, the technology would prove its worth in time. The Institute of Medicine and coalition groups such as Leapfrog Group have recognized the problem that permeates the health care industry, manifests in many ways, and requires the many solutions that information technology offer.

  5. A cost analysis of an internet based medication adherence intervention for people living with HIV

    PubMed Central

    Page, Timothy F.; Horvath, Keith J.; Danilenko, Gene P.; Williams, Mark

    2012-01-01

    The purpose of the study was to document development costs and estimate implementation costs of an internet based medication adherence intervention for people living with HIV in the US. Participants (n=61) were enrolled in the 8 week study in 2011 and entered the intervention website remotely in the setting of their choice. Development costs were obtained from a feasibility and acceptability study of an internet based medication adherence intervention. Implementation costs were estimated based on an 8 week trial period during the feasibility and acceptability study. Results indicated that although developing an internet based medication adherence intervention is expensive, the monthly cost of implementing and delivering the intervention is low. If the efficacy of similar interventions can be established, these results suggest the internet could be an effective method for delivering medication adherence interventions to persons residing in areas with limited access to in-person adherence services. PMID:22362156

  6. Distributed Medical Informatics Education Using Internet2

    PubMed Central

    Cummings, Joseph; Tidmarsh, Patricia; Hersh, William; Friedman, Charles

    2001-01-01

    The subject expertise of most medical informatics training programs funded by the National Library of Medicine (NLM) is incomplete. This not only limits the topical content students from individual sites are taught, but also restricts the project work they can undertake. This goal of this pilot project is to enable students in the informatics programs at two different sites - Oregon Health Sciences University (OHSU) and University of Pittsburgh (UP) - to have access to a broader range of faculty, their subject expertise, and other students with whom to collaborate using high-speed networking and distance learning modalities. Students at OHSU and UP participate in real time training program activities via IP-based/Internet2 videoconferences.

  7. The internet doctor and medical ethics. Ethical implications of the introduction of the Internet into medical encounters.

    PubMed

    Collste, Göran

    2002-01-01

    In this article, consultation via the Internet and the use of the Internet as a source of medical information is examined from an ethical point of view. It is argued that important ethical aspects of the clinical interaction, such as dialogue and trust will be difficult to realise in an Internet-consultation. Further, it is doubtful whether an Internet doctor will accept responsibility. However, medical information via the Internet can be a valuable resource for patients wanting to know more about their disease and, thus, it is a means to enhancing their autonomy.

  8. Computer and Internet use among Undergraduate Medical Students in Iran

    PubMed Central

    Ayatollahi, Ali; Ayatollahi, Jamshid; Ayatollahi, Fatemeh; Ayatollahi, Reza; Shahcheraghi, Seyed Hossein

    2014-01-01

    Objective: Although computer technologies are now widely used in medicine, little is known about its use among medical students in Iran. The aim of this study was to determine the competence and access to computer and internet among the medical students. Methods: In this descriptive study, medical students of Shahid Sadoughi University of Medical Science, Yazd, Iran from the fifth years were asked to answer a questionnaire during a time-tabled lecture slot. The chi-square test was used to compare the frequency of computer and internet use between the two genders, and the level of statistical significance for all test was set at 0.05. Results: All the students have a personal computer and internet access. There were no statistically significant differences between men and women for the computer and internet access, use wireless device to access internet, having laptop and e-mail address and the difficulties encountered using internet. The main reason for less utilization of internet was slow speed of data transfer. Conclusions: Because of the wide range of computer skills and internet information among medical students in our institution, a single computer and internet course for all students would not be useful nor would it be accepted. PMID:25225525

  9. Internet use and its addiction level in medical students

    PubMed Central

    Upadhayay, Namrata; Guragain, Sanjeev

    2017-01-01

    Objective To compare the Internet addiction levels between male and female medical students. Methods One hundred medical students (male: 50, female: 50) aged 17–30 years were included in a cross-sectional study. A standardized questionnaire was used to assess their Internet addiction level. Additionally, a self-designed questionnaire was used to identify the various purposes of Internet use among the students. The Internet addiction score (based on the Internet Addiction Test) was compared between male and female students by using the Mann–Whitney U test (p≤0.05). After knowing their addiction level, we interviewed students to know if Internet use had any bad/good impact on their life. Results The Internet Addiction Test scores obtained by the students were in the range of 11–70. Out of 100 students, 21 (male: 13, female: 8) were found to be slightly addicted to the Internet. The remaining 79 students were average online users. There was no significant difference between male and female students in the addiction level (score). However, males were more addicted than females. The major use of Internet was to download and watch movies and songs and to communicate with friends and family (76/100). Some students (24/100) used the Internet to assess information that helped them in their educational and learning activities. Some students mentioned that overuse of the Internet lead to insufficient amounts of sleep and affected their concentration levels in the classroom during lectures. Conclusion Medical students are experiencing problems due to Internet overuse. They experience poor academic progress and lack of concentration while studying. The main use of the Internet was for entertainment and to communicate with friends and family.

  10. Internet-Related Work Activities and Academic Government Documents Librarians' Professional Relationships.

    ERIC Educational Resources Information Center

    Roselle, Ann

    1999-01-01

    Examines specific Internet-related work activities of academic government documents librarians in the United States and how these activities are affecting academic government documents librarians' professional relationships. Results are reported from a national survey of 226 academic government documents librarians that indicate closer…

  11. An introduction to Internet for medical professionals.

    PubMed

    Guay, T

    1994-06-01

    This article is a wonderful description of what I think is the most remarkable communication and information system ever devised. INTERNET is literally a world of data, dialogue, and discourse on any topic imaginable, right at your fingertips. I invite all PAs to begin to explore the world of interpersonal computing via INTERNET. I am putting together a list of PAs with E-Mail accounts to provide a forum for sharing information and linking PAs with common interests.

  12. Drugs on the Internet, part II: antidepressant medication web sites.

    PubMed

    Morgan, Melissa; Montagne, Michael

    2011-01-01

    Antidepressant medications have been the fastest growing category of use of pharmaceutical products over the past decade. Selected Internet web sites providing information on antidepressant medications were identified and assessed using code of conduct criteria for posting health information on the Internet as developed by the Health on the Internet Foundation. Thirteen representative web sites were evaluated. Degree of compliance with each of the eight criterion varied by site, though all 13 sites met the criterion for legality of content and conduct on their web site. WebMD and FamilyDoctor.org met most of the criteria, while pharmaceutical company sites tended to meet the fewest criteria.

  13. Tobacco industry documents: comparing the Minnesota Depository and internet access

    PubMed Central

    Balbach, E; Gasior, R; Barbeau, E

    2002-01-01

    Objective: To assess the comparability of searches conducted on two publicly available tobacco industry document collections: hard copies housed and maintained by a neutral party in the Minnesota Depository and electronic copies available through tobacco industry maintained websites. Methods: We conducted a set of searches in Minnesota and then conducted the same searches using the industry websites. We matched documents by Bates number, weeded out duplicates, and coded documents that were unique to either collection as major, minor, or trivial. Results: Among hundreds of documents produced by several searches, we found only four unique major documents in the Minnesota Depository. By contrast, we found 62 unique major documents using the websites. Conclusion: These results suggest that researchers can rely on industry websites while waiting for improved access resulting from searching, indexing, and document storage administered by the tobacco control community. Searching the tobacco industry websites is at least as good as searching in Minnesota and may in some instances actually be better. Four smaller subcollections, however, can only be searched by hand in Minnesota. PMID:11891371

  14. SGML-based construction and automatic organization of comprehensive medical textbook on the Internet.

    PubMed

    Miyo, K; Ohe, K

    1998-01-01

    The amount of knowledge required in practical medicine is large and ever increasing. Medical staff must select and use appropriate pieces of the knowledge from this flood of medical information. Recent Internet technology may be solving these problems because it makes information open to the public immediately after it is created and enables many people to share it. Medical resources on the Internet are however currently not always well organized, because these are often voluntarily provided by the experts of a particular field. We therefore decided to create a comprehensive medical database on the Internet, which is well organized, and of a high quality for practical medical use. In order to make full use of the benefits provided by electronic media, we created a new structured data set of information. We then commissioned authors to write manuscripts from which we created Standard General Mark-up Language (SGML) documents. We then wrote a translation program that took the SGML and automatically created a fully inter-linked HyperText Mark-up Language (HTML) document. The translation program generated 4,814 HTML files created from 1,373 number of SGML documents. The total data size including pictures was about 640 MB. 205,775 related links were created. We then published our electronic medical textbook described in HTML publicly on the Internet. Using SGML-based structured data, we constructed a complex electronic medical textbook created organically from simple SGML instances. Our electronic medical textbook is systematic and comprehensive, and has a homogeneous structure. We believe that this is the first comprehensive medical textbook available on the Internet. Furthermore, it was found that our approach to the electronic medical textbook has two major advantages. One is automatic generation of inter-links among documents, and another is easy to maintain documents. In addition, once we construct the electronic textbase in SGML format, the data can be utilized to

  15. Prescription medication abuse and illegitimate internet-based pharmacies.

    PubMed

    Jena, Anupam B; Goldman, Dana P; Foster, Susan E; Califano, Joseph A

    2011-12-20

    Abuse of controlled prescription medications in the United States exceeds that of all illicit drugs combined except marijuana and has grown considerably in the past decade. Although available through traditional channels, controlled prescription medications can also be purchased on the Internet without a prescription. This issue has gained the attention of federal regulators, law enforcement, and the media, but physician awareness of the problem is scarce. This article describes the nature of the problem and its magnitude, discusses the challenges to federal and private efforts to combat illegitimate online pharmacies, and outlines strategies for physicians to recognize and minimize the unwarranted effects of the availability of these medications on the Internet.

  16. Use of the Internet by Sudanese doctors and medical students.

    PubMed

    Ahmed, A M; Yousif, E; Abdalla, M E

    2008-01-01

    Patterns of use of the Internet were investigated by a questionnaire survey of 102 hospital doctors and 123 medical students in Khartoum, Sudan, in January 2005. More doctors (84.3%) had used the Internet than had students (78.9%). Half of consultants (55.0%) used the Internet daily, compared with only 18.2% of junior doctors. Many consultants and junior doctors rated their abilities as poor (60.0% and53.1%). One-third of students (33.3%) used the Internet only for personal and not for academic purposes. Barriers to greater use of the Internet by doctors included: time constraints (80.2%), poor skills (54.6%), no access to full texts of journal articles (53.4%), difficulty in verifying the quality of information (47.6%) and high costs (41.8%). Students faced similar barriers but also listed poor knowledge of the English language.

  17. An Experimental Study in Automatically Categorizing Medical Documents.

    ERIC Educational Resources Information Center

    Ribeiro-Neto, Berthier; Laender, Alberto H. F.; de Lima, Luciano R. S.

    2001-01-01

    Evaluates the retrieval performance of an algorithm that automatically categorizes medical documents, which consists in assigning an International Code of Disease (ICD) based on well-known information retrieval techniques. Reports on experimental results that tested precision using a database of over 20,000 medical documents. (Author/LRW)

  18. What the Internet means for the medical device industry.

    PubMed

    Frank, T

    2000-12-01

    The Internet is dramatically changing the structure of the industry. For the first time, direct communication between all suppliers and all hospitals is available. The Internet-based electronic market place not only provides the ability to choose products from a standardized catalogue, but also to send orders direct to suppliers' enterprise resource planning systems. One-to-one marketing is also becoming a reality. Medical device manufacturers are advised to test the different electronic sales and marketing initiatives that are now available.

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

    PubMed

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

    2014-02-01

    Medical record documentation of cancer inpatients is a core component of continuity of care. The main goal of the study was an assessment of medical record documentation in a palliative care unit (PCU) using a targeted clinical audit based on deceased inpatients' charts. Stage 1 (2010): a clinical audit of medical record documentation assessed by a list of items (diagnosis, prognosis, treatment, power of attorney directive, advance directives). Stage 2 (2011): corrective measures. Stage 3 (2012): re-assessment with the same items' list after six month. Forty cases were investigated during stage 1 and 3. After the corrective measures, inpatient's medical record documentation was significantly improved, including for diagnosis (P = 0.01), diseases extension and treatment (P < 0.001). Our results highlighted the persistence of a weak rate of medical record documentation for advanced directives (P = 0.145).

  20. Simulated Medical Learning Environments on the Internet

    PubMed Central

    Dev, Parvati; Montgomery, Kevin; Senger, Steven; Heinrichs, W. Leroy; Srivastava, Sakti; Waldron, Kenneth

    2002-01-01

    Learning anatomy and surgical procedures requires both a conceptual understanding of three-dimensional anatomy and a hands-on manipulation of tools and tissue. Such virtual resources are not available widely, are expensive, and may be culturally disallowed. Simulation technology, using high-performance computers and graphics, permits realistic real-time display of anatomy. Haptics technology supports the ability to probe and feel this virtual anatomy through the use of virtual tools. The Internet permits world-wide access to resources. We have brought together high-performance servers and high-bandwidth communication using the Next Generation Internet and complex bimanual haptics to simulate a tool-based learning environment for wide use. This article presents the technologic basis of this environment and some evaluation of its use in the gross anatomy course at Stanford University. PMID:12223496

  1. Trends to access internet among medical students of a government medical college in West Bengal.

    PubMed

    Banerjee, Indranil; Biswas, Supreeti; Biswas, Ashish; De, Mausumi; Begum, Sabnam Ara; Haldar, Swaraj

    2011-07-01

    The use of computer and information technology is on an escalation. The internet, one of the key developments in this field, provides instant access to latest medical information. The present study was conducted (i) to estimate the extent and purpose of internet usage among undergraduate (UG) and postgraduate (PG) medical students, (ii) to identify factors that encourage the students to use internet for medical information, (iii) to assess the need for incorporating computer education in medical curriculum. A prospective, cross-sectional, questionnaire-based study was conducted on 150 students of Burdwan Medical College and Hospital between June 2009 and December 2009. Majority of the students accessed internet from their home PC (42% UGs and 52% PGs).Common search engines browsed commonly by both UGs and PGs include Google and yahoo. Regarding principles of telemedicine and evidence-based medicine, majority of the PGs are well versed while UGs are not (p-value 0.0001). Almost all students agreed to incorporate computer education in medical curriculum. Primary source of medical information was textbook for UGs (62%) and internet for the PGs (48%). Majority of UGs (48%) used internet as a ready source of information thus saving time while PGs (68%) primarily relied on internet for recent advances in their disciplines. The primary purposes of internet use are educational for both UGs and PGs. The data obtained indicates that majority of the medical students participating in the present study embrace and use internet to access medical information. It also justifies the need to incorporate internet and associated information technology into existing medical curriculum.

  2. Cultural diversity: blind spot in medical curriculum documents, a document analysis.

    PubMed

    Paternotte, Emma; Fokkema, Joanne P I; van Loon, Karsten A; van Dulmen, Sandra; Scheele, Fedde

    2014-08-22

    Cultural diversity among patients presents specific challenges to physicians. Therefore, cultural diversity training is needed in medical education. In cases where strategic curriculum documents form the basis of medical training it is expected that the topic of cultural diversity is included in these documents, especially if these have been recently updated. The aim of this study was to assess the current formal status of cultural diversity training in the Netherlands, which is a multi-ethnic country with recently updated medical curriculum documents. In February and March 2013, a document analysis was performed of strategic curriculum documents for undergraduate and postgraduate medical education in the Netherlands. All text phrases that referred to cultural diversity were extracted from these documents. Subsequently, these phrases were sorted into objectives, training methods or evaluation tools to assess how they contributed to adequate curriculum design. Of a total of 52 documents, 33 documents contained phrases with information about cultural diversity training. Cultural diversity aspects were more prominently described in the curriculum documents for undergraduate education than in those for postgraduate education. The most specific information about cultural diversity was found in the blueprint for undergraduate medical education. In the postgraduate curriculum documents, attention to cultural diversity differed among specialties and was mainly superficial. Cultural diversity is an underrepresented topic in the Dutch documents that form the basis for actual medical training, although the documents have been updated recently. Attention to the topic is thus unwarranted. This situation does not fit the demand of a multi-ethnic society for doctors with cultural diversity competences. Multi-ethnic countries should be critical on the content of the bases for their medical educational curricula.

  3. Cultural diversity: blind spot in medical curriculum documents, a document analysis

    PubMed Central

    2014-01-01

    Background Cultural diversity among patients presents specific challenges to physicians. Therefore, cultural diversity training is needed in medical education. In cases where strategic curriculum documents form the basis of medical training it is expected that the topic of cultural diversity is included in these documents, especially if these have been recently updated. The aim of this study was to assess the current formal status of cultural diversity training in the Netherlands, which is a multi-ethnic country with recently updated medical curriculum documents. Methods In February and March 2013, a document analysis was performed of strategic curriculum documents for undergraduate and postgraduate medical education in the Netherlands. All text phrases that referred to cultural diversity were extracted from these documents. Subsequently, these phrases were sorted into objectives, training methods or evaluation tools to assess how they contributed to adequate curriculum design. Results Of a total of 52 documents, 33 documents contained phrases with information about cultural diversity training. Cultural diversity aspects were more prominently described in the curriculum documents for undergraduate education than in those for postgraduate education. The most specific information about cultural diversity was found in the blueprint for undergraduate medical education. In the postgraduate curriculum documents, attention to cultural diversity differed among specialties and was mainly superficial. Conclusions Cultural diversity is an underrepresented topic in the Dutch documents that form the basis for actual medical training, although the documents have been updated recently. Attention to the topic is thus unwarranted. This situation does not fit the demand of a multi-ethnic society for doctors with cultural diversity competences. Multi-ethnic countries should be critical on the content of the bases for their medical educational curricula. PMID:25150546

  4. International medical education between Hawaii and Thailand over Internet2.

    PubMed

    Vincent, Dale S; Berg, Benjamin W; Hudson, Donald A; Chitpatima, Suwicha T

    2003-01-01

    International medical education sessions have been successfully conducted by videoconferencing using Internet2. The sessions were between two tertiary care medical centres, in Honolulu and Bangkok. However, video quality was lower than for similar sessions using ISDN and audience satisfaction was less. The main reasons for the lower quality were network congestion and bandwidth allocation by the videoconferencing equipment. Software to ensure quality of service is available, but is not easy to implement. There were also network security problems and the costs were high. Our international videoconferences averaged 40-50 hours per year, an activity level at which connection costs were lower for ISDN than for Internet2. It appears that Internet2 videoconferencing for medical education is best reserved for academic institutions that have other high-bandwidth network requirements.

  5. ISO and CEN documents on quality in medical laboratories.

    PubMed

    Kenny, D

    2001-07-20

    The forthcoming international standard ISO 15189 "Quality management in the medical laboratory" is a document of great importance for the development of quality systems and accreditation for medical/clinical laboratories. For the first time, there will be an internationally recognized standard designed specifically for the accreditation of medical laboratories. The document takes into account the special requirements imposed by the medical environment and by the essential contribution of the medical laboratory service to patient care. It recognizes that medical laboratories must provide not only testing of patient samples, but also advisory, interpretative and educational services. A further document, still in draft form (ISO/DIS 15190), deals with safety management for medical laboratories. ISO 15189 (and probably 15190 also) are expected be adopted by CEN as a European Standard (EN).

  6. [An internet based medical communication server].

    PubMed

    Hu, B; Bai, J; Ye, D

    1998-04-01

    The telemedicine and medical conference usually need multi-point to multi-point communication. Because the communication users can be patients, specialists or medical centers, they have different communication ratios and different physical connection, therefore, this kind of communication is complicated and limited by the communication ratios. In this paper, to meet the requirements of medical communication, we presented a concept of medical communication server which is able to receive data packages and deliver them according to the request of clients, and described its implementation in Windows 95 environment by using Windows Sockets.

  7. Quality of Life in Medical Students With Internet Addiction.

    PubMed

    Fatehi, Farzad; Monajemi, Alireza; Sadeghi, Anahita; Mojtahedzadeh, Rita; Mirzazadeh, Azim

    2016-10-01

    The widespread use of internet has caused new psychological, social, and educational problems for the students. The aim of this study was to examine the quality of life in medical students who suffer from internet addiction. This cross-sectional survey was carried out in Tehran University of Medical Sciences, and a total of 174 fourth-to seventh-year undergraduate medical students were enrolled. The quality of life was assessed by WHOQOL-BREF questionnaire which covers four domains of physical health, psychological, social relationships, and the environment. For assessing internet addiction, we used Internet Addiction Test (IAT) of Young. The students with IAT score higher than 50 were considered as addicted. For evaluating academic performance, the students were requested to report their grade point average (GPA). The mean IA score (±SD) was 34.13±12.76. Twenty-eight students (16.90%) had IAT score above 50. The mean quality of life score in internet addicted group was 54.97±11.38 versus 61.65±11.21 in normal group (P=0.005). Furthermore, there was a negative correlation between IA score and physical domain (r=-0.18, P=0.02); psychological domain (r=-0.35, P=0.000); and social relation domain (r=-0.26, P=0.001). Mean GPA was significantly lower in the addicted group. It seems that quality of life is lower in the internet addicted medical students; moreover, such students academically perform poorer in comparison with non-addicts. Since internet addiction is increasing at a rapid pace which may provoke considerable academic, psychological and social implications; as a result, it may require screening programs to the immediate finding of such problem to give consultations to prevent unwanted complications.

  8. [Security specifications for electronic medical records on the Internet].

    PubMed

    Mocanu, Mihai; Mocanu, Carmen

    2007-01-01

    The extension for the Web applications of the Electronic Medical Record seems both interesting and promising. Correlated with the expansion of Internet in our country, it allows the interconnection of physicians of different specialties and their collaboration for better treatment of patients. In this respect, the ophthalmologic medical applications consider the increased possibilities for monitoring chronic ocular diseases and for the identification of some elements for early diagnosis and risk factors supervision. We emphasize in this survey some possible solutions to the problems of interconnecting medical information systems to the Internet: the achievement of interoperability within medical organizations through the use of open standards, the automated input and processing for ocular imaging, the use of data reduction techniques in order to increase the speed of image retrieval in large databases, and, last but not least, the resolution of security and confidentiality problems in medical databases.

  9. Internet medical usage in Japan: current situation and issues.

    PubMed

    Tatsumi, H; Mitani, H; Haruki, Y; Ogushi, Y

    2001-01-01

    Internet use by physicians and patients has become very popular in Japan. Fifty percent of physicians use the Internet to search for medical and other information. Over the past year, 22% of patients used the Internet to obtain medical information. Because there are no restrictions within Japan on using Web sites to advertise medical treatment, information can be freely sent out, and over the past two or three years this practice has increased dramatically. Internet medical information provides information about illnesses and medications, and it helps improve the quality of life of patients and families. Yet, depending on the content of the information provided and the way this information is used, there is a potential negative side as well. On principle, users are responsible for the way information is used, but there is a need for information providers to consider users safety and to make the information effective for use. Because there is no absolute standard for evaluating the value of medical information, it is necessary to establish a system that opens a dialogue with society and that continuously accumulates high-quality information through the collection of various evaluations, rather than rely on an established authority. For industries and organizations related to commercial pursuits, in particular, it is most effective to establish their own codes for ethical conduct, rather than rely on governmental regulations. At the same time, it is important to have a confirmation function to evaluate how goals set by the outside are being implemented. Aiming at establishing a framework for the Internet medical usage, the Japan Internet Medical Association (JIMA) was founded in 1998 by medical professionals, lawyers, researchers, consumer representatives, patients and their families. We propose a system that would combine feedback from users, who would take on the role of evaluators of the implementation of an ethical code, with a displayed mark that verifies the

  10. Privacy and medical information on the Internet.

    PubMed

    Nelson, Steven B

    2006-02-01

    Health-care consumers are beginning to realize the presence and value of health-care information available on the Internet, but they need to be aware of risks that may be involved. In addition to delivering information, some Web sites collect information. Though not all of the information might be classified as protected health information, consumers need to realize what is collected and how it might be used. Consumers should know a Web site\\'s privacy policy before divulging any personal information. Health-care providers have a responsibility to know what information they are collecting and why. Web servers may collect large amounts of visitor information by default, and they should be modified to limit data collection to only what is necessary. Providers need to be cognizant of the many regulations concerning collection and disclosure of information obtained from consumers. Providers should also provide an easily understood privacy policy for users.

  11. Internet-based survey on medical manga in Japan.

    PubMed

    Kishi, Yukiko; Matsumura, Tomoko; Murishige, Naoko; Kodama, Yuko; Hatanaka, Nobuyo; Takita, Morihito; Sakamoto, Kenjiro; Hamaki, Tamae; Kusumi, Eiji; Kobayashi, Kazuhiko; Yuji, Koichiro; Narimatsu, Hiroto; Kami, Masahiro

    2011-10-01

    The more manga (Japanese graphic novels) communicate medical information, the more people are likely to be influenced by manga. We investigated through an Internet search using Google the characteristics of medical manga published in Japan, defined as those in which the main character is a medical professional and that occur in a medical setting. As of December 2008, 173 medical manga had been published. For a period of time after the first medical manga by Osamu Tezuka in 1970, the number of publications maintained a steady level, but increased rapidly in the mid 1980s. The professions of the protagonist were 134 doctors, 19 nurses, 3 dentists, 3 medical students, and 1 nursing student. Although the main character was mostly a doctor, manga featuring paramedical professionals have increased since 1990s. Medical manga may be a powerful tool for increasing the awareness of the public regarding medicine.

  12. Feasibility and accuracy of medication checks via Internet video.

    PubMed

    Bradford, Natalie; Armfield, Nigel R; Young, Jeanine; Smith, Anthony C

    2012-04-01

    We investigated the feasibility and accuracy of using Internet-based videoconferencing for double-checking medications. Ten participants checked 30 different medications using a desktop PC and a webcam. The accuracy of the video-based checks was compared with 'face-to-vial' checks. The checks included the drug name, dosage and expiry dates of ampoules, vials and tablets, as well as graduations on syringes. There was 100% accuracy for drug name, dosage, and graduations on syringes greater than 1 unit. The expiry dates proved more difficult to read, and accuracy was only 63%. The mean overall accuracy was 91% for all items. Internet video-based medication double-checks may have a useful role to play in processes to ensure the safe use of medications in home care.

  13. 28 CFR 79.5 - Requirements for medical documentation, contemporaneous records, and other records or documents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Requirements for medical documentation, contemporaneous records, and other records or documents. 79.5 Section 79.5 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CLAIMS UNDER THE RADIATION EXPOSURE COMPENSATION ACT General § 79.5 Requirements...

  14. 42 CFR 130.20 - Form of medical documentation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Form of medical documentation. 130.20 Section 130.20 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Documentation Required for Complete Petitions §...

  15. 42 CFR 130.20 - Form of medical documentation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Form of medical documentation. 130.20 Section 130.20 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Documentation Required for Complete Petitions § 130.20...

  16. 42 CFR 130.20 - Form of medical documentation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Form of medical documentation. 130.20 Section 130.20 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Documentation Required for Complete Petitions § 130.20...

  17. 42 CFR 130.20 - Form of medical documentation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Form of medical documentation. 130.20 Section 130.20 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPASSIONATE PAYMENTS RICKY RAY HEMOPHILIA RELIEF FUND PROGRAM Documentation Required for Complete Petitions § 130.20...

  18. How medical students use the computer and Internet at a Turkish military medical school.

    PubMed

    Kir, Tayfun; Ogur, Recai; Kilic, Selim; Tekbas, Omer Faruk; Hasde, Metin

    2004-12-01

    The aim of this study was to determine how medical students use the computer and World Wide Web at a Turkish military medical school and to discuss characteristics related to this computer use. The study was conducted in 2003 in the Department of Public Health at the Gulhane Military Medical School in Ankara, Turkey. A survey developed by the authors was distributed to 508 students, after pretest. Responses were analyzed statistically by using a computer. Most of the students (86.4%) could access a computer and the Internet and all of the computers that were used by students had Internet connections, and a small group (8.9%) had owned their own computers. One-half of the students use notes provided by attending stuff and textbooks as assistant resources for their studies. The most common usage of computers was connecting to the Internet (91.9%), and the most common use of the Internet was e-mail communication (81.6%). The most preferred site category for daily visit was newspaper sites (62.8%). Approximately 44.1% of students visited medical sites when they were surfing. Also, there was a negative correlation between school performance and the time spent for computer and Internet use (-0.056 and -0.034, respectively). It was observed that medical students used the computer and Internet essentially for nonmedical purposes. To encourage students to use the computer and Internet for medical purposes, tutors should use the computer and Internet during their teaching activities, and software companies should produce assistant applications for medical students. Also, medical schools should build interactive World Wide Web sites, e-mail groups, discussion boards, and study areas for medical students.

  19. WCALive: broadcasting a major medical conference on the Internet.

    PubMed

    Palmer, T E; Cumpston, P H; Ruskin, K; Jones, R D

    1997-11-01

    Live video and sound from the 11th World Congress of Anaesthesiology in Sydney, Australia were broadcast over the Internet using the CuSeeme software package as part of an ongoing evaluation of Internet-based telecommunication in the delivery of Continuing Medical Education (CME). This was the first time such a broadcast had been attempted from a medical convention. The broadcast lasted for four days, during which a functioning combination of computer hardware and software was established. Technical issues relating to broadcast of these real time signals over ISDN links and the Internet itself were addressed. Over 200 anaesthetists from around the world were able to 'attend' the plenary sessions via the Internet. Evidenced by feedback received audio reception was quite good. Video reception was less successful for those receiving the broadcast via a modem based Internet connection. The received signal in such circumstances was adequate to provide a video presence of the speaker but inadequate to allow details of 35 mm slides to be visualised. We conclude that this technology will be of use in the delivery of CME materials to remote areas provided simultaneous viewing of high resolution still images is possible using another medium, such as the World Wide Web.

  20. Internet addiction in Greek medical students: an online survey.

    PubMed

    Tsimtsiou, Zoi; Haidich, Anna-Bettina; Spachos, Dimitris; Kokkali, Stamatia; Bamidis, Panagiotis; Dardavesis, Theodoros; Arvanitidou, Malamatenia

    2015-06-01

    The authors investigated the prevalence of Internet addiction (IA) in undergraduate medical students to identify possible associations with sociodemographics and Internet habits. All students at the Aristotle University of Thessaloniki School of Medicine, Greece, were invited to complete the online Internet Addiction Test (IAT) along with sociodemographics and preferences on Internet activities. The authors received 585 responses after three reminders (23.5 % response rate). Mild IA was found in 24.5 %, moderate in 5.4 %, and severe in 0.2 %. In multivariable analysis, the odds to develop IA were increased with visits in Internet cafes (Odds Ratio [OR] 3.49, 95 % Confidence Interval [CI]: 1.45, 8.46), the use of Facebook (OR 2.43, 95 % CI: 1.35, 4.38), Twitter (OR 2.45, 95 % CI: 1.37, 4.39), and online games (OR 1.95, 95 % CI: 1.29, 2.94). Using e-mails seemed to be protective against IA (OR 0.59, 95 % CI: 0.37, 0.94). This is the first IA prevalence study in a European medical school. Early-detection systems and other ways to help students with pathological behaviors should be developed.

  1. Medical Problem and Document Model for Natural Language Understanding

    PubMed Central

    Meystre, Stephane; Haug, Peter J.

    2003-01-01

    We are developing tools to help maintain a complete, accurate and timely problem list within a general purpose Electronic Medical Record system. As a part of this project, we have designed a system t o automatically retrieve medical problems from free-text documents. Here we describe an information model based on XML (eXtensible Markup Language) and compliant with the CDA (Clinical Document Architecture). This model is used to ease the exchange of clinical data between the Natural Language Understanding application that retrieves potential problems from narrative document, and the problem list management application. PMID:14728214

  2. Medical problem and document model for natural language understanding.

    PubMed

    Meystre, Stephanie; Haug, Peter J

    2003-01-01

    We are developing tools to help maintain a complete, accurate and timely problem list within a general purpose Electronic Medical Record system. As a part of this project, we have designed a system to automatically retrieve medical problems from free-text documents. Here we describe an information model based on XML (eXtensible Markup Language) and compliant with the CDA (Clinical Document Architecture). This model is used to ease the exchange of clinical data between the Natural Language Understanding application that retrieves potential problems from narrative document, and the problem list management application.

  3. Toward Medical Documentation That Enhances Situational Awareness Learning.

    PubMed

    Lenert, Leslie A

    2016-01-01

    The purpose of writing medical notes in a computer system goes beyond documentation for medical-legal purposes or billing. The structure of documentation is a checklist that serves as a cognitive aid and a potential index to retrieve information for learning from the record. For the past 50 years, one of the primary organizing structures for physicians' clinical documentation have been the SOAP note (Subjective, Objective, Assessment, Plan). The cognitive check list is well-suited to differential diagnosis but may not support detection of changes in systems and/or learning from cases. We describe an alternative cognitive checklist called the OODA Loop (Observe, Orient, Decide, Act. Through incorporation of projections of anticipated course events with and without treatment and by making "Decisions" an explicit category of documentation in the medical record in the context of a variable temporal cycle for observations, OODA may enhance opportunities to learn from clinical care.

  4. Toward Medical Documentation That Enhances Situational Awareness Learning

    PubMed Central

    Lenert, Leslie A.

    2016-01-01

    The purpose of writing medical notes in a computer system goes beyond documentation for medical-legal purposes or billing. The structure of documentation is a checklist that serves as a cognitive aid and a potential index to retrieve information for learning from the record. For the past 50 years, one of the primary organizing structures for physicians’ clinical documentation have been the SOAP note (Subjective, Objective, Assessment, Plan). The cognitive check list is well-suited to differential diagnosis but may not support detection of changes in systems and/or learning from cases. We describe an alternative cognitive checklist called the OODA Loop (Observe, Orient, Decide, Act. Through incorporation of projections of anticipated course events with and without treatment and by making “Decisions” an explicit category of documentation in the medical record in the context of a variable temporal cycle for observations, OODA may enhance opportunities to learn from clinical care. PMID:28269872

  5. Medical emergencies on board commercial airlines: is documentation as expected?

    PubMed Central

    2012-01-01

    Introduction The purpose of this study was to perform a descriptive, content-based analysis on the different forms of documentation for in-flight medical emergencies that are currently provided in the emergency medical kits on board commercial airlines. Methods Passenger airlines in the World Airline Directory were contacted between March and May 2011. For each participating airline, sample in-flight medical emergency documentation forms were obtained. All items in the sample documentation forms were subjected to a descriptive analysis and compared to a sample "medical incident report" form published by the International Air Transport Association (IATA). Results A total of 1,318 airlines were contacted. Ten airlines agreed to participate in the study and provided a copy of their documentation forms. A descriptive analysis revealed a total of 199 different items, which were summarized into five sub-categories: non-medical data (63), signs and symptoms (68), diagnosis (26), treatment (22) and outcome (20). Conclusions The data in this study illustrate a large variation in the documentation of in-flight medical emergencies by different airlines. A higher degree of standardization is preferable to increase the data quality in epidemiologic aeromedical research in the future. PMID:22397530

  6. Medical emergencies on board commercial airlines: is documentation as expected?

    PubMed

    Sand, Michael; Morrosch, Stephan; Sand, Daniel; Altmeyer, Peter; Bechara, Falk G

    2012-12-12

    The purpose of this study was to perform a descriptive, content-based analysis on the different forms of documentation for in-flight medical emergencies that are currently provided in the emergency medical kits on board commercial airlines. Passenger airlines in the World Airline Directory were contacted between March and May 2011. For each participating airline, sample in-flight medical emergency documentation forms were obtained. All items in the sample documentation forms were subjected to a descriptive analysis and compared to a sample "medical incident report" form published by the International Air Transport Association (IATA). A total of 1,318 airlines were contacted. Ten airlines agreed to participate in the study and provided a copy of their documentation forms. A descriptive analysis revealed a total of 199 different items, which were summarized into five sub-categories: non-medical data (63), signs and symptoms (68), diagnosis (26), treatment (22) and outcome (20). The data in this study illustrate a large variation in the documentation of in-flight medical emergencies by different airlines. A higher degree of standardization is preferable to increase the data quality in epidemiologic aeromedical research in the future.

  7. Documentation of clinical care in hospital patients' medical records: A qualitative study of medical students' perspectives on clinical documentation education.

    PubMed

    Rowlands, Stella; Coverdale, Steven; Callen, Joanne

    2016-12-01

    Clinical documentation is essential for communication between health professionals and the provision of quality care to patients. To examine medical students' perspectives of their education in documentation of clinical care in hospital patients' medical records. A qualitative design using semi-structured interviews with fourth-year medical students was undertaken at a hospital-based clinical school in an Australian university. Several themes reflecting medical students' clinical documentation education emerged from the data: formal clinical documentation education using lectures and tutorials was minimal; most education occurred on the job by junior doctors and student's expressed concerns regarding variation in education between teams and receiving limited feedback on performance. Respondents reported on the importance of feedback for their learning of disease processes and treatments. They suggested that improvements could be made in the timing of clinical documentation education and they stressed the importance of training on the job. On-the-job education with feedback in clinical documentation provides a learning opportunity for medical students and is essential in order to ensure accurate, safe, succinct and timely clinical notes. © The Author(s) 2016.

  8. Combination of visual and textual similarity retrieval from medical documents.

    PubMed

    Eggel, Ivan; Müller, Henning

    2009-01-01

    Medical visual information retrieval has been an active research area over the past ten years as an increasing amount of images are produced digitally and have become available in patient records, scientific literature, and other medical documents. Most visual retrieval systems concentrate on images only, but it has become apparent that the retrieval of similar images alone is of limited interest, and rather the retrieval of similar documents is an important domain. Most medical institutions as well as the World Health Organization (WHO) produce many complex documents. Searching them, including a visual search, can help finding important information and also facilitates the reuse of document content and images. The work described in this paper is based on a proposal of the WHO that produces large amounts of documents from studies but also for training. The majority of these documents are in complex formats such as PDF, Microsoft Word, Excel, or PowerPoint. Goal is to create an information retrieval system that allows easy addition of documents and search by keywords and visual content. For text retrieval, Lucene is used and for image retrieval the GNU Image Finding Tool (GIFT). A Web 2.0 interface allows for an easy upload as well as simple searching.

  9. Local CD-ROM in interaction with HTML documents over the Internet.

    PubMed

    Mattheos, N; Nattestad, A; Attström, R

    2000-08-01

    The internet and computer assisted learning have enhanced the possibilities of providing quality distance learning in dentistry. The use of multimedia material is an essential part of such distance learning courses. However the Internet technology available has limitations regarding transmission of large multimedia files. Therefore especially when addressing undergraduate students or geographically isolated professionals, large download times make distance learning unattractive. This problem was technically solved in a distance learning course for undergraduate students from all over Europe. The present communication describes a method to bypass the problem of transmitting large multimedia files by the use of a specially designed CD-ROM. This CD-ROM was run locally on the students' PC interacting with HTML documents sent over the Internet.

  10. Image-based document management systems for medical records.

    PubMed

    Massengill, S P

    1992-03-01

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

  11. Computers, the Internet and medical education in Africa.

    PubMed

    Williams, Christopher D; Pitchforth, Emma L; O'Callaghan, Christopher

    2010-05-01

    OBJECTIVES This study aimed to explore the use of information and communications technology (ICT) in undergraduate medical education in developing countries. METHODS Educators (deans and heads of medical education) in English-speaking countries across Africa were sent a questionnaire to establish the current state of ICT at medical schools. Non-respondents were contacted firstly by e-mail, subsequently by two postal mailings at 3-month intervals, and finally by telephone. Main outcome measures included cross-sectional data about the availability of computers, specifications, Internet connection speeds, use of ICT by students, and teaching of ICT and computerised research skills, presented by country or region. RESULTS The mean computer : student ratio was 0.123. Internet speeds were rated as 'slow' or 'very slow' on a 5-point Likert scale by 25.0% of respondents overall, but by 58.3% in East Africa and 33.3% in West Africa (including Cameroon). Mean estimates showed that campus computers more commonly supported CD-ROM (91.4%) and sound (87.3%) than DVD-ROM (48.1%) and Internet (72.5%). The teaching of ICT and computerised research skills, and the use of computers by medical students for research, assignments and personal projects were common. CONCLUSIONS It is clear that ICT infrastructure in Africa lags behind that in other regions. Poor download speeds limit the potential of Internet resources (especially videos, sound and other large downloads) to benefit students, particularly in East and West (including Cameroon) Africa. CD-ROM capability is more widely available, but has not yet gained momentum as a means of distributing materials. Despite infrastructure limitations, ICT is already being used and there is enthusiasm for developing this further. Priority should be given to developing partnerships to improve ICT infrastructure and maximise the potential of existing technology.

  12. A classification of errors in lay comprehension of medical documents

    PubMed Central

    Keselman, Alla; Smith, Catherine Arnott

    2012-01-01

    Emphasis on participatory medicine requires that patients and consumers participate in tasks traditionally reserved for healthcare providers. This includes reading and comprehending medical documents, often but not necessarily in the context of interacting with Personal Health Records (PHRs). Research suggests that while giving patients access to medical documents has many benefits (e.g., improved patient-provider communication), lay people often have difficulty understanding medical information. Informatics can address the problem by developing tools that support comprehension; this requires in-depth understanding of the nature and causes of errors that lay people make when comprehending clinical documents. The objective of this study was to develop a classification scheme of comprehension errors, based on lay individuals’ retellings of two documents containing clinical text: a description of a clinical trial and a typical office visit note. While not comprehensive, the scheme can serve as a foundation of further development of a taxonomy of patients’ comprehension errors. Eighty participants, all healthy volunteers, read and retold two medical documents. A data-driven content analysis procedure was used to extract and classify retelling errors. The resulting hierarchical classification scheme contains nine categories and twenty-three subcategories. The most common error made by the participants involved incorrectly recalling brand names of medications. Other common errors included misunderstanding clinical concepts, misreporting the objective of a clinical research study and physician’s findings during a patient’s visit, and confusing and misspelling clinical terms. A combination of informatics support and health education is likely to improve the accuracy of lay comprehension of medical documents. PMID:22925723

  13. [Some documents on the education in the Ottoman Medical School].

    PubMed

    Dramur, R

    1999-01-01

    After the foundation of the Ottoman Medical School in 1838 in Galatasaray in Istanbul, we have examined in the Ottoman archives some documents about the physician and professors who are in charge of the Ottoman Medical School. We have learned with these documents that the chief physician Abdülhâk Molla was honored with a mension and an ordonnance was given by the sultan for the publication of his book, and in the chemical laboratory of the medical school all of the examinations are done without payment. In 1867 when it was an epidemic of cholera in Istanbul, Mr. Georges Ralli was charged in the Hospital of Humbarahane. The directory of the Medical School ordered cupboards for the School. When the typhoid fever epidemic appeared in 1865 in Istanbul a physician was attended in the Medical School. An order was given by the sultan for the pick up of the medical opium in the mounth Uludağ for the pharmacy of the medical school and for the exercise of the lessons of obstetrics in the Medical School, a lady was invited from Austria. Many professors in the Medical School received different compensations.

  14. [Readability and internet accessibility of informative documents for spinal cord injury patients in Spanish].

    PubMed

    Bea-Muñoz, M; Medina-Sánchez, M; Flórez-García, M T

    2015-01-01

    Patients with spinal cord injuries and their carers have access to leaflets on Internet that they can use as educational material to complement traditional forms of education. The aim of this study is to evaluate the readability of informative documents in Spanish, obtained from Internet and aimed at patients with spinal cord injuries. A search was made with the Google search engine using the following key words: recommendation, advice, guide, manual, self-care, education and information, adding spinal cord injury, paraplegia and tetraplegia to each of the terms. We analyzed the first 50 results of each search. The readability of the leaflets was studied with the Flesch-Szigriszt index and the INFLESZ scale, both available on the INFLESZ program. Also indicated were year of publication, country and number of authors of the documents obtained. We obtained 16 documents, developed between 2001 and 2011. Readability oscillated between 43.34 (some-what difficult) and 62 (normal), with an average value of 51.56 (somewhat difficult). Only 4 pamphlets (25%) showed a Flesch-Szigriszt index of ≥ 55 (normal). There was no difference in readability by year, authors or country of publication. The readability of 75% of the documents studied was "somewhat difficult" according to the INFLESZ scale. These results coincide with previous studies, in both Spanish and English. If the readability of this type of documents is improved, it will be easier to achieve their educational goal.

  15. Evaluation of Internet-based oncologic teaching for medical students.

    PubMed

    Mehta, M P; Sinha, P; Kanwar, K; Inman, A; Albanese, M; Fahl, W

    1998-01-01

    Electronic tools with substantial educational applications are now widely available. In a prospective, randomized study, the value of Web-based educational tools for teaching second-year medical students was evaluated. The 35-hour, image-intensive multifaculty neoplasia course was selected for the experiment, with 103 students assigned to the control group (C) and 61 to the experimental group (E). Representative password-controlled multimedia course modules, accessible via the Internet, were developed. The E cohort was exposed to both classroom and Web-aided materials, whereas the C group had access to the Web modules only after the experiment was concluded (but before the final examination). Pre- and post-exposure questionnaires assessed computer knowledge, familiarity with the Internet, availability of computer access, and the value of Web-based education for both cohorts. Additionally, pre-and post-exposure tests were administered to both cohorts based on educational materials presented in the Web modules. The overall participation rate was 64% (E = 69%; C = 60%). The post-test showed no major performance difference between the two groups. The questionnaires revealed that: less than 1% of the students had not accessed the Internet previously; less than 5% had not used the Internet for medical education before; 34% felt that computer resources on campus were inadequate; and over 75% found Web-based education to be an important additional educational resource. The major negative aspect was the slow pace of data transfer for modem-based home access. Only 1% of students felt that Web-based education could completely replace traditional teaching. The potential for incorporating Web-based education in the medical curriculum is considerable.

  16. Computer program and user documentation medical data tape retrieval system

    NASA Technical Reports Server (NTRS)

    Anderson, J.

    1971-01-01

    This volume provides several levels of documentation for the program module of the NASA medical directorate mini-computer storage and retrieval system. A biomedical information system overview describes some of the reasons for the development of the mini-computer storage and retrieval system. It briefly outlines all of the program modules which constitute the system.

  17. [Medical museology the exhibition: The history of Rome medical faculty through images and documents].

    PubMed

    Serarcangeli, Carla

    2004-01-01

    The Museum and Library of History of Medicine celebrated the 700th anniversary of the foundation of the University of Rome "La Sapienza" with an exhibition of images and documents recalling the history of the medical faculty. Dissecting tools and surgical instruments testify to the long history of anatomical and surgical studies and to the great worth of the teachers at Rome University. Documents, archival papers, books and pictures document the historical inheritance of the Medical School in Rome.

  18. Medical Student Documentation in the Electronic Medical Record: Patterns of Use and Barriers.

    PubMed

    Wittels, Kathleen; Wallenstein, Joshua; Patwari, Rahul; Patel, Sundip

    2017-01-01

    Electronic health records (EHR) have become ubiquitous in emergency departments. Medical students rotating on emergency medicine (EM) clerkships at these sites have constant exposure to EHRs as they learn essential skills. The Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Alliance for Clinical Education (ACE) have determined that documentation of the patient encounter in the medical record is an essential skill that all medical students must learn. However, little is known about the current practices or perceived barriers to student documentation in EHRs on EM clerkships. We performed a cross-sectional study of EM clerkship directors at United States medical schools between March and May 2016. A 13-question IRB-approved electronic survey on student documentation was sent to all EM clerkship directors. Only one response from each institution was permitted. We received survey responses from 100 institutions, yielding a response rate of 86%. Currently, 63% of EM clerkships allow medical students to document a patient encounter in the EHR. The most common reasons cited for not permitting students to document a patient encounter were hospital or medical school rule forbidding student documentation (80%), concern for medical liability (60%), and inability of student notes to support medical billing (53%). Almost 95% of respondents provided feedback on student documentation with supervising faculty being the most common group to deliver feedback (92%), followed by residents (64%). Close to two-thirds of medical students are allowed to document in the EHR on EM clerkships. While this number is robust, many organizations such as the AAMC and ACE have issued statements and guidelines that would look to increase this number even further to ensure that students are prepared for residency as well as their future careers. Almost all EM clerkships provided feedback on student documentation indicating the importance for

  19. Medical Student Documentation in the Electronic Medical Record: Patterns of Use and Barriers

    PubMed Central

    Wittels, Kathleen; Wallenstein, Joshua; Patwari, Rahul; Patel, Sundip

    2017-01-01

    Introduction Electronic health records (EHR) have become ubiquitous in emergency departments. Medical students rotating on emergency medicine (EM) clerkships at these sites have constant exposure to EHRs as they learn essential skills. The Association of American Medical Colleges (AAMC), the Liaison Committee on Medical Education (LCME), and the Alliance for Clinical Education (ACE) have determined that documentation of the patient encounter in the medical record is an essential skill that all medical students must learn. However, little is known about the current practices or perceived barriers to student documentation in EHRs on EM clerkships. Methods We performed a cross-sectional study of EM clerkship directors at United States medical schools between March and May 2016. A 13-question IRB-approved electronic survey on student documentation was sent to all EM clerkship directors. Only one response from each institution was permitted. Results We received survey responses from 100 institutions, yielding a response rate of 86%. Currently, 63% of EM clerkships allow medical students to document a patient encounter in the EHR. The most common reasons cited for not permitting students to document a patient encounter were hospital or medical school rule forbidding student documentation (80%), concern for medical liability (60%), and inability of student notes to support medical billing (53%). Almost 95% of respondents provided feedback on student documentation with supervising faculty being the most common group to deliver feedback (92%), followed by residents (64%). Conclusion Close to two-thirds of medical students are allowed to document in the EHR on EM clerkships. While this number is robust, many organizations such as the AAMC and ACE have issued statements and guidelines that would look to increase this number even further to ensure that students are prepared for residency as well as their future careers. Almost all EM clerkships provided feedback on student

  20. Using formal methods for content validation of medical procedure documents.

    PubMed

    Cota, Érika; Ribeiro, Leila; Bezerra, Jonas Santos; Costa, Andrei; da Silva, Rosiana Estefane; Cota, Gláucia

    2017-08-01

    We propose the use of a formal approach to support content validation of a standard operating procedure (SOP) for a therapeutic intervention. Such an approach provides a useful tool to identify ambiguities, omissions and inconsistencies, and improves the applicability and efficacy of documents in the health settings. We apply and evaluate a methodology originally proposed for the verification of software specification documents to a specific SOP. The verification methodology uses the graph formalism to model the document. Semi-automatic analysis identifies possible problems in the model and in the original document. The verification is an iterative process that identifies possible faults in the original text that should be revised by its authors and/or specialists. The proposed method was able to identify 23 possible issues in the original document (ambiguities, omissions, redundant information, and inaccuracies, among others). The formal verification process aided the specialists to consider a wider range of usage scenarios and to identify which instructions form the kernel of the proposed SOP and which ones represent additional or required knowledge that are mandatory for the correct application of the medical document. By using the proposed verification process, a simpler and yet more complete SOP could be produced. As consequence, during the validation process the experts received a more mature document and could focus on the technical aspects of the procedure itself. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. A study of prehospital medical documentation by military medical providers during precombat training.

    PubMed

    McGarry, Adam B; Mott, Jeffrey C; Kotwal, Russ S

    2015-01-01

    Documentation of medical care provided is paramount for improving performance and ultimately reducing morbidity and mortality. However, documentation of prehospital trauma care on the battlefield has historically been suboptimal. Modernization of prehospital documentation tools have aligned data and information to be gathered with up-to-date treatment being rendered through Tactical Combat Casualty Care (TCCC) protocols and practices. Our study was conducted to evaluate TCCC Card completion, and accuracy of card completion, by military medical providers conducting precombat training through the Tactical Combat Medical Care Course. Study results do not show a deficiency in TCCC documentation training as provided by this course which should translate to adequate ability to accurately document prehospital trauma care on the battlefield. Leadership emphasis and community acceptance is required to increase compliance with prehospital documentation.

  2. 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.

  3. [Reliable cryptology as a means for confidentiality and safety in medical communication and documentation].

    PubMed

    Stehle, W

    1998-01-01

    The application of strong cryptography secures the integrity of medical data and their confidentiality during transmission. Encryption allows to use the Internet for the transmission of confidential medical data rendering an expensive specialised Internet like the DGN superfluous. By signing and timestamping medical records electronically their probative force is substantially improved in case of a law-suit.

  4. Documentation of Nursing Practice Using a Computerized Medical Information System

    PubMed Central

    Romano, Carol

    1981-01-01

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

  5. Translating medical documents into plain language enhances communication skills in medical students--A pilot study.

    PubMed

    Bittner, Anja; Jonietz, Ansgar; Bittner, Johannes; Beickert, Luise; Harendza, Sigrid

    2015-09-01

    To train and assess undergraduate medical students' written communication skills by exercises in translating medical reports into plain language for real patients. 27 medical students participated in a newly developed communication course. They attended a 3-h seminar including a briefing on patient-centered communication and an introduction to working with the internet platform http://washabich.de. In the following ten weeks, participants "translated" one medical report every fortnight on this platform receiving feedback by a near-peer supervisor. A pre- and post-course assignment consisted of a self-assessment questionnaire on communication skills, analysis of a medical text with respect to medical jargon, and the translation of a medical report into plain language. In the self-assessment, students rated themselves in most aspects of patient-centered communication significantly higher after attending the course. After the course they marked significantly more medical jargon terms correctly than before (p<0.001). In a written plain language translation of a medical report they scored significantly higher with respect to communicative aspects (p<0.05) and medical correctness (p<0.001). Translating medical reports into plain language under near-peer supervision is associated with improved communication skills and medical knowledge in undergraduate medical students. To include translation exercises in the undergraduate medical curriculum. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Medical Device Integration Model Based on the Internet of Things.

    PubMed

    Hao, Aiyu; Wang, Ling

    2015-01-01

    At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

  7. Medical Device Integration Model Based on the Internet of Things

    PubMed Central

    Hao, Aiyu; Wang, Ling

    2015-01-01

    At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching

  8. MEDTAG: tag-like semantics for medical document indexing.

    PubMed

    Ruch, P; Wagner, J; Bouillon, P; Baud, R H; Rassinoux, A M; Scherrer, J R

    1999-01-01

    Medical documentation is central in health care, as it constitutes the main means of communication between care providers. However, there is a gap to bridge between storing information and extracting the relevant underlying knowledge. We believe natural language processing (NLP) is the best solution to handle such a large amount of textual information. In this paper we describe the construction of a semantic tagset for medical document indexing purposes. Rather than attempting to produce a home-made tagset, we decided to use, as far as possible, standard medicine resources. This step has led us to choose UMLS hierarchical classes as a basis for our tagset. We also show that semantic tagging is not only providing bases for disambiguisation between senses, but is also useful in the query expansion process of the retrieval system. We finally focus on assessing the results of the semantic tagger.

  9. Medical Photography: Documentation, Art, and the Expression of Human Emotions.

    PubMed

    Aberer, Elisabeth; Stieber, Werner; Homayoon, Donja; Fink-Puches, Regina; Lichen, Roland; Salmhofer, Wolfgang; Gruber-Wackernagel, Alexandra; Aberer, Werner

    2016-01-01

    Medical photography is the state of the art for the documentation of dermatological disease. Experienced photographers take pictures of the most typical skin lesions in order to assist the clinician in assessing disease morphology and activity. In this study, we present 6 individuals with a variety of dermatoses and the expression of the patients' emotions. The patients were asked to show their diseased skin and to present typically involved areas in the respective disease. The feelings expressed by their body movements and positions are viewed and interpreted. The patients' history will be reported retrospectively. The aim of the report is to show that the art of medical photography does not only document skin lesions but also the disease burden and the associated impairment of quality of life. Moreover, dermatologic photography is a sensitive intervention for patients viewed in the light of teaching and patient care.

  10. Medical Photography: Documentation, Art, and the Expression of Human Emotions

    PubMed Central

    Aberer, Elisabeth; Stieber, Werner; Homayoon, Donja; Fink-Puches, Regina; Lichen, Roland; Salmhofer, Wolfgang; Gruber-Wackernagel, Alexandra; Aberer, Werner

    2016-01-01

    Medical photography is the state of the art for the documentation of dermatological disease. Experienced photographers take pictures of the most typical skin lesions in order to assist the clinician in assessing disease morphology and activity. In this study, we present 6 individuals with a variety of dermatoses and the expression of the patients’ emotions. The patients were asked to show their diseased skin and to present typically involved areas in the respective disease. The feelings expressed by their body movements and positions are viewed and interpreted. The patients’ history will be reported retrospectively. The aim of the report is to show that the art of medical photography does not only document skin lesions but also the disease burden and the associated impairment of quality of life. Moreover, dermatologic photography is a sensitive intervention for patients viewed in the light of teaching and patient care. PMID:27790112

  11. A grammar of integrity constraints in medical documentation systems.

    PubMed

    Goertzen, Ralf; Stausberg, Jürgen

    2007-04-01

    An essential aspect for the utilization of medical data is their quality, thus a main feature of computer-based medical documentation systems should be to assist the user in complete and plausible data acquisition and maintenance. In this paper we define a grammar for modeling medical documentation systems to increase integrity and completeness of collected data, focusing attention on integrity constraints. An integrity constraint defines requirements that involved entities had to comply with. Furthermore it defines possibly implications in case of failure. The constraints presented in this paper are type constraint, length constraint, domain constraint, key constraint, quantity constraint, reference constraint, search constraint, result constraint, hierarchy constraint, and semantic constraint. Their grammar is declared using a schema in extensible markup language-format (XML-schema). The model introduced here can be used in computer-aided design and implementation of clinical documentation both minimizing effort and ensuring data quality, which was tested by an evaluation based on a specification of a registry for HIV-infected patients.

  12. Indexing of Internet resources in order to improve the provision of problem-relevant medical information.

    PubMed

    Hoelzer, Simon; Schweiger, Ralf Kurt; Boettcher, Hanno; Rieger, Joerg; Dudeck, Joachim

    2002-01-01

    Due to the information overload and the unstructured access to (medical) information of the internet, it isn't hardly possible to find problem-relevant medical information in an appropriate time (e.g. during a consultation). The web offers a mixture of web pages, forums, newsgroups and databases. The search for problem-relevant information for a certain knowledge area encounters on two basic problems. On the one hand, you have to find in the jungle of the information, relevant resources for your individual clinical case (treatment, diagnosis, therapeutic option etc..). The second problem consists of being able to judge the quality of individual contents of inteernet pages. On the basis of the different informational needs of health care professionals and patients a catalog with inteernet resources was created to tumor diseases such as lung cancer (small cell and non-small cell carcinoma), colorectal cancer and thyroid cancer. Explicit and implicit metainformation, if available, such as the title of the document, language, date or keywords are stored in the database. The database entries are editorially revised, so that further specific metainformation is available for the information retrieval. Our pragmatic approach of searching, editing, and archiving of internet content is still necessary since most of the web documents are based on HTML, which doesn't allow for structuring (medical) information and assigning metainformation sufficiently. The use of specific metainformation is crucial in order to improve the recall and precision of internet searches. In the future, XML and related technologies (RDF) will meet these requirements.

  13. Medication communication through documentation in medical wards: knowledge and power relations.

    PubMed

    Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

    2014-09-01

    Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals.

  14. Search systems and medical data quoting from the internet.

    PubMed

    Cvitanović, Hrvoje; Situm, Mirna

    2002-09-01

    The Internet as a new medium also has its use in medicine. Plenty of information which can be found on the world computer network, needs an efficient searching as well as an evaluation system and quoting of the information obtained. Twelve most popular search engines were chosen--9 general: Netscape, Altavista, HotBot, Goggle, Northern Light, Magellan, Infoseek, MSN; 2 specialized medical search engines: Medscape and Medline; and one Croatian search engine: Cross. The efficiency of searching was observed by analyzing the number of obtained pages, their contents and examples of the quoted references from the Internet. The searching was done using the mentioned search engines, and results varied from 2,189,793 network pages found on the Infoseek for the term 'skin cancer' to 0 pages with the search engine Cross for the term 'melanoma+therapy'. When comparing the results for a single term using various search engines, it is concluded that the number of pages varied because of different databases and specialized scooters that search and make indexes. It is possible to use logical operators and more advanced search systems with the majority of search engines. The quoting system is based on mentioning the names of the author and his work, the access date and url (uniform resource locator) addresses of the network pages. Permanent and reliable access to quotations could not be established with previous quotation systems. Dermatologic terms have been well dealt with concerning general population, whereas professionals are recommended to use Medline and reviewed web pages. There have been very few professional and professionally relevant and comprehensive pages on the Internet relative to the total of web pages.

  15. A Hybrid Approach to Extract Keyphrases from Medical Documents

    NASA Astrophysics Data System (ADS)

    Sarkar, Kamal

    2013-02-01

    Keyphrases are the phrases, consisting of one or more words, representing the important concepts in the articles. Keyphrases are useful for a variety of tasks such as text summarization, automatic indexing, clustering/classification, text mining etc. This paper presents a hybrid approach to keyphrase extraction from medical documents. The keyphrase extraction approach presented in this paper is an amalgamation of two methods: the first one assigns weights to candidate keyphrases based on an effective combination of features such as position, term frequency, inverse document frequency and the second one assign weights to candidate keyphrases using some knowledge about their similarities to the structure and characteristics of keyphrases available in the memory (stored list of keyphrases). An efficient candidate keyphrase identification method as the first component of the proposed keyphrase extraction system has also been introduced in this paper. The experimental results show that the proposed hybrid approach performs better than some state-of-the art keyphrase extraction approaches.

  16. Comparison of internet addiction, pattern and psychopathology between medical and dental students.

    PubMed

    Gedam, Sachin Ratan; Shivji, Imran Ali; Goyal, Arvind; Modi, Lipsy; Ghosh, Santanu

    2016-08-01

    There has been an enormous use of internet among health professionals in the last decade. It has made significant changes in the health care system. Besides its several benefits, the excessive undisciplined use has led to the emergence of concept of internet addiction. The objectives of our study were to estimate prevalence of internet addiction among medical and dental students; to determine association of internet use pattern and psychopathology between medical and dental internet addicted (IA) students. A cross-sectional study was conducted among 597 students from medical and dental colleges. They completed semi-structured data, internet addiction test and mental health inventory questionnaires as per instructions provided. Students were divided into medical internet addicts and dental internet addicts for comparison. The prevalence of severe internet addiction was more among dental students (2.3%) than that among medical students (1.2%). There was significant difference between the students of medical and dental faculties, who fall under the category of addiction on the basis of-gender, computer ownership and purpose of internet use (P<0.05). The psychiatric symptoms such as depression and emotional ties also had statistically significant difference (P<0.05). Significant differences were seen in some of the parameters of internet use pattern and psychopathology among the two groups of internet addict from health professionals. So, further studies need to be conducted among different groups of internet addicts to evaluate different parameters. Specific measures should be taken to prevent internet addiction and its complications. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Computer Program and User Documentation Medical Data Input System

    NASA Technical Reports Server (NTRS)

    Anderson, J.

    1971-01-01

    Several levels of documentation are presented for the program module of the NASA medical directorate minicomputer storage and retrieval system. The biomedical information system overview gives reasons for the development of the minicomputer storage and retrieval system. It briefly describes all of the program modules which constitute the system. A technical discussion oriented to the programmer is given. Each subroutine is described in enough detail to permit in-depth understanding of the routines and to facilitate program modifications. The program utilization section may be used as a users guide.

  18. An Internet-based ontology editor for medical appropriateness criteria.

    PubMed

    Kahn, C E

    1998-04-01

    Appropriateness criteria and practice guidelines seek to promote the cost-effectiveness use of medical interventions, and can be most useful when integrated with computer-based patient records and order-entry systems. Building an abstract model (ontology) of appropriateness criteria can require considerable effort among investigators at geographically dispersed institutions. To facilitate the construction and maintenance of ontologies for clinical appropriateness criteria, the author developed an Internet-based system for viewing and editing the knowledge model. The system, called NEON (Network-based Editor for ONtologies), uses the World Wide Web as a platform-independent user interface. NEON allows users to edit the indexing terms and the semantic network that form the ontology for a set of appropriateness criteria. Ontologies built using the system can be imported and exported using an open, internationally standardized format based on the Standard Generalized Markup Language (SGML).

  19. [Internet-based continuing medical education: as effective as live continuing medical education].

    PubMed

    Maisonneuve, Hervé; Chabot, Olivier

    2009-10-01

    E-learning consists in using new multimedia and Internet technologies to improve the quality of learning activities by facilitating access to resources and services, as well as exchanges and remote collaboration. The Internet is used for adult education in most professional domains, but its use for continuing medical education is less developed. Advantages are observed for teachers (e.g., permanent updating, interactive links, illustrations, archiving, and collective intelligence) and for the learners (e.g., accessibility, autonomy, flexibility, and adaptable pace). Research and meta-analyses have shown that e-CME is as effective as live events for immediate and retained learning. English-language educational medical websites that grant CME credits are numerous; few such French-language sites can currently grant credits. Accreditation of websites for CME, in its infancy in Europe, is common in North America.

  20. Internet use and addiction among medical students of Universiti Sultan Zainal Abidin, Malaysia

    PubMed Central

    Haque, Mainul; Rahman, Nor Azlina A; Majumder, Md Anwarul Azim; Haque, Seraj Zohurul; Kamal, Zubair M; Islam, Zakirul; Haque, ATM Emdadul; Rahman, Nor Iza A; Alattraqchi, Ahmed Ghazi

    2016-01-01

    Background The use of Internet has now become indispensable, and the technology has revolutionized the medical education and practice worldwide. Currently, medical students and professionals have an enormous opportunity to keep them always updated with the exponential growth of knowledge because of potential progression of Internet throughout the world that enables them to become a lifelong learner. Internet addiction is a widespread phenomenon among students and academicians at universities in Malaysia. Students use the Internet for recreational purpose and personal and professional development. The Internet has become an integral part of day-to-day life of the university students, including medical students. The aim of the present study was to examine the Internet use and addiction among students of Universiti Sultan Zainal Abidin, Malaysia. Methods This was a cross-sectional study in which a questionnaire, Internet Addiction Diagnostic Questionnaire, developed by the Center for Internet Addiction, USA, was used. One hundred forty-nine medical students of Universiti Sultan Zainal Abidin participated in this study. Data were analyzed using Statistical Package for the Social Sciences software. Results The mean scores were 44.9±14.05 and 41.4±13.05 for male and female participants, respectively, which indicated that both the genders were suffering from mild Internet addiction. Conclusion This study shows almost similar level of Internet usage among medical students irrespective of their socioeconomic background, with no statistically significant (p>0.05) differences, except among the years of study (p=0.007). Overall, from the research data and having worked with this cohort very closely, Universiti Sultan Zainal Abidin medical students can be labeled as wonted and recurring users of the Internet. Nevertheless, it is very difficult to define as Internet addicts or pathological users of the Internet because of small sample size and cross-sectional study. PMID

  1. Internet use and addiction among medical students of Universiti Sultan Zainal Abidin, Malaysia.

    PubMed

    Haque, Mainul; Rahman, Nor Azlina A; Majumder, Md Anwarul Azim; Haque, Seraj Zohurul; Kamal, Zubair M; Islam, Zakirul; Haque, Atm Emdadul; Rahman, Nor Iza A; Alattraqchi, Ahmed Ghazi

    2016-01-01

    The use of Internet has now become indispensable, and the technology has revolutionized the medical education and practice worldwide. Currently, medical students and professionals have an enormous opportunity to keep them always updated with the exponential growth of knowledge because of potential progression of Internet throughout the world that enables them to become a lifelong learner. Internet addiction is a widespread phenomenon among students and academicians at universities in Malaysia. Students use the Internet for recreational purpose and personal and professional development. The Internet has become an integral part of day-to-day life of the university students, including medical students. The aim of the present study was to examine the Internet use and addiction among students of Universiti Sultan Zainal Abidin, Malaysia. This was a cross-sectional study in which a questionnaire, Internet Addiction Diagnostic Questionnaire, developed by the Center for Internet Addiction, USA, was used. One hundred forty-nine medical students of Universiti Sultan Zainal Abidin participated in this study. Data were analyzed using Statistical Package for the Social Sciences software. The mean scores were 44.9±14.05 and 41.4±13.05 for male and female participants, respectively, which indicated that both the genders were suffering from mild Internet addiction. This study shows almost similar level of Internet usage among medical students irrespective of their socioeconomic background, with no statistically significant (p>0.05) differences, except among the years of study (p=0.007). Overall, from the research data and having worked with this cohort very closely, Universiti Sultan Zainal Abidin medical students can be labeled as wonted and recurring users of the Internet. Nevertheless, it is very difficult to define as Internet addicts or pathological users of the Internet because of small sample size and cross-sectional study.

  2. Evaluation of internet access and utilization by medical students in Lahore, Pakistan

    PubMed Central

    2011-01-01

    Background The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan. Methods A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution. Results A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from

  3. Medical Internet of Things and Big Data in Healthcare.

    PubMed

    Dimitrov, Dimiter V

    2016-07-01

    A number of technologies can reduce overall costs for the prevention or management of chronic illnesses. These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real-time health data when a patient self-administers a therapy. Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs. These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT). This paper reviews mIoT and big data in healthcare fields. mIoT is a critical piece of the digital transformation of healthcare, as it allows new business models to emerge and enables changes in work processes, productivity improvements, cost containment and enhanced customer experiences. Wearables and mobile apps today support fitness, health education, symptom tracking, and collaborative disease management and care coordination. All those platform analytics can raise the relevancy of data interpretations, reducing the amount of time that end users spend piecing together data outputs. Insights gained from big data analysis will drive the digital disruption of the healthcare world, business processes and real-time decision-making. A new category of "personalised preventative health coaches" (Digital Health Advisors) will emerge. These workers will possess the skills and the ability to interpret and understand health and well-being data. They will help their clients avoid chronic and diet-related illness, improve cognitive function, achieve improved mental health and achieve improved lifestyles overall. As the global population ages, such roles will become increasingly important.

  4. Medical Internet of Things and Big Data in Healthcare

    PubMed Central

    2016-01-01

    Objectives A number of technologies can reduce overall costs for the prevention or management of chronic illnesses. These include devices that constantly monitor health indicators, devices that auto-administer therapies, or devices that track real-time health data when a patient self-administers a therapy. Because they have increased access to high-speed Internet and smartphones, many patients have started to use mobile applications (apps) to manage various health needs. These devices and mobile apps are now increasingly used and integrated with telemedicine and telehealth via the medical Internet of Things (mIoT). This paper reviews mIoT and big data in healthcare fields. Methods mIoT is a critical piece of the digital transformation of healthcare, as it allows new business models to emerge and enables changes in work processes, productivity improvements, cost containment and enhanced customer experiences. Results Wearables and mobile apps today support fitness, health education, symptom tracking, and collaborative disease management and care coordination. All those platform analytics can raise the relevancy of data interpretations, reducing the amount of time that end users spend piecing together data outputs. Insights gained from big data analysis will drive the digital disruption of the healthcare world, business processes and real-time decision-making. Conclusions A new category of "personalised preventative health coaches" (Digital Health Advisors) will emerge. These workers will possess the skills and the ability to interpret and understand health and well-being data. They will help their clients avoid chronic and diet-related illness, improve cognitive function, achieve improved mental health and achieve improved lifestyles overall. As the global population ages, such roles will become increasingly important. PMID:27525156

  5. Medically Documented Suicide Ideation Among U.S. Army Soldiers.

    PubMed

    Ursano, Robert J; Kessler, Ronald C; Stein, Murray B; Naifeh, James A; Nock, Matthew K; Aliaga, Pablo A; Fullerton, Carol S; Wynn, Gary H; Ng, Tsz Hin Hinz; Dinh, Hieu M; Sampson, Nancy A; Kao, Tzu-Cheg; Schoenbaum, Michael; McCarroll, James E; Cox, Kenneth L; Heeringa, Steven G

    2016-11-29

    We used administrative data to examine predictors of medically documented suicide ideation (SI) among Regular Army soldiers from 2006 through 2009 (N = 10,466 ideators, 124,959 control person-months). Enlisted ideators (97.8% of all cases) were more likely than controls to be female, younger, older when entering service, less educated, never or previously deployed, and have a recent mental health diagnosis. Officer ideators were more likely than controls to be female, younger, younger when entering service, never married, and have a recent mental health diagnosis. Risk among enlisted soldiers peaked in the second month of service and declined steadily, whereas risk among officers remained relatively stable over time. Risk of SI is highest among enlisted soldiers early in Army service, females, and those with a recent mental health diagnosis.

  6. Internet addiction and modeling its risk factors in medical students, iran.

    PubMed

    Ghamari, Farhad; Mohammadbeigi, Abolfazl; Mohammadsalehi, Narges; Hashiani, Amir Almasi

    2011-07-01

    Today's internet is a usual and common method for identifying and fulfilling unknown practices. Internet network has been prepared rapid and comfortable access to information. Internet addiction is a new and attractive subject that has been regarded as behavior-based addiction recently. To estimate the prevalence of internet addiction and some of the related factors among medical students, Iran. An analytical cross-sectional study was conducted on 426 students selected through two-stage sampling method. Yang standard internet addiction questionnaire was used for data collection. After data entry, χ(2), t-test, and Pearson coefficient statistical tests were applied. 0.05 was considered as the significance level. The overall prevalence of internet addiction was 10.8%, with moderate and severe internet addiction equal to 8% and 2.8%, respectively. Mean and standard deviation of Yang internet addiction score was calculated as 32.74±14.52. Internet addiction was associated with sex, marital status, father's job, rate of knowledge about computer and internet, and educational level (P<0.05). But it was not associated with the parents' education, residential area, field of study and level, and school of education (P>0.05). Because internet addiction leads to wasting of the students' leisure time and also useful time, it affects the educational situation inversely. Some measures should be taken to plan and improve the use of internet.

  7. Prevalence of internet addiction and associated factors among medical students from mashhad, iran in 2013.

    PubMed

    Salehi, Maryam; Norozi Khalili, Mina; Hojjat, Seyed Kaveh; Salehi, Mahta; Danesh, Ali

    2014-05-01

    Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students. This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences. A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior. It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption. Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group.

  8. Prevalence of Internet Addiction and Associated Factors Among Medical Students From Mashhad, Iran in 2013

    PubMed Central

    Salehi, Maryam; Norozi Khalili, Mina; Hojjat, Seyed Kaveh; Salehi, Mahta; Danesh, Ali

    2014-01-01

    Background: Problematic internet use is on the increase and has caused serious problems in many areas. This issue seems to be more important for medical students. Objectives: This study was designed to explore the prevalence of internet addiction and its related factors among the students of Mashhad University of Medical Sciences. Materials and Methods: A cross sectional study was conducted on 383 medical students of Mashhad in 2013. Four hundred participants were selected through two-stage stratified sampling method proportional to the number of students in each stage of education. Data Collection was done through using the Chen Internet Addiction Scale (CIAS) and a checklist of demographic details and characteristics of internet usage behavior. Results: It was found that 2.1% of the studied population were at risk and 5.2% were addicted users. Chatting with new people, communicating with friends and families, and playing games were the most popular activities in these groups. The factors related to internet addiction included: male sex, stage of education, daily time spent on using internet, most frequent time of internet use, monthly cost of use, and tea consumption. Conclusions: Although our study showed the prevalence of internet addiction was not more than other populations and universities, since the prevalence of internet addiction is rapidly increasing worldwide, this population might also be at risk of addiction. Thus, focusing on related factors can help us in designing more effective interventions and treatments for this susceptible group. PMID:25031856

  9. Psychotropics without borders: ethics and legal implications of internet-based access to psychiatric medications.

    PubMed

    Klein, Carolina A

    2011-01-01

    Medical practitioners are revisiting many of the ethics and the legal implications surrounding the clinical frameworks within which we operate. In today's world, distinguishing between virtual and physical reality continues to be increasingly difficult. The physician may be found grappling with the decision of whether to continue to treat a patient who may be obtaining psychotropic medications through the Internet. This article approaches some of the clinical and legal implications and the ethics regarding the availability of prescription psychotropics over the Internet.

  10. Analysis of internet use behaviors among clinical medical students in China.

    PubMed

    Yang, Hua; Chen, Yunxiang; Zheng, Liqiang; Xu, Xin; Cao, Xia

    2014-04-02

    The availability of internet-based information resources is increasing and the appropriate use of such resources is an important subject for clinical medical students. The aims of this study were to investigate the behaviors of clinical medical students regarding the use of internet-based activities, to analyze the behavior and characteristics of the students' information demands, and to discuss the behaviors and time preferences related to internet use of students with different levels of education. Librarians obtained real-time feedback from 999 clinical medical students to record online activities. The data was recorded in a standard form and then analyzed statistically. There were significant differences in the use of the internet for learning activities among the different groups of clinical medical students (P < 0.0001). Learning accounted for 73.5% of all internet use for doctoral candidates, 47.6% of internet use for master's candidates, 28.7% of internet use for seven-year undergraduate students, and 14.1% of use for five-year undergraduate students. There was also a significant difference in the proportions of leisure and e-commerce activities among the student groups (P < 0.0001), with five-year students displaying the highest total proportion of these activities (59.4% and 18.8%). Internet use for entertainment activities was the same for all groups of clinical medical students. Time of day of internet use was consistent across all student groups, but internet use differed by day of the week (P < 0.01). There was no difference among the time of day of internet use for learning, leisure and entertainment activities during a single day (P > 0.05), but e-commerce activities varied according to time of day (P < 0.05). Learning and e-commerce activities by clinical medical students did not vary by day of the week (P > 0.05), but the distributions of leisure and entertainment activities were different according to day of the week (P < 0.05). A stronger demand

  11. Analysis of internet use behaviors among clinical medical students in China

    PubMed Central

    2014-01-01

    Background The availability of internet-based information resources is increasing and the appropriate use of such resources is an important subject for clinical medical students. The aims of this study were to investigate the behaviors of clinical medical students regarding the use of internet-based activities, to analyze the behavior and characteristics of the students’ information demands, and to discuss the behaviors and time preferences related to internet use of students with different levels of education. Methods Librarians obtained real-time feedback from 999 clinical medical students to record online activities. The data was recorded in a standard form and then analyzed statistically. Results There were significant differences in the use of the internet for learning activities among the different groups of clinical medical students (P < 0.0001). Learning accounted for 73.5% of all internet use for doctoral candidates, 47.6% of internet use for master’s candidates, 28.7% of internet use for seven-year undergraduate students, and 14.1% of use for five-year undergraduate students. There was also a significant difference in the proportions of leisure and e-commerce activities among the student groups (P < 0.0001), with five-year students displaying the highest total proportion of these activities (59.4% and 18.8%). Internet use for entertainment activities was the same for all groups of clinical medical students. Time of day of internet use was consistent across all student groups, but internet use differed by day of the week (P < 0.01). There was no difference among the time of day of internet use for learning, leisure and entertainment activities during a single day (P > 0.05), but e-commerce activities varied according to time of day (P < 0.05). Learning and e-commerce activities by clinical medical students did not vary by day of the week (P > 0.05), but the distributions of leisure and entertainment activities were different

  12. Internet integrated in the daily medical practice within an electronic patient record.

    PubMed

    Lovis, C; Baud, R H; Scherrer, J R

    1998-09-01

    Healthcare enters the information age and professionals are finding an ever-growing role for computers in the daily practice of medicine. However, a number of problematic issues are associated with electronic publications, especially through Internet. Whilst access to any information has been improved, access to specific information has become more and more difficult [1], due to the lack of a general meta-knowledge allowing to structure Internet resources. Physicians have to learn and adapt themselves to computers and Internet, but Internet has to meet the specific requirements of Healthcare. Important issues must therefore be addressed to allow a real and daily use of Internet in the medical practice. The paper discusses most of these issues and proposes a solution developed at the University Hospital of Geneva that integrates an Electronic Patient Record with Internet, without compromises on security or on performances and that runs on standard PCs'.

  13. Exploring the association of ego defense mechanisms with problematic internet use in a Pakistani medical school.

    PubMed

    Waqas, Ahmed; Rehman, Abdul; Malik, Aamenah; Aftab, Ramsha; Allah Yar, Aroosa; Allah Yar, Arooj; Rai, Aitzaz Bin Sultan

    2016-09-30

    The present study was designed to analyze association between problematic internet use and use of ego defense mechanisms in medical students. This cross-sectional study was undertaken at CMH Lahore Medical College (CMH LMC) in Lahore, Pakistan from 1st March, 2015 to 30th May, 2015. 522 medical and dental students were included in the study. The questionnaire consisted of three sections: a) demographic characteristics of respondent b) the Defense Style Questionnaire-40 (DSQ-40) and c) the Internet Addiction Test (IAT). All data were analyzed in SPSS v20. Chi square, Independent sample t test and One Way ANOVA were run to analyze association of different variables with scores on IAT. Multiple regression analysis was used to delineate ego defenses as predictors of problematic internet use. A total of 32 (6.1%) students reported severe problems with internet usage. Males had higher scores on IAT i.e had more problematic use of internet. Scores on internet addiction test (IAT) were negatively associated with sublimation and positively associated with projection, denial, autistic fantasy, passive aggression and displacement. There was a high prevalence of problematic use of internet among medical and dental students. It had significant associations with several defense mechanisms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Subdividing the digital divide: differences in internet access and use among rural residents with medical limitations.

    PubMed

    Wang, Jong-Yi; Bennett, Kevin; Probst, Janice

    2011-03-03

    Access to health care is often contingent upon an individual's ability to travel for services. Certain groups, such as those with physical limitations and rural residents, have more travel barriers than other groups, reducing their access to services. The use of the Internet may be a way for these groups to seek care or information to support their health care needs. The purpose of this study was to examine Internet use among those whose are, for medical reasons, limited in their ability to travel. We also examined disparities in Internet use by race/ethnicity and rural residence, particularly among persons with medical conditions. We used data from the 2001 National Household Travel Survey (NHTS), a nationally representative sample of US households, to examine Internet use among individuals with medical conditions, rural residents, and minority populations. Internet use was defined as any use within the past 6 months; among users, frequency of use and location of use were explored. Control variables included sociodemographics, family life cycle, employment status, region, and job density in the community. All analyses were weighted to reflect the complex NHTS sampling frame. Individuals with medical conditions were far less likely to report Internet use than those without medical conditions (32.6% vs 70.3%, P < .001). Similarly, rural residents were less likely to report Internet access and use than urban residents (59.7% vs 69.4%, P < .001). Nationally, 72.8% of white respondents, versus 65.7% of persons of "other" race, 51.5% of African Americans, and 38.0% of Hispanics reported accessing the Internet (P < .001). In adjusted analyses, persons with medical conditions and minority populations were less likely to report Internet use. Rural-urban differences were no longer significant with demographic and ecological characteristics held constant. This analysis confirmed previous findings of a digital divide between urban and rural residents. Internet use and

  15. [Internet- and mobile-based approaches : Psycho-social diagnostics and treatment in medical rehabilitation].

    PubMed

    Baumeister, Harald; Lin, Jiaxi; Ebert, David Daniel

    2017-02-21

    Technology-based approaches for psychosocial diagnostics and interventions provide an attractive opportunity to optimize medical rehabilitation. Based on an Internet- and mobile-based assessment of existing functional health impairments, appropriate planning, implementation of corresponding courses of action as well as outcome assessment can take place. This can be implemented in the form of Internet- and mobile-based interventions (IMI).The present article provides an overview of the basic knowledge of IMI and their evidence base both in general and in particular for their use in medical rehabilitation. Important aspects of internet and mobile-based psycho-social diagnostics are discussed subsequently. Finally, an outlook for the use of Internet- and mobile-based diagnostics and interventions in medical rehabilitation is given.

  16. Internet addiction and its predictors in guilan medical sciences students, 2012.

    PubMed

    Asiri, Shahla; Fallahi, Fatemeh; Ghanbari, Atefeh; Kazemnejad-Leili, Ehsan

    2013-06-01

    Internet is one of the technologies of the modern era that is being extensively used around the world. It is believed that excessive Internet use can be pathological and addictive. Though, academic use of the Internet is primarily intended for learning and research, students are one of the groups at risk of Internet addiction. Due to the expanding use of Internet among the university students, this study was conducted to examine the Internet addiction and its predictors among Guilan University of Medical Sciences students. A cross-sectional study was conducted on 583 students during the first semester of 2012. A two-stage stratified random sampling was conducted and a two-part instrument was used for data collection. The first part of the instrument was consisted of questions about demographic characteristics and the second part was the Young's Internet addiction inventory. Chi-square, Kruskal-Wallis testes, Spearman correlation coefficient and ranked logistic regression were used for data analysis. About 5.7% of the students were moderately dependent to the Internet, while 44.1% were at risk for Internet addiction. Significant relationships were observed between the Internet addiction with age (P < 0.001), gender (P < 0.001), marital status (P < 0.001), major (P = 0.016), Grade point average (P = 0.017), semester of studying (P = 0.009) and student residence place (P = 0.014). However, no significant relationship was observed between the internet addiction score and level of discipline, parental job status and education level or the students' accommodation. About half of the participants in this study were at risk of Internet addiction. This finding can be a warning sign for the authorities in universities to pay more attention to this issue. A wide range of education along with empowering programs may be needed to inform the university students about the advantages and disadvantages of internet and the correct manner of using it.

  17. [Disease management programs in Germany: Validity of the medical documentation].

    PubMed

    Linder, R; Horenkamp-Sonntag, D; Engel, S; Köppel, D; Heilmann, T; Verheyen, F

    2014-01-01

    The specific documentation for disease management programs (DMP) in Germany with respect to § 137 Social Code Book V is the basis for evaluating the DMP. DMP run up costs of the order of a billion euro without assessing evidence-based benefit so far. Aim of this study was to question if and to which extent this documentation may be suitable for reliable quality assurance in its present form. Data of nearly 300000 insured persons of a German Statutory Health Insurance (Techniker Krankenkasse, TK) which were continuously registered from July 1st 2009 until December 31st 2010 in a DMP were analyzed. We analyzed how items which were components of claims data and of DMP documentation were matched. With regard to prescriptions there were some considerable differences. Prescription of glibenclamid was documented twice as frequently in the DMP documentation compared to prescriptions filled in pharmacies. Only a fraction of emergency hospitalizations documented in the claims data were found in the DMP documentation. Investigations of the fundus oculi for diabetics are mentioned three times more frequently in the DMP documentation than they are accounted by ophthalmologists. There are considerable differences between claims data and DMP specific documentation. The latter shows a plainly reduced validity for investigated fields in the documentation forms. Reasons for this are manifold. Former evaluations of DM Ps carried out just on the basis of DMP documentation are thus highly questionable. Therefore, the DMPs themselves and their documentation have to be reformed. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Medical teleconference about thoracic surgery using free Internet software.

    PubMed

    Obuchi, Toshiro; Shiono, Hiroyuki; Shimada, Junichi; Kaga, Kichizo; Kurihara, Masatoshi; Iwasaki, Akinori

    2011-11-01

    Surgical teleconferences using advanced academic networks are becoming common; however, reports regarding Internet teleconferencing using free software packages such as Skype, USTREAM, and Dropbox are very rare. Teleconferences concerning mainly surgical techniques were held five times between Fukuoka University Hospital and other institutions from April to September 2010. These teleconferences used Skype and USTREAM as videophones to establish communication. Both PowerPoint presentations and surgical videos were made. These presentation files were previously sent to all stations via mail, e-mail, or Dropbox, and shared. A slide-show was simultaneously performed following the presenter's cue in each station. All teleconferences were successfully completed, even though there were minor instances of the Skype link being broken for unknown reasons during the telecommunication. Internet surgical teleconferences using ordinary software are therefore considered to be sufficiently feasible. This method will become more convenient and common as the Internet environments advance.

  19. [The management of implantable medical device and the application of the internet of things in hospitals].

    PubMed

    Zhou, Li; Xu, Liang

    2011-11-01

    Implantable medical device is a special product which belongs to medical devices. It not only possesses product characteristics in common, but also has specificity for safety and effectiveness. Implantable medical device must be managed by the relevant laws and regulations of the State Food and Drug Administration. In this paper, we have used cardiac pacemakers as an example to describe the significance of the management of implantable medical device products and the application of the internet of things in hospitals.

  20. [Introduction of accompanying documents on the new EMC standard of medical electrical equipment].

    PubMed

    Wang, Weiming

    2013-07-01

    The article introduces the requirements of accompanying documents on the new EMC standard of medical electrical equipment (YY 0505-2012), hope it can be useful for the manufacturers of medical electrical equipment.

  1. A survey on internet usage and online learning behaviour among medical undergraduates.

    PubMed

    Venkatesh, Soma; Chandrasekaran, Venkatesh; Dhandapany, Gunasekaran; Palanisamy, Soundararajan; Sadagopan, Srinivasan

    2017-05-01

    To determine the magnitude and pattern of internet usage by undergraduate medical students to retrieve medical information. A pretested questionnaire-based survey was conducted among undergraduate medical students who were willing to participate. The institute ethics committee approved the study. The responses of students to the questionnaire were analysed using VassarStats online statistical programme. Categorical variables were expressed as proportions. To determine the significance of the difference between proportions, the χ(2) test or Fisher's exact test was used. Log-linear analysis was performed for significance of association among interacting variables. A p value <0.05 was considered significant. A total of 115 undergraduate medical students participated in the survey. The response was 100% and involved mainly IX and VIII semester students. Internet usage was found to be 97.4%. Of the students interviewed, 35.7% were frequent internet users and 57.4% used their mobile phones to access the internet. The majority (60.9%) had their own portable 3G internet connection. Monthly expenditure for the majority (82.6%) was less than 1000 Indian Rupees per month. The most popular medical site accessed by students was Medscape, followed by Wikipedia and WebMD. Of the students studied, 8% had attended one or more online continuing medical education programmes. On log-linear analysis, a linear relationship was found for medical time and social time. An encouraging trend is seen in the use of the internet by medical students to access medical information, but this has not translated into improved online learning behaviour. 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/.

  2. Computer and Internet Utilization among the Medical Students in Qassim University, Saudi Arabia

    PubMed Central

    Aldebasi, Yousef Homood; Ahmed, Mohamed Issa

    2013-01-01

    Background: Computer-based training (CBT) and internet-based training (IBT) have become a vital part of the Medical Education. A cross-sectional study was carried out in Qassim University-Kingdom of Saudi Arabia (KSA), with the objective of assessing the pattern of the computer and Internet utilization among both male and female medical students. Methods: A total of 500 medical students from 4 different medical colleges of Qassim University participated in this study. A semi-structured, pre-tested questionnaire was used to collect the data and the data analysis was done by using SPSS, Version 17. Results: Forty two percent female and twenty four percent male students used computers to get general information, 80% of the students reported using computers for academic activities and 52% females and 22% males used computers for entertainment. Most of the females preferred using computers at home (84%), while 54% males used computers at cyber cafés. For the information retrieval, 84% males used the internet, followed by journals/library (36%) and textbooks (35%), while the females preferred textbooks (75%) and the internet (14%). Google was found to be most commonly used search engine. Conclusion: The internet creates an educational delivery system; it is highly needed to increase the credit hours for the university requirement courses in computer application and the internet use for both among the male and female students. PMID:23905114

  3. Internet Self-Assessment in Pharmacology: A Model for Internet Medical Education.

    ERIC Educational Resources Information Center

    Konstan, Joseph A.; Sturm, Paul; McLeod, John; Lichtblau, Leonard

    1997-01-01

    Describes ISAP (Internet Self-Assessment in Pharmacology; http://www.med.umn.edu/ISAP), a World Wide Web-based educational environment for health professionals. This active learning environment that includes text (lecture outlines), reference manual (drug reference cards), and study guide (exam questions), allows users to access and review drug…

  4. Prognosis: wired. Why Internet technology is the next medical breakthrough.

    PubMed

    Menduno, M

    1998-11-05

    One observer calls it "e-mail on steroids." Whizzing along the Internet and encrypted against hacking, clinical messaging lets doctors consult on tough cases, speed up test results, even chat with their patients. So why aren't these systems widely used? Blame politics, not the technology.

  5. Introduction to an open source internet-based testing program for medical student examinations.

    PubMed

    Lee, Yoon-Hwan

    2009-12-20

    The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.

  6. The virtual course: delivery of live and recorded continuing medical education material over the Internet.

    PubMed

    Tello, R; Davison, B D; Blickman, J G

    2000-06-01

    Our objective was to deliver live and recorded lectures from a continuing medical education course, including the representations of original slides, over the Internet, using streaming audio media. The streaming audio media, an emerging technology, not only delivers large lectures over the Internet using commercially available PCs and modems, but also allows review at any time by individuals with access to the Web. An interactive conference of continuing medical education curriculum can thus be delivered and continuing medical education credit earned without leaving home.

  7. Direct-to-consumer advertisements of prescription medications over the Internet.

    PubMed

    Fogel, Joshua; Novick, Daniel

    2009-01-01

    This study sought data on the impact of direct-to-consumer (DTC) advertisements and both intentions and frequency to seek more information about the drug being advertised. Data were collected from 498 college students regarding intention to seek and how frequently they obtained more information about prescription medications. For intentions, grocery or pharmacy and radio advertisements were associated with lesser intentions. For frequency, Internet advertisements were associated, while newspaper and spam e-mail advertisements were not. Types of sources associated with seeking additional information were doctor, Internet, and 1-800 information numbers. A significant interaction existed for seeing Internet advertisements for drugs and then seeking additional information from a doctor and not from the Internet. In conclusion, Internet advertising is associated with seeking additional information from a reliable source such as a doctor.

  8. Perceived barriers to information access among medical residents in Iran: obstacles to answering clinical queries in settings with limited Internet accessibility.

    PubMed

    Mazloomdoost, Danesh; Mehregan, Shervineh; Mahmoudi, Hilda; Soltani, Akbar; Embi, Peter J

    2007-10-11

    Studies performed in the US and other Western countries have documented that physicians generate many clinical questions during a typical day and rely on various information sources for answers. Little is known about the information seeking behaviors of physicians practicing in other countries, particularly those with limited Internet connectivity. We conducted this study to document the perceived barriers to information resources used by medical residents in Iran. Our findings reveal that different perceived barriers exist for electronic versus paper-based resources. Notably, paper-based resources are perceived to be limited by resident time-constraints and availability of resources, whereas electronic resources are limited by cost decentralized resources (such as PDAs) and accessibility of centralized, Internet access. These findings add to the limited literature regarding health information-seeking activities in international healthcare settings, particularly those with limited Internet connectivity, and will supplement future studies of and interventions in such settings.

  9. Acquisition and review of diagnostic images for use in medical research and medical testing examinations via the Internet

    NASA Astrophysics Data System (ADS)

    Pauley, Mark A.; Dalrymple, Glenn V.; Zhu, Quiming; Chu, Wei-Kom

    2000-12-01

    With the continued centralization of medical care into large, regional centers, there is a growing need for a flexible, inexpensive, and secure system to rapidly provide referring physicians in the field with the results of the sophisticated medical tests performed at these facilities. Furthermore, the medical community has long recognized the need for a system with similar characteristics to maintain and upgrade patient case sets for oral and written student examinations. With the move toward filmless radiographic instrumentation, the widespread and growing use of digital methods and the Internet, both of these processes can now be realized. This article describes the conceptual development and testing of a protocol that allow users to transmit, modify, remotely store and display the images and textual information of medical cases via the Internet. We also discuss some of the legal issues we encountered regarding the transmission of medical information; these issues have had a direct impact on the implementation of the results of this project.

  10. Medical informatics on the Internet: creating the sci.med. informatics newsgroup.

    PubMed Central

    Zakaria, A M; Sittig, D F

    1995-01-01

    A Usenet newsgroup, sci.med.informatics, has been created to serve as an international electronic forum for discussion of issues related to medical informatics. The creation process follows a set of administrative rules set out by the Usenet administration on the Internet and consists of five steps: 1) informal discussion, 2) request for formal discussion, 3) formal discussion, 4) voting, and 5) posting of results. The newsgroup can be accessed using any news reader via the Internet. PMID:7583645

  11. Effect of Gender and Physical Activity on Internet Addiction in Medical Students

    PubMed Central

    Khan, Muhammad Alamgir; Shabbir, Faizania; Rajput, Tausif Ahmed

    2017-01-01

    Objective: To determine the effect of gender and physical activity on internet addiction in medical students. Methods: In this cross sectional, analytical study Young’s internet addiction test questionnaire was distributed to 350 MBBS students of Army Medical College, Rawalpindi. The study was conducted from January to May 2015. A dichotomous response from students regarding physical activity was obtained which was verified from the sports department of the institution. Based upon total score, internet addiction was categorized as no addiction if the score was less than or equal to 49, moderate addiction when the score was 50 to 79 and severe when the score was 80 to 100. Results: Out of 322 respondents 175 (54.3%) were males and 147 (42.7%) females with a mean age of 19.27±1.01 years. Total internet addiction score and frequency of internet addiction were similar between males and females (37.71±11.9 vs 38.63±14.00, p=0.18 and 25 vs 29, p=0.20). However, total score and frequency of internet addiction were higher in students lacking physical activity as compared to those with regular physical activity (40.37±15.05 vs 36.38±11.76, p=0.01 and 30 vs 24, p=0.01). Conclusion: Internet addiction is unrelated to gender however it is inversely related to physical activity. PMID:28367198

  12. Effect of Gender and Physical Activity on Internet Addiction in Medical Students.

    PubMed

    Khan, Muhammad Alamgir; Shabbir, Faizania; Rajput, Tausif Ahmed

    2017-01-01

    To determine the effect of gender and physical activity on internet addiction in medical students. In this cross sectional, analytical study Young's internet addiction test questionnaire was distributed to 350 MBBS students of Army Medical College, Rawalpindi. The study was conducted from January to May 2015. A dichotomous response from students regarding physical activity was obtained which was verified from the sports department of the institution. Based upon total score, internet addiction was categorized as no addiction if the score was less than or equal to 49, moderate addiction when the score was 50 to 79 and severe when the score was 80 to 100. Out of 322 respondents 175 (54.3%) were males and 147 (42.7%) females with a mean age of 19.27±1.01 years. Total internet addiction score and frequency of internet addiction were similar between males and females (37.71±11.9 vs 38.63±14.00, p=0.18 and 25 vs 29, p=0.20). However, total score and frequency of internet addiction were higher in students lacking physical activity as compared to those with regular physical activity (40.37±15.05 vs 36.38±11.76, p=0.01 and 30 vs 24, p=0.01). Internet addiction is unrelated to gender however it is inversely related to physical activity.

  13. Problematic Internet Use and Its Correlates Among Students from Three Medical Schools Across Three Countries.

    PubMed

    Balhara, Yatan Pal Singh; Gupta, Rishab; Atilola, Olayinka; Knez, Rajna; Mohorović, Tonka; Gajdhar, Wamique; Javed, Ahmed O; Lal, Rakesh

    2015-12-01

    The authors aimed to assess and compare problematic internet use among medical students enrolled in a graduate degree course in one school each from Croatia, India, and Nigeria and to assess correlates of problematic use among these students. The questionnaire included a sociodemographic profile of participants and Young's Internet Addiction Test. The final analysis included 842 subjects. Overall, 38.7 and 10.5 % of respondents scored in the mild and moderate categories. Only a small fraction (0.5 %) of students scored in the severe category. Being male and spending more time on the internet were correlated with problematic internet use. Moreover, a significantly higher proportion of participants who scored above the cutoff used the Internet for browsing, social networking, chatting, gaming, shopping, and viewing pornography. However, there was no difference between the two groups with regard to using the internet for e-mailing or academic activities. It is important to address problematic internet use among medical students. The correlates can help identify those at increased risk.

  14. "Did They Actually Really Believe This?" Authentic Medical Documents as a Window on the Past.

    ERIC Educational Resources Information Center

    Riley, Julie

    1999-01-01

    Presents an assignment in which students choose a historical medical document, focusing on bloodletting techniques, tendon repair in the calf, or phrenology, and then convince the doctor or specialist who wrote the document that he was incorrect or did not use the best medical treatment. Provides historical background on phrenology. (CMK)

  15. "Did They Actually Really Believe This?" Authentic Medical Documents as a Window on the Past.

    ERIC Educational Resources Information Center

    Riley, Julie

    1999-01-01

    Presents an assignment in which students choose a historical medical document, focusing on bloodletting techniques, tendon repair in the calf, or phrenology, and then convince the doctor or specialist who wrote the document that he was incorrect or did not use the best medical treatment. Provides historical background on phrenology. (CMK)

  16. The Prevalence of Internet and Social Media Based Medication Information Seeking Behavior in Saudi Arabia.

    PubMed

    Bahkali, Salwa; Alfurih, Suha; Aldremly, Maha; Alzayyat, Ma'an; Alsurimi, Khaled; Househ, Mowafa

    2016-01-01

    The internet has become an important resource to help people search for online medication information. This study aims to report the prevalence and profile of Saudi online medication seeking behavior. Conducted via a web-based survey with Twitter participants between January-February, 2015, the primary outcome measures were the self-reported rates of using the internet to search for medication related information. A valid sample of 4847 participants was collected over the period of the study. Out of the total participants, 68.3% (n=3311) were found to seek online medication related information frequently. Most of the social media users were female 83.5% (n=2766). The majority of respondents 63.6% (n= 3081) used Google, followed by Twitter 28.7% (n= 1392), Snapchat 21%, (n=1019), WhatsApp 13.8% (n= 670), Instagram 11.4%, (n= 553), and Facebook 5.5 % (n= 267), with few searching YouTube 1.3% (n=65) to access online medication information. Findings indicate that the Saudi population actively uses the internet and social media to obtain medication information. Further studies are needed to explore the influence of the internet and social media on user perception, attitude, and behavior with the use of online medication information.

  17. Internet addiction in a group of medical students: a cross sectional study.

    PubMed

    Pramanik, T; Sherpa, M T; Shrestha, R

    2012-03-01

    The use of Internet for education, recreation and communication is increasing day by day. Nevertheless, the possibility of exploitation and addiction leading to impairment in academic performance and emotional balance cannot be denied, especially among young population. The study was aimed to measure the degree of Internet addiction among a group of medical students. Internet addiction test questionnaire developed by Young was used to assess mild, moderate and severe addiction. Amongst the study population (n=130, age 19-23 years), 40% had mild addiction. Moderate and severe addiction was found in 41.53% and 3.07% of the participants respectively. The study revealed that 24% often and 19.2% always found themselves using Internet longer than they had planned or thought. Late night Internet surfing leading to sleep deprivation was found in 31.53% of the participants. Almost one fourth of them (25.38%) occasionally tried to cut down the time they spent on the Internet but failed and 31.53% sometimes experienced restlessness when deprived of Internet access. Results reflected that a significant number of participants suffered from mild to moderate addiction. The role of counseling and education should be emphasized for prevention of Internet addiction.

  18. Automatic Classification Using Supervised Learning in a Medical Document Filtering Application.

    ERIC Educational Resources Information Center

    Mostafa, J.; Lam, W.

    2000-01-01

    Presents a multilevel model of the information filtering process that permits document classification. Evaluates a document classification approach based on a supervised learning algorithm, measures the accuracy of the algorithm in a neural network that was trained to classify medical documents on cell biology, and discusses filtering…

  19. Automatic Classification Using Supervised Learning in a Medical Document Filtering Application.

    ERIC Educational Resources Information Center

    Mostafa, J.; Lam, W.

    2000-01-01

    Presents a multilevel model of the information filtering process that permits document classification. Evaluates a document classification approach based on a supervised learning algorithm, measures the accuracy of the algorithm in a neural network that was trained to classify medical documents on cell biology, and discusses filtering…

  20. Medication counseling: analysis of electronic documentation using the clinical care classification system.

    PubMed

    Saranto, Kaija; Moss, Jacqueline; Jylhä, Virpi

    2010-01-01

    Medication counseling is a central aspect of medication safety. Counseling refers to the process of informing, advising and administering medication to help patients manage their medication regimen. This pilot study examined 379 descriptions of medication counseling carried out in surgical care and documented in an electronic patient record system by using the Clinical Care Classification System. The objective was to identify counseling methods and to evaluate the need for additional counseling descriptor codes in the record. Eleven counseling methods were identified and the data were classified according to counseling methods with and without documentation of the nature of the interaction with patients. There were no descriptions of the nature of counseling conducted in 127 of the documented entries. These results can be used when developing the documentation of medication care in electronic patient records.

  1. Internet-Based Medical Visit and Diagnosis for Common Medical Problems: Experience of First User Cohort

    PubMed Central

    Shevchik, Grant J.; Paone, Suzanne; Martich, G. Daniel

    2011-01-01

    Abstract Objective Internet-based medical visits, or “structured e-Visits,” allow patients to report symptoms and seek diagnosis and treatment from their doctor over a secure Web site, without calling or visiting the physician's office. While acceptability of e-Visits has been investigated, outcomes associated with e-Visits, that is, whether patients receiving diagnoses receive appropriate care or need to return to the doctor, remain unexplored. Materials and Methods: The first 156 e-Visit users from a large family medicine practice were surveyed regarding their experience with the e-Visit and e-Visit outcomes. In addition, medical records for patients making e-Visits were reviewed to examine need for follow-up care within 7 days. Results: Interviews were completed with 121 patients (77.6% participation). The most common type of e-Visit was for “other” symptoms or concerns (37%), followed by sinus/cold symptoms (35%). Back pain, urinary symptoms, cough, diarrhea, conjunctivitis, and vaginal irritation were each less frequent (<10%). A majority, 61% completed e-Visits with their own physician. The majority of patients (57.0%) reported receipt of a diagnosis without need for follow-up beyond a prescription; 75% of patients thought the e-Visit was as good as or better than an in-person visit, and only 11.6% felt that their concerns or questions were incompletely addressed. In a review of medical records, 16.9% had a follow-up visit within 7 days, mostly for the same condition. Four of these were on the same day as the e-Visit, including one emergency department visit. Conclusions: Outcomes for the e-Visit suggest that it is an appropriate and potentially cost-saving addition to in-person delivery of primary care. PMID:21457013

  2. Checklist clerking document improves health promotion among medical admissions

    PubMed Central

    Cousins, Sarah

    2013-01-01

    Health promotion, as defined by the Ottawa Charter (1) is the ‘process of enabling people to increase control over, and to improve their health’. Four life style risk factors: smoking, alcohol, obesity and physical activity are recognised as leading to health inequalities. These factors have implications at an individual, community and national level and the burden of disease has large cost implications for the NHS and country as a whole. Therefore the assessment of these risk factors, and the provision of good health promotion assist to address these problems. A pilot and initial audit demonstrated that assessment for the key life style risk factors and the provision of health promotion was poor. This quality improvement audit developed an easy to use, checklist based, amended clerking document. This improved both assessment and provision of health promotion and will be carried forward to influence the designing of a new clerking document. PMID:26734175

  3. Medical information and the Internet: do you know what you are getting?

    PubMed

    Craan, Fitzgerald; Oleske, Denise M

    2002-12-01

    Due to the Internet technology, hundreds of Web sites are accessible for medical information, and the retrieval of such information is quite rapid. Once you as a consumer obtain all of this information, how do you determine whether the information you are looking at is valid and current and even relevant to your needs? This article presents various criteria necessary to evaluate the information on a medical Web site; no standards currently are in place to mandate the validity of information published on the Internet.

  4. Validity of the Malay version of the Internet Addiction Test: a study on a group of medical students in Malaysia.

    PubMed

    Guan, Ng Chong; Isa, Saramah Mohammed; Hashim, Aili Hanim; Pillai, Subash Kumar; Harbajan Singh, Manveen Kaur

    2015-03-01

    The use of the Internet has been increasing dramatically over the decade in Malaysia. Excessive usage of the Internet has lead to a phenomenon called Internet addiction. There is a need for a reliable, valid, and simple-to-use scale to measure Internet addiction in the Malaysian population for clinical practice and research purposes. The aim of this study was to validate the Malay version of the Internet Addiction Test, using a sample of 162 medical students. The instrument displayed good internal consistency (Cronbach's α = .91), parallel reliability (intraclass coefficient = .88, P < .001), and concurrent validity with the Compulsive Internet Use Scale (Pearson's correlation = .84, P < .001). Receiver operating characteristic analysis showed that 43 was the optimal cutoff score to discriminate students with and without Internet dependence. Principal component analysis with varimax rotation identified a 5-factor model. The Malay version of the Internet Addiction Test appeared to be a valid instrument for assessing Internet addiction in Malaysian university students.

  5. [Some medical documents written by Ahmed Cevdet Pasha].

    PubMed

    Izgoer, A Z

    1998-01-01

    The assumption that civilization was originated in the East, was one of the most important points emphasized by the intelligentsia of the late Ottoman reign. This conviction was appreciated in the thought of Ahmed Cevdet Pasha (1823 - 1895), a famous figure of the period. Cevdet Pasha, who believed that the source of science and education was started in the East, claimed that Europe was acquainted with Islamic science during the Crusades. In this paper Cevdet Pasha's ideas related with small-pox, cholera, plague, poisons and microbes are mentioned. This study is based on Cevdet Pasha's documents related with these subjects; and the transcriptions of the texts are given.

  6. ["The fungal jungle". Medical mycology on the Internet].

    PubMed

    Voss, H; Hort, W; Wagner, R; Mayser, P

    2005-01-01

    The World Wide Web offers an enormous variety of information about medical mycology. To go through the "fungal jungle" and find the website containing the information that is needed requires a great deal of effort and a lot of time. This article provides help in finding information about medical mycology and describes the contents of preselected websites in German and English. These pages address physicians, scientists, and students interested in dermato-mycology. Most of the pages also contain information about mycoses relevant to other medical specialties.

  7. [Internet use among medical students in Batna (Algeria), Rouen (France), Sousse (Tunisia)].

    PubMed

    Ladner, Joël; Nadir, Boussouf; Abdelaziz, Ahmed Ben; Benmaïza, Soumeya; Alaoua, Omar; Tavolacci, Marie-Pierre

    2010-01-01

    The objective of this study was to evaluate the use of the Internet by students in three francophone Faculties of Medicine, in Batna (Algeria), Rouen (France) and Sousse (Tunisia), and to identify and assess students' research skills in seeking educational resources. In 2008, a cross-sectional study was conducted in the three faculties. An anonymous self-administered questionnaire gathered information on the students' IT equipment, the interest and relevance of the Internet in the curriculum of medical studies, and information on the last three research efforts for educational resources done using the Internet. In Batna, 300 students were enrolled, 182 in Rouen and 87 in Sousse. Nearly 80% of students used the Internet to research educational resources. Students in Batna and Sousse more frequently reported a lack of appropriate or sufficient training for Internet use than students in Rouen. In total, 1288 Internet searches were analyzed. For an individual research effort on the Internet, the average time was 61,9 minutes (standard deviation [SD] = 65,9) in Batna, 26,3 minutes (SD = 30,2) in Rouen and 42,6 minutes (SD = 51, 0) Sousse (p 10-4). Less than one in two students considered their research successful. It is important to provide advice and guidance to students on how to use and interpret the multiple types and sources of medical information of varying quality that are found on the Internet. It is the responsibility of teachers to fulfill this role and help to facilitate the navigation of this new source of information.

  8. Clinical Documents Clustering Based on Medication/Symptom Names Using Multi-View Nonnegative Matrix Factorization.

    PubMed

    Ling, Yuan; Pan, Xuelian; Li, Guangrong; Hu, Xiaohua

    2015-07-01

    Clinical documents are rich free-text data sources containing valuable medication and symptom information, which have a great potential to improve health care. In this paper, we build an integrating system for extracting medication names and symptom names from clinical notes. Then we apply nonnegative matrix factorization (NMF) and multi-view NMF to cluster clinical notes into meaningful clusters based on sample-feature matrices. Our experimental results show that multi-view NMF is a preferable method for clinical document clustering. Moreover, we find that using extracted medication/symptom names to cluster clinical documents outperforms just using words.

  9. Prevalence of Internet Addiction in Medical Students: a Meta-analysis.

    PubMed

    Zhang, Melvyn W B; Lim, Russell B C; Lee, Cheng; Ho, Roger C M

    2017-08-28

    With the development of online learning, communication, and entertainment, the Internet has become an indispensable tool for university students. Internet addiction (IA) has emerged as a health problem and the prevalence of IA varies from country to country. To date, the global prevalence of IA in medical students remains unknown. The objective of this meta-analysis was to establish precise estimates of the prevalence of IA among medical students in different countries. The pooled prevalence of IA among medical students was determined by the random-effects model. Meta-regression and subgroup analysis were performed to identify potential factors that could contribute to heterogeneity. The pooled prevalence of IA among 3651 medical students is 30.1% (95% confidence interval (CI) 28.5-31.8%, Z = -20.66, df = 9, τ (2) = 0.90) with significant heterogeneity (I (2) = 98.12). Subgroup analysis shows the pooled prevalence of IA diagnosed by the Chen's Internet Addiction Scale (CIAS) (5.2, 95% CI 3.4-8.0%) is significantly lower than Young's Internet Addiction Test (YIAT) (32.2, 95% CI 20.9-45.9%) (p < 0.0001). Meta-regression analyses show that the mean age of medical students, gender proportion and the severity of IA are not significant moderators. In conclusion, this meta-analysis identified the pooled prevalence of IA among medical students is approximately five times than that of the general population. Age, gender, and severity of IA did not account for high heterogeneity in prevalence, but IA assessment questionnaire was a potential source of heterogeneity. Given the high prevalence of IA, medical teachers and medical school administrators should identify medical students who suffer from IA and refer them for intervention.

  10. Internet Addiction and its Predictors in Guilan Medical Sciences Students, 2012

    PubMed Central

    Asiri, Shahla; Fallahi, Fatemeh; Ghanbari, Atefeh; Kazemnejad-leili, Ehsan

    2013-01-01

    Background: Internet is one of the technologies of the modern era that is being extensively used around the world. It is believed that excessive Internet use can be pathological and addictive. Though, academic use of the Internet is primarily intended for learning and research, students are one of the groups at risk of Internet addiction. Objectives: Due to the expanding use of Internet among the university students, this study was conducted to examine the Internet addiction and its predictors among Guilan University of Medical Sciences students. Materials and Methods: A cross-sectional study was conducted on 583 students during the first semester of 2012. A two-stage stratified random sampling was conducted and a two-part instrument was used for data collection. The first part of the instrument was consisted of questions about demographic characteristics and the second part was the Young's Internet addiction inventory. Chi-square, Kruskal-Wallis testes, Spearman correlation coefficient and ranked logistic regression were used for data analysis. Results: About 5.7% of the students were moderately dependent to the Internet, while 44.1% were at risk for Internet addiction. Significant relationships were observed between the Internet addiction with age (P < 0.001), gender (P < 0.001), marital status (P < 0.001), major (P = 0.016), Grade point average (P = 0.017), semester of studying (P = 0.009) and student residence place (P = 0.014). However, no significant relationship was observed between the internet addiction score and level of discipline, parental job status and education level or the students’ accommodation. Conclusion: About half of the participants in this study were at risk of Internet addiction. This finding can be a warning sign for the authorities in universities to pay more attention to this issue. A wide range of education along with empowering programs may be needed to inform the university students about the advantages and disadvantages of internet

  11. Usage of medical internet and e-health services by the elderly.

    PubMed

    Bujnowska-Fedak, Maria M; Mastalerz-Migas, Agnieszka

    2015-01-01

    Internet and e-health services have a substantial potential to support efficient and effective care for the elderly. The aim of the study was to investigate the use of Internet for health-related purposes among Polish elderly, the frequency and reasons of use, the importance of e-health services, and factors affecting their use. A total of 242 elderly at the age of ≥60 years were selected from the Polish population by random sampling. Data collection was carried out by phone interviews in October-November 2012. The study shows that the Internet was ever used by 32% of the elderly and 1/5 claimed a regular use. Among the Internet users, 81% of older people used it to obtain information about health or illness. The Internet was one of the less important sources of information (important for 27% of respondents), face to face contact with health professionals and family and friends are still the most required source of medical information (75%). Only 7% of elderly Internet users approached the family physician, specialists, or other health professionals over the Internet. Factors that positively affected the use of Internet among elderly were male gender, younger age, higher education, living with family, mobile phone use, and a subjective assessment of one's own health as good. The doctor's provision of Internet-based services was important in the opinion of approximately 1/4 of older people. We conclude that the development of information and communications technology (ICT) tools increasingly meets the evolving needs of patients in the field of e-health. More and more elderly become beneficiaries of these services.

  12. Using POSTDOC to recognize biomedical concepts in medical school curricular documents.

    PubMed

    Kanter, S L; Miller, R A; Tan, M; Schwartz, J

    1994-07-01

    Recognition of the biomedical concepts in a document is prerequisite to further processing of the document: medical educators examine curricular documents to discover the coverage of certain topics, detect unwanted redundancies, integrate new content, and delete old content; and clinicians are concerned with terms in patient medical records for purposes ranging from creation of an electronic medical record to identification of medical literature relevant to a particular case. POSTDOC (POSTprocessor of DOCuments) is a computer application that (1) accepts as input a free-text, ASCII-formatted document and uses the Unified Medical Language System (UMLS) Metathesaurus to recognize relevant main concept terms; (2) provides term co-occurrence data and thus is able to identify potentially increasing correlations among concepts within the document; and (3) retrieves references from MEDLINE files based on user identification of relevant subjects. This paper describes a formative evaluation of POSTDOC's ability to recognize UMLS Metathesaurus biomedical concepts in medical school lecture outlines. The "precision" and "recall" varied over a wide range and were deemed not yet acceptable for automated creation of a database of concepts from curricular documents. However, results were good enough to warrant further study and continued system development.

  13. Self-epistemic authority and nurses' reactions to medical information that is retrieved from Internet sites of different credibility.

    PubMed

    Barnoy, Sivia; Volfin-Pruss, Diana; Ehrenfeld, Malka; Kushnir, Talma

    2011-09-01

    This cross-sectional study investigated nurses' reactions to Internet medical information that was retrieved from sources of different scientific credibility and the association between self-epistemic authority and these reactions. The participants filled in questionnaires on their reactions to Internet medical information and self-epistemic authority. The nurses' reactions to Internet medical information from a highly credible source (Medline) correlated positively with self-epistemic authority. However, no such correlation was found with Internet medical information from a less credible Internet source (Ynet). Compared with the nurses without an academic degree, the nurses with an academic degree had more positive reactions to the information that was retrieved from Medline. The reactions to the medical information that was retrieved from Ynet did not differ by the education of the nurses. This study shows that nurses' reactions to different sources of Internet information vary according to their level of self-epistemic authority and education. As patients' use of Internet medical information is increasing, nurses need to expand their expertise in the various professional and popular medical information sites. Such skills will help to reduce any negative feeling that might arise when they encounter patients who present medical information from the Internet. © 2011 Blackwell Publishing Asia Pty Ltd.

  14. Physician Internet Medical Information Seeking and On-line Continuing Education Use Patterns.

    ERIC Educational Resources Information Center

    Casebeer, Linda; Bennett, Nancy; Kristofco, Robert; Carillo, Anna; Centor, Robert

    2002-01-01

    Responses from 2,200 physicians indicated that nearly all have Internet access and use it primarily for medical information and professional development, not for communicating with patients. Credibility of source, speed, accessibility, and searching ease were most important. Barriers included information overload and too little information…

  15. Internet addiction among students of the medical university of białystok.

    PubMed

    Krajewska-Kułak, Elżbieta; Kułak, Wojciech; Marcinkowski, Jerzy Tadeusz; Damme-Ostapowicz, Katarzyna Van; Lewko, Jolanta; Lankau, Agnieszka; Lukaszuk, Cecylia; Rozwadowska, Emilia

    2011-11-01

    The objective of this research was to assess Internet addiction among students of the Faculty of Health Prevention at the Medical University of Białystok. The present study included 358 students-nursing (n = 232), midwifery (n = 71), and medical rescue (n = 55). The following instruments were administered to the participants:the Young test, a test of the intensity of the abstinence syndrome, and a test of "online" addiction. Students who did not have a computer at home spent 3 hours a day on the Internet; students who did have a computer at home spent 0.5 to 8hours. On average, all respondents spent 1.8 ± 1.3 hours daily online. Internet addiction was confirmed among 24 (10.3%) nursing, 7 (9.9%) midwifery, and 5(9.1%) medical rescue students. The abstinence syndrome was noted among 11 (4.7%) nursing, 7(9.9%) obstetrics, and 7 (12.7%) medical rescue students. Several students had both an Internet addiction and the abstinence syndrome.

  16. Physician Internet Medical Information Seeking and On-line Continuing Education Use Patterns.

    ERIC Educational Resources Information Center

    Casebeer, Linda; Bennett, Nancy; Kristofco, Robert; Carillo, Anna; Centor, Robert

    2002-01-01

    Responses from 2,200 physicians indicated that nearly all have Internet access and use it primarily for medical information and professional development, not for communicating with patients. Credibility of source, speed, accessibility, and searching ease were most important. Barriers included information overload and too little information…

  17. Documentation.

    ERIC Educational Resources Information Center

    Burt, Lorna; Lewandowski, Carol

    This workbook, designed for workplace literacy courses, contains materials for a course on documentation. The six sessions of the course cover the following topics: (1) general principles of procedure writing; (2) principles of clear communication (clarity, audience, visuals) and identification of systems types, accounts, and customer requests;…

  18. Giving Patients Access to Their Medical Records via the Internet

    PubMed Central

    Masys, Daniel; Baker, Dixie; Butros, Amy; Cowles, Kevin E.

    2002-01-01

    Objective: The Patient-Centered Access to Secure Systems Online (pcasso) project is designed to apply state-of-the-art-security to the communication of clinical information over the Internet. Design: The authors report the legal and regulatory issues associated with deploying the system, and results of its use by providers and patients. Human subject protection concerns raised by the Institutional Review Board focused on three areas—unauthorized access to information by persons other than the patient; the effect of startling or poorly understood information; and the effect of patient access to records on the record-keeping behavior of providers. Measurements: Objective and subjective measures of security and usability were obtained. Results: During its initial deployment phase, the project enrolled 216 physicians and 41 patients; of these, 68 physicians and 26 patients used the system one or more times. The system performed as designed, with no unauthorized information access or intrusions detected. Providers rated the usability of the system low because of the complexity of the secure login and other security features and restrictions limiting their access to those patients with whom they had a professional relationship. In contrast, patients rated the usability and functionality of the system favorably. Conclusion: High-assurance systems that serve both patients and providers will need to address differing expectations regarding security and ease of use. PMID:11861633

  19. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  20. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  1. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  2. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  3. 42 CFR 102.60 - Documentation an eligible requester seeking medical benefits must submit.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Documentation an eligible requester seeking medical benefits must submit. 102.60 Section 102.60 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES VACCINES SMALLPOX COMPENSATION PROGRAM Required Documentation for Eligible Requesters To...

  4. Patient-directed Internet-based Medical Image Exchange: Experience from an Initial Multicenter Implementation

    PubMed Central

    Greco, Giampaolo; Patel, Anand S.; Lewis, Sara C.; Shi, Wei; Rasul, Rehana; Torosyan, Mary; Erickson, Bradley J.; Hiremath, Atheeth; Moskowitz, Alan J.; Tellis, Wyatt M.; Siegel, Eliot L.; Arenson, Ronald L.; Mendelson, David S.

    2015-01-01

    Rationale and Objectives Inefficient transfer of personal health records among providers negatively impacts quality of health care and increases cost. This multicenter study evaluates the implementation of the first Internet-based image-sharing system that gives patients ownership and control of their imaging exams, including assessment of patient satisfaction. Materials and Methods Patients receiving any medical imaging exams in four academic centers were eligible to have images uploaded into an online, Internet-based personal health record. Satisfaction surveys were provided during recruitment with questions on ease of use, privacy and security, and timeliness of access to images. Responses were rated on a five-point scale and compared using logistic regression and McNemar's test. Results A total of 2562 patients enrolled from July 2012 to August 2013. The median number of imaging exams uploaded per patient was 5. Most commonly, exams were plain X-rays (34.7%), computed tomography (25.7%), and magnetic resonance imaging (16.1%). Of 502 (19.6%) patient surveys returned, 448 indicated the method of image sharing (Internet, compact discs [CDs], both, other). Nearly all patients (96.5%) responded favorably to having direct access to images, and 78% reported viewing their medical images independently. There was no difference between Internet and CD users in satisfaction with privacy and security and timeliness of access to medical images. A greater percentage of Internet users compared to CD users reported access without difficulty (88.3% vs. 77.5%, P < 0.0001). Conclusion A patient-directed, interoperable, Internet-based image-sharing system is feasible and surpasses the use of CDs with respect to accessibility of imaging exams while generating similar satisfaction with respect to privacy. PMID:26625706

  5. Patient-directed Internet-based Medical Image Exchange: Experience from an Initial Multicenter Implementation.

    PubMed

    Greco, Giampaolo; Patel, Anand S; Lewis, Sara C; Shi, Wei; Rasul, Rehana; Torosyan, Mary; Erickson, Bradley J; Hiremath, Atheeth; Moskowitz, Alan J; Tellis, Wyatt M; Siegel, Eliot L; Arenson, Ronald L; Mendelson, David S

    2016-02-01

    Inefficient transfer of personal health records among providers negatively impacts quality of health care and increases cost. This multicenter study evaluates the implementation of the first Internet-based image-sharing system that gives patients ownership and control of their imaging exams, including assessment of patient satisfaction. Patients receiving any medical imaging exams in four academic centers were eligible to have images uploaded into an online, Internet-based personal health record. Satisfaction surveys were provided during recruitment with questions on ease of use, privacy and security, and timeliness of access to images. Responses were rated on a five-point scale and compared using logistic regression and McNemar's test. A total of 2562 patients enrolled from July 2012 to August 2013. The median number of imaging exams uploaded per patient was 5. Most commonly, exams were plain X-rays (34.7%), computed tomography (25.7%), and magnetic resonance imaging (16.1%). Of 502 (19.6%) patient surveys returned, 448 indicated the method of image sharing (Internet, compact discs [CDs], both, other). Nearly all patients (96.5%) responded favorably to having direct access to images, and 78% reported viewing their medical images independently. There was no difference between Internet and CD users in satisfaction with privacy and security and timeliness of access to medical images. A greater percentage of Internet users compared to CD users reported access without difficulty (88.3% vs. 77.5%, P < 0.0001). A patient-directed, interoperable, Internet-based image-sharing system is feasible and surpasses the use of CDs with respect to accessibility of imaging exams while generating similar satisfaction with respect to privacy. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  6. 'What is not written does not exist': the importance of proper documentation of medication use history.

    PubMed

    Silvestre, Carina Carvalho; Santos, Lincoln Marques Cavalcante; de Oliveira-Filho, Alfredo Dias; de Lyra, Divaldo Pereira

    2017-08-19

    Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44.8%). Similarly, in the medical charts of 52 (53.6%) paediatric patients, there was no record of parents and/or relatives interviews about prior use of medications. One hundred thirty-seven medical charts of adult patients (52.4%) and seventy-two medical charts of paediatric patients (74.2%) had no record about medication allergies and intolerances. In other words, there was a lack of basic documentation regarding the patient's medication use history. As patients move between settings in care, there is insufficient tracking of verbal and written information related to medication changes, which results in a progressive and cumulative loss of information, as evidenced by problems associated with clinical transfers and medication orders. Proper documentation of medication information during transfer is a key step in the procedure; hence, it should be rightly performed. It remains unclear whether interviews, and other investigations about medication use history have been performed but have not been recorded as health-care data. Therefore, it is crucial to the improvement of medication use safety that documentation of all drug-related information-even if not directly related to the actual event-become routine practice in health-care organizations, since 'what is not written does not exist'.

  7. An eight-year study of internet-based remote medical counselling.

    PubMed

    Labiris, G; Coertzen, I; Katsikas, A; Karydis, A; Petounis, A

    2002-01-01

    We carried out a prospective study of an Internet-based remote counselling service. A total of 15456 Internet users visited the Website over eight years. From these, 1500 users were randomly selected for analysis. Medical counselling had been granted to 901 of the people requesting it (60%). One hundred and sixty-four physicians formed project groups to process the requests and responded using email. The distribution of patients using the service was similar to the availability of the Internet: 78% were from the European Union, North America and Australia. Sixty-seven per cent of the patients lived in urban areas and the remainder were residents of remote rural areas with limited local medical coverage. Sixty-five per cent of the requests were about problems of internal medicine and 30% of the requests concerned surgical issues. The remaining 5% of the patients sought information about recent developments, such molecular medicine or aviation medicine. During the project, our portal became inaccessible five times, and counselling was not possible on 44 days. There was no hacking of the Website. Internet-based medical counselling is a helpful addition to conventional practice.

  8. A model for online interactive remote education for medical physics using the Internet.

    PubMed

    Woo, Milton K; Ng, Kwan-Hoong

    2003-01-01

    Medical physics is a relatively small community but it spans great geographical distances, usually with a scarcity of experts whose expertise could greatly benefit students entering into the field. In addition there are many software systems for which an interactive education method would be most advantageous. To develop a process to optimally use the Internet for real-time interactive remote education of medical physics and to present the experience of the study. The project is a collaboration of the Department of Medical Physics at the Toronto-Sunnybrook Regional Cancer Centre in Canada and the Department of Radiology at the University of Malaya in Malaysia. A class of medical-physics graduate students at the University of Malaya attended lectures provided by lecturers in Toronto, using the Internet as the main tool of communication. The different methods that can be used to provide the real-time interactive remote education were explored, and various topics-including traditional classroom lectures as well as hands-on workshops-were also delivered. The concept of real-time interactive remote education is viable and holds promise for providing economical and practical tele-education to the medical physics community, but depends heavily on the availability of the Internet in many developing countries.

  9. A Model for Online Interactive Remote Education for Medical Physics Using the Internet

    PubMed Central

    Ng, Kwan-Hoong

    2003-01-01

    Background Medical physics is a relatively small community but it spans great geographical distances, usually with a scarcity of experts whose expertise could greatly benefit students entering into the field. In addition there are many software systems for which an interactive education method would be most advantageous. Objective To develop a process to optimally use the Internet for real-time interactive remote education of medical physics and to present the experience of the study. Methods The project is a collaboration of the Department of Medical Physics at the Toronto-Sunnybrook Regional Cancer Centre in Canada and the Department of Radiology at the University of Malaya in Malaysia. A class of medical-physics graduate students at the University of Malaya attended lectures provided by lecturers in Toronto, using the Internet as the main tool of communication. Results The different methods that can be used to provide the real-time interactive remote education were explored, and various topics — including traditional classroom lectures as well as hands-on workshops — were also delivered. Conclusions The concept of real-time interactive remote education is viable and holds promise for providing economical and practical tele-education to the medical physics community, but depends heavily on the availability of the Internet in many developing countries. PMID:12746208

  10. The Internet as an Opportunity for Students to Create Their Own Document-Based Question

    ERIC Educational Resources Information Center

    Kotzin, Daniel

    2001-01-01

    The Document-Based Question (DBQ) is an integral part of the United States History Advanced Placement Exam, and is required as part of an exam that also includes answering two general "free response" essays and a multiple choice question section. For the DBQ, students are given a question about a specific time period in American history,…

  11. Internet supply ordering. Helping medical group practices improve business operations.

    PubMed

    Mayer, D

    2000-01-01

    Technology has opened the door to a new world of management tools in the physician practice environment. Productivity aids on the Web promise to alter forever the way we do everything--from interacting with vendors to caring for patients. Online medical, surgical and pharmaceutical supply acquisition sites, for example, already offer more efficient alternatives to phone and fax ordering, back-order challenges and supply cost monitoring. Not all sites are the same, however, and physicians and practice administrators must compare and contrast their needs with site offerings.

  12. Prevalence and factors associated with internet addiction among medical students - A cross-sectional study in Malaysia.

    PubMed

    Ching, S M; Hamidin, A; Vasudevan, R; Sazlyna, M S L; Wan Aliaa, W S; Foo, Y L; Yee, A; Hoo, F K

    2017-02-01

    Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia. This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis. The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09- 1.67). Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes.

  13. The single source architecture x4T to connect medical documentation and clinical research.

    PubMed

    Dziuballe, Philipp; Forster, Christian; Breil, Bernhard; Thiemann, Volker; Fritz, Fleur; Lechtenbörger, Jens; Vossen, Gottfried; Dugas, Martin

    2011-01-01

    Clinical trials often require large and redundant documentation efforts, because information systems in patient care and research are separated. In two clinical trials we have assessed the number of study items available in the clinical information system for re-use in clinical research. We have analysed common standards such as HL7, IHE RFD and CDISC ODM, regulatory constraints and the documentation process. Based on this analysis we have designed and implemented an architecture for an integrated clinical trial documentation workflow. Key aspects are the re-use of existing medical routine data and the integration into current documentation workflows.

  14. Medical teleconferencing with high-definition video presentation on the 'usual' Internet.

    PubMed

    Obuchi, Toshiro; Shima, Hiroji; Iwasaki, Akinori

    2013-06-01

    Although medical teleconferences on advanced academic networks have been common (Telemed J E Health 15:112-117, 1; Asian J Endosc Surg 3:185-188, 2; Surg Today 41:1579-1581, 3; Telemedicine development center of Asia. http://www.aqua.med.kyushu-u.ac.jp/eg/index.html . Accessed 6 March 2013, 4), reports regarding 'usual' Internet teleconferences or tele-lectures employing a telecommunication system for business use are very rare. Medical teleconferences and tele-lectures on the Internet were held three times between our institutions and other institutions, using the 'HD Com' made by Panasonic (HD Com. http://panasonic.biz/com/visual/ . Accessed 6 March 2013, 5), which is a high-definition telecommunication system for business tele-meeting. All of our medical telecommunications were successfully completed without any troubles. This system allows for all kinds of presentations using personal computers to be made from each station, so that discussions with high-definition surgical video presentation, which has recently been developed, could be effortlessly established despite the distance between institutions. Unlike telecommunication using advanced academic networks, this system can run without any need for specific engineering support, on the usual Internet. Medical telecommunication employing this system is likely to become common among ordinary hospitals in the near future.

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

    PubMed Central

    Kaisers, Wolfgang; Wassmuth, Ralf; Mayatepek, Ertan

    2015-01-01

    Background 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. Objective 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. Methods 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. Results 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

  16. 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

  17. Medical student documentation in electronic health records: a collaborative statement from the Alliance for Clinical Education.

    PubMed

    Hammoud, Maya M; Dalymple, John L; Christner, Jennifer G; Stewart, Robyn A; Fisher, Jonathan; Margo, Katherine; Ali, Imran I; Briscoe, Gregory W; Pangaro, Louis N

    2012-01-01

    The electronic health record (EHR) is an important advancement in health care. It facilitates improvement of health care delivery and coordination of care, but it creates special challenges for student education. This article represents a collaborative effort of the Alliance for Clinical Education (ACE), a multidisciplinary group formed in 1992. ACE recognizes the importance of medical student participation in patient care including the ability of documentation. This article proposes guidelines that can be used by educators to establish expectations on medical student documentation in EHRs. To provide the best education for medical students in the electronic era, ACE proposes to use the following as practice guidelines for medical student documentation in the EHR: (a) Students must document in the patient's chart and their notes should be reviewed for content and format, (b) students must have the opportunity to practice order entry in an EHR--in actual or simulated patient cases--prior to graduation, (c) students should be exposed to the utilization of the decision aids that typically accompany EHRs, and (d) schools must develop a set of medical student competencies related to charting in the EHR and state how they would evaluate it. This should include specific competencies to be documented at each stage, and by time of graduation. In addition, ACE recommends that accreditation bodies such as the Liaison Committee for Medical Education utilize stronger language in their educational directives standards to ensure compliance with educational principles. This will guarantee that the necessary training and resources are available to ensure that medical students have the fundamental skills for lifelong clinical practice. ACE recommends that medical schools develop a clear set of competencies related to student in the EHR which medical students must achieve prior to graduation in order to ensure they are ready for clinical practice.

  18. Chaplain Documentation and the Electronic Medical Record: A Survey of ACPE Residency Programs.

    PubMed

    Tartaglia, Alexander; Dodd-McCue, Diane; Ford, Timothy; Demm, Charles; Hassell, Alma

    2016-01-01

    This study explores the extent to which chaplaincy departments at ACPE-accredited residency programs make use of the electronic medical record (EMR) for documentation and training. Survey data solicited from 219 programs with a 45% response rate and interview findings from 11 centers demonstrate a high level of usage of the EMR as well as an expectation that CPE residents document each patient/family encounter. Centers provided considerable initial training, but less ongoing monitoring of chaplain documentation. Centers used multiple sources to develop documentation tools for the EMR. One center was verified as having created the spiritual assessment component of the documentation tool from a peer reviewed published model. Interviews found intermittent use of the student chart notes for educational purposes. One center verified a structured manner of monitoring chart notes as a performance improvement activity. Findings suggested potential for the development of a standard documentation tool for chaplain charting and training.

  19. Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial.

    PubMed

    Kashiwagi, Kenji; Tsukahara, Shigeo

    2014-01-15

    Glaucoma is one of the leading causes of blindness. Reduction of intraocular pressure is the only proven way to prevent progression of glaucomatous optic neuropathy. The majority of glaucoma patients need to use antiglaucoma ophthalmic solutions over the course of their life. Thus, good adherence and persistency of glaucoma treatment are important factors for better glaucoma care. The purpose of this study was to investigate the impact of an Internet-based glaucoma care support system on glaucoma medication use. Patients were randomly divided into two groups. The non-Internet access (NIA) group consisted of patients who had access to the Internet-based glaucoma care support system during the 4-year period only when they were examined by ophthalmologists. The Internet access (IA) group consisted of patients who had the same Internet-based glaucoma care support system access as the NIA group for the first 2 years following enrollment but who were also given free access to the glaucoma care support system for the remaining 2 years. Changes in glaucoma medication use were investigated. In total, 81 patients in the IA group and 90 patients in the NIA group satisfied the study protocol. The number of antiglaucoma ophthalmic solutions used during the study period significantly increased in the NIA group (P<.03) but not in the IA group. The percentages of patients with unchanged, increased, and decreased antiglaucoma ophthalmic solution use during the study period were 61.1% (55/90), 17.8% (16/90), and 3.3% (3/90), respectively, in the NIA group, and 56.8% (46/81), 8.6% (7/81), and 13.6% (11/81), respectively, in the IA group (P<.001). Internet access significantly shifted from an increasing intraocular pressure trend to a decreasing trend in the IA group (P=.002) among the patients who did not have any medication changes. Allowing patients to browse their medical data may reduce the use and improve the effectiveness of glaucoma medication. UMIN-CTR Clinical Trial Number

  20. An assessment of pregnant women's knowledge and use of the Internet for medication safety information and purchase.

    PubMed

    Sinclair, Marlene; Lagan, B M; Dolk, Helen; McCullough, Julie E M

    2017-09-07

    The aim of this study was to assess pregnant women's Internet searching activity about medication safety, knowledge and perceptions of medication risk and willingness to take prescribed and non-prescribed medication or make online medication purchases. Online medication advice for pregnant women is complex. The quality and veracity of this data is increasingly important as more midwives report women are bringing retrieved online information to clinical appointments. Pregnant women's use of the Internet for seeking medication advice and purchasing medications has not yet been fully investigated. Online survey conducted from January - March 2013. Of the 284 respondents, 39% were taking a medication when they became pregnant and 76% had searched the Internet for medication safety information. Analgesics were the most commonly searched category (41%). Health service sites were the most common online source and regarded as the most helpful and trusted. Regardless of age and education level, 90% of women agreed that if trying to become pregnant they would reconsider taking any medications because of the potential risk to their unborn baby. Forty-six percent of women with higher levels of education consider buying medication online as safe, a greater proportion than those of lower education. Five percent of women reported buying medication online. The lack of specific recommendations for medication use during pregnancy is challenging for healthcare staff and pregnant women who need robust evidence to make informed treatment decisions. The Internet is a recognized, commonly accessed, source of medication information for pregnant women. © 2017 John Wiley & Sons Ltd.

  1. Medical information on the internet: a tool for measuring consumer perception of quality aspects.

    PubMed

    Dubowicz, Arthur; Schulz, Peter J

    2015-03-30

    Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the "online-diagnosers" independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<.001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. The scale reliably distinguished high- and low-quality of medical advice given on websites.

  2. Medical Information on the Internet: A Tool for Measuring Consumer Perception of Quality Aspects

    PubMed Central

    2015-01-01

    Background Most of adult Internet users have searched for health information on the Internet. The Internet has become one of the most important sources for health information and treatment advice. In most cases, the information found is not verified with a medical doctor, but judged by the “online-diagnosers” independently. Facing this situation, public health authorities raise concern over the quality of medical information laypersons can find on the Internet. Objective The objective of the study was aimed at developing a measure to evaluate the credibility of websites that offer medical advice and information. The measure was tested in a quasi-experimental study on two sleeping-disorder websites of different quality. Methods There were 45 survey items for rating the credibility of websites that were tested in a quasi-experimental study with a random assignment of 454 participants to either a high- or a low-quality website exposure. Using principal component analysis, the original items were reduced to 13 and sorted into the factors: trustworthiness, textual deficits of the content, interferences (external links on the Web site), and advertisements. The first two factors focus more on the provided content itself, while the other two describe the embedding of the content into the website. The 45 survey items had been designed previously using exploratory observations and literature research. Results The final scale showed adequate power and reliability for all factors. The loadings of the principal component analysis ranged satisfactorily (.644 to .854). Significant differences at P<.001 were found between the low- and high-quality groups. Advertisements on the website were rated as disturbing in both experimental conditions, meaning that they do not differentiate between good and bad information. Conclusions The scale reliably distinguished high- and low-quality of medical advice given on websites. PMID:25835333

  3. Platform-independent software for medical image processing on the Internet

    NASA Astrophysics Data System (ADS)

    Mancuso, Michael E.; Pathak, Sayan D.; Kim, Yongmin

    1997-05-01

    We have developed a software tool for image processing over the Internet. The tool is a general purpose, easy to use, flexible, platform independent image processing software package with functions most commonly used in medical image processing.It provides for processing of medical images located wither remotely on the Internet or locally. The software was written in Java - the new programming language developed by Sun Microsystems. It was compiled and tested using Microsoft's Visual Java 1.0 and Microsoft's Just in Time Compiler 1.00.6211. The software is simple and easy to use. In order to use the tool, the user needs to download the software from our site before he/she runs it using any Java interpreter, such as those supplied by Sun, Symantec, Borland or Microsoft. Future versions of the operating systems supplied by Sun, Microsoft, Apple, IBM, and others will include Java interpreters. The software is then able to access and process any image on the iNternet or on the local computer. Using a 512 X 512 X 8-bit image, a 3 X 3 convolution took 0.88 seconds on an Intel Pentium Pro PC running at 200 MHz with 64 Mbytes of memory. A window/level operation took 0.38 seconds while a 3 X 3 median filter took 0.71 seconds. These performance numbers demonstrate the feasibility of using this software interactively on desktop computes. Our software tool supports various image processing techniques commonly used in medical image processing and can run without the need of any specialized hardware. It can become an easily accessible resource over the Internet to promote the learning and of understanding image processing algorithms. Also, it could facilitate sharing of medical image databases and collaboration amongst researchers and clinicians, regardless of location.

  4. Nazi Medical Experiment Report: Evidence from the Nuremberg Medical Trial. Teaching with Documents.

    ERIC Educational Resources Information Center

    Haverkamp, Beth; Schamel, Wynell

    1995-01-01

    Describes the historical background to the Nuremberg War Trials. Asserts that there is a wealth of evidence in the National Archives documenting atrocities committed by the Nazis. Presents primary source documents used in the Trials and provides seven suggested teaching strategies. (CFR)

  5. Medical Computing Law—The Way to Correct Medical Information and Documentation

    PubMed Central

    Beier, Bernd R.

    1983-01-01

    This presentation will report some reflections about “MEDICAL COMPUTING LAW.” The experience with practice in the field of computer application in medical care brought many problems with the law: E.G. privacy, data protection and data security problems, questions of contracting in hardware and software, use of computers in medicine, liability for medical computer decision making, etc. All these problems and questions call for a new view of law in the computer field, especially in the medical sector. So we decided to describe MEDICAL COMPUTING LAW as an interdisciplinary legal science with the function of integration of legal concepts.

  6. Understanding the mobile internet to develop the next generation of online medical teaching tools

    PubMed Central

    Christiano, Cynthia; Ferris, Maria

    2011-01-01

    Healthcare providers (HCPs) use online medical information for self-directed learning and patient care. Recently, the mobile internet has emerged as a new platform for accessing medical information as it allows mobile devices to access online information in a manner compatible with their restricted storage. We investigated mobile internet usage parameters to direct the future development of mobile internet teaching websites. Nephrology On-Demand Mobile (NODM) (http://www.nephrologyondemand.org) was made accessible to all mobile devices. From February 1 to December 31, 2010, HCP use of NODM was tracked using code inserted into the root files. Nephrology On-Demand received 15 258 visits, of which approximately 10% were made to NODM, with the majority coming from the USA. Most access to NODM was through the Apple iOS family of devices and cellular connections were the most frequently used. These findings provide a basis for the future development of mobile nephrology and medical teaching tools. PMID:21659443

  7. An ODA-based coder/decoder for multimedia medical documents.

    PubMed Central

    Marti, V.; Navio, J.; Salvador, C. H.; Pulido, N.; Muñoz, A.; Gonzalez, M. A.; Dueñas, A.

    1993-01-01

    This paper describes the prototype of a coder/decoder based on the Open Document Architecture (ODA) standard for management of medical documents, as well as the working environment in which it has been developed. The prototype has been assessed in an X-Windows-equipped workstation with a relational database containing patient folders (text and still images) from the departmental information system of the liver transplantation unit. PMID:8130599

  8. Translating medical documents improves students' communication skills in simulated physician-patient encounters.

    PubMed

    Bittner, Anja; Bittner, Johannes; Jonietz, Ansgar; Dybowski, Christoph; Harendza, Sigrid

    2016-02-27

    Patient-physician communication should be based on plain and simple language. Despite communication skill trainings in undergraduate medical curricula medical students and physicians are often still not aware of using medical jargon when communicating with patients. The aim of this study was to compare linguistic communication skills of undergraduate medical students who voluntarily translate medical documents into plain language with students who do not participate in this voluntary task. Fifty-nine undergraduate medical students participated in this study. Twenty-nine participants were actively involved in voluntarily translating medical documents for real patients into plain language on the online-platform https://washabich.de (WHI group) and 30 participants were not (non-WHI group). The assessment resembled a virtual consultation hour, where participants were connected via skype to six simulated patients (SPs). The SPs assessed participants' communication skills. All conversations were transcribed and assessed for communication skills and medical correctness by a blinded expert. All participants completed a self-assessment questionnaire on their communication skills. Across all raters, the WHI group was assessed significantly (p = .007) better than the non-WHI group regarding the use of plain language. The blinded expert assessed the WHI group significantly (p = .018) better regarding the use of stylistic devices of communication. The SPs would choose participants from the WHI group significantly (p = .041) more frequently as their personal physician. No significant differences between the two groups were observed with respect to the medical correctness of the consultations. Written translation of medical documents is associated with significantly more frequent use of plain language in simulated physician-patient encounters. Similar extracurricular exercises might be a useful tool for medical students to enhance their communication skills with

  9. Description of internet addiction among Chilean medical students: a cross-sectional study.

    PubMed

    Berner, Juan Enrique; Santander, Jaime; Contreras, Ana María; Gómez, Teresita

    2014-02-01

    Internet addiction (IA) has been described as an emerging behavior related to the development of new technologies, with scarce studies on the subject and none involving medical students. The Internet Addiction Test (IAT) is a screening instrument used to detect IA worldwide, which was published in 1998 and inspired by the DSM-IV criteria for pathologic gambling. The objective of this study aims to measure the prevalence of IA in Chilean medical students and its possible association with demographic variables and depressive symptoms. First- to fifth-year undergraduate medical students at a medical school in Santiago de Chile answered a self-administered survey that included demographic data, the IAT scale, and the Goldberg's General Health Questionnaire (GHQ-12) to screen for IA and depressive symptoms, respectively. Three hundred eighty-four students participated, achieving a response rate of 69.8 %, of which 11.5 % were classified as problematic users according to the IAT. The authors found a statistical association between positive results on the IAT and positive scores on the GHQ-12, as well as with the male gender. In this first study of IA in medical students, the authors found a rate of incidence similar to what has been published in the literature focusing on college students. Additionally, there was a positive association between emotional symptoms and other abuse behaviors.

  10. 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.

  11. Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment.

    PubMed

    Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun; Cha, Hyo Soung

    2015-10-01

    Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.

  12. Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment

    PubMed Central

    Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun

    2015-01-01

    Objectives Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. Methods This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. Results The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. Conclusions The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical

  13. The Use of the Internet in Geriatrics Education: Results of a National Survey of Medical Geriatrics Academic Programs

    ERIC Educational Resources Information Center

    Hajjar, Ihab M.; Ruiz, Jorge G.; Teasdale, Thomas A.; Mintzer, Michael J.

    2007-01-01

    In order to characterize use of the Internet in medical geriatrics education programs, 130 medical education programs in the U.S. that train medical students, interns, residents, fellows and practicing physicians were asked to complete a survey developed by the Consortium of E-Learning in Geriatrics Instruction (CELGI). Sixty-eight programs…

  14. The Use of the Internet in Geriatrics Education: Results of a National Survey of Medical Geriatrics Academic Programs

    ERIC Educational Resources Information Center

    Hajjar, Ihab M.; Ruiz, Jorge G.; Teasdale, Thomas A.; Mintzer, Michael J.

    2007-01-01

    In order to characterize use of the Internet in medical geriatrics education programs, 130 medical education programs in the U.S. that train medical students, interns, residents, fellows and practicing physicians were asked to complete a survey developed by the Consortium of E-Learning in Geriatrics Instruction (CELGI). Sixty-eight programs…

  15. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications.

    PubMed

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-06-01

    Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young's questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. More than 79.9% of students reported their general health good and very good. The student's mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. The good SRH of medical students was higher than general population but in health faculty' students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH.

  16. Expert consensus document: A consensus on the medical treatment of acromegaly.

    PubMed

    Giustina, Andrea; Chanson, Philippe; Kleinberg, David; Bronstein, Marcello D; Clemmons, David R; Klibanski, Anne; van der Lely, Aart J; Strasburger, Christian J; Lamberts, Steven W; Ho, Ken K Y; Casanueva, Felipe F; Melmed, Shlomo

    2014-04-01

    In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.

  17. The sensitivity of medical diagnostic decision-support knowledge bases in delineating appropriate terms to document in the medical record.

    PubMed

    Feldman, M J; Barnett, G O; Morgan, M M

    1991-01-01

    A pertinent, legible and complete medical record facilitates good patient care. The recording of the symptoms, signs and lab findings which are relevant to a patient's condition contributes importantly to the medical record. The consideration and documentation of other disease states known to be related to the patient's primary illness provide further enhancement. We propose that developing sets of disease-specific core elements which a physician may want to document in the medical record can have many benefits. We hypothesize that for a given disease, terms with high importance (TI) and frequency (TF) in the DX-plain, QMR and Iliad knowledge bases (KBs) are terms which are used commonly in the medical record, and may be, in fact, terms which physicians would find useful to document. A study was undertaken to validate ten such sets of disease-specific core elements. For each of ten prevalent diseases, high TI and TF terms from the three KBs mentioned were pooled to derive the set of core elements. For each disease, all patient records (range 385 to 16,972) from a computerized ambulatory medical record database were searched to document the actual use by physicians of each of these core elements. A significant percentage (range 50 to 86%) of each set of core elements was confirmed as being used by the physicians. In addition, all medical concepts from a selection of full text records were identified, and an average of 65% of the concepts were found to be core elements.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. The sensitivity of medical diagnostic decision-support knowledge bases in delineating appropriate terms to document in the medical record.

    PubMed Central

    Feldman, M. J.; Barnett, G. O.; Morgan, M. M.

    1991-01-01

    A pertinent, legible and complete medical record facilitates good patient care. The recording of the symptoms, signs and lab findings which are relevant to a patient's condition contributes importantly to the medical record. The consideration and documentation of other disease states known to be related to the patient's primary illness provide further enhancement. We propose that developing sets of disease-specific core elements which a physician may want to document in the medical record can have many benefits. We hypothesize that for a given disease, terms with high importance (TI) and frequency (TF) in the DX-plain, QMR and Iliad knowledge bases (KBs) are terms which are used commonly in the medical record, and may be, in fact, terms which physicians would find useful to document. A study was undertaken to validate ten such sets of disease-specific core elements. For each of ten prevalent diseases, high TI and TF terms from the three KBs mentioned were pooled to derive the set of core elements. For each disease, all patient records (range 385 to 16,972) from a computerized ambulatory medical record database were searched to document the actual use by physicians of each of these core elements. A significant percentage (range 50 to 86%) of each set of core elements was confirmed as being used by the physicians. In addition, all medical concepts from a selection of full text records were identified, and an average of 65% of the concepts were found to be core elements.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1807600

  19. [What language is your doctor speaking? Facing the problems of translating medical documents into English].

    PubMed

    Mićović, Dragoslava

    2013-01-01

    What is translation--a craft, an art, a profession or a job? Although one of the oldest human activities, translation has not still been fully defined, and it is still young in terms of an academic discipline. The paper defines the difference between translation and interpreting and then attempts to find the answer to the question what characteristics, knowledge and skills a translator must have, particularly the one involved in court translation, and where his/her place in the communication process (both written and oral communication) is. When translating medical documentation, a translator is set within a medical language environment as an intermediary between two doctors (in other words, two professionals) in the process of communication which would be impossible without him, since it is conducted in two different languages. The paper also gives an insight into types of medical documentation and who they are intended for. It gives practical examples of the problems faced in the course of translation of certain types of medical documentation (hospital discharge papers, diagnoses, case reports,...). Is it possible to make this kind of communication between professionals (doctors) standardized, which would subsequently make their translation easier? Although great efforts are made in Serbia regarding medical language and medical terminology, the conclusion is that specific problems encountered by translators can hardly be overcome using only dictionaries and translation manuals.

  20. Comparison of advance medical directive inquiry and documentation for hospital inpatients in three medical services: implications for policy changes.

    PubMed

    Anunobi, Echezona; Detweiler, Mark B; Sethi, Roopa; Thomas, Reena; Lutgens, Brian; Detweiler, Jonna G

    2015-01-01

    Following the introduction of the Patient Self-Determination Act of 1990, the Veterans Health Administration developed its own advance medical directive (AMD) policy, which most recently states that documentation is mandatory for all hospital patients in all settings. The object of this study was to assess the effectiveness of AMD documentation at a local Veterans Affairs Medical Center. AMD documentation was compared among three inpatient services: surgery, medicine, and psychiatry. Retrospective in nature, 594 inpatient cases were compared. Results revealed that, overall, the rate of AMD documentation was 37.7%. AMD documentation on surgery was statistically more frequent (45.6%) than for either medicine (33.2%) or psychiatry (34.5%). The difference between the numbers of days to AMD documentation for all three services was not statistically significant. While there was no statistically significant difference across gender, Caucasians had AMDs documented more frequently than African Americans (p < .001). Logistic regression reveals that social worker and physician intervention, not patient-specific variables, are the primary predictors of AMD incidence. Policy makers may need to consider the realities of hospital care, especially in emergency settings, and be more specific in the steps of implementation of the policy in the evenings, weekends, and holidays. True adherence to policy implementation may require hospital administrators to increase staff and educational efforts so that the concept of AMD communication and documentation is completely explained to all staff and patients. Policy should include an electronic record reminder that is renewed every 3 years and provisions for accommodating patients who arrive on weekends and holidays, with special awareness of the particular communication needs of minority groups. The study conclusions are that further inquiry is needed to understand these policy nuances to enable the Veterans Affairs Administration to

  1. Guidelines for medical and health information sites on the internet: principles governing AMA web sites. American Medical Association.

    PubMed

    Winker, M A; Flanagin, A; Chi-Lum, B; White, J; Andrews, K; Kennett, R L; DeAngelis, C D; Musacchio, R A

    Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.

  2. Digitization of Full-Text Documents Before Publishing on the Internet: A Case Study Reviewing the Latest Optical Character Recognition Technologies.

    ERIC Educational Resources Information Center

    McClean, Clare M.

    1998-01-01

    Reviews strengths and weaknesses of five optical character recognition (OCR) software packages used to digitize paper documents before publishing on the Internet. Outlines options available and stages of the conversion process. Describes the learning experience of Eurotext, a United Kingdom-based electronic libraries project (eLib). (PEN)

  3. Seeking Medical Information Using Mobile Apps and the Internet: Are Family Caregivers Different from the General Public?

    PubMed

    Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip

    2017-03-01

    Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.

  4. Hierarchical Medical System Based on Big Data and Mobile Internet: A New Strategic Choice in Health Care.

    PubMed

    Wang, Yaogang; Sun, Li; Hou, Jie

    2017-08-08

    China is setting up a hierarchical medical system to solve the problems of biased resource allocation and high patient flows to large hospitals. The development of big data and mobile Internet technology provides a new perspective for the establishment of hierarchical medical system. This viewpoint discusses the challenges with the hierarchical medical system in China and how big data and mobile Internet can be used to mitigate these challenges. ©Yaogang Wang, Li Sun, Jie Hou. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 08.08.2017.

  5. [New documentation sheet for medical examination due to exposures to dust].

    PubMed

    Hagemeyer, O; Mannes, E; Koppisch, D; Otten, H; Dahmann, D

    2004-05-01

    With beginning of the year 2004 a new documentation sheet for occupational preventive medical examinations according to exposures to mineral dust (quartz, asbestos, ceramic fibres) will replace the existing sheet. The new investigation sheet is presented in this publication and changes are described.

  6. Association between Internet addiction and depression in Thai medical students at Faculty of Medicine, Ramathibodi Hospital

    PubMed Central

    Boonvisudhi, Thummaporn

    2017-01-01

    Objective To study the extent of Internet addiction (IA) and its association with depression in Thai medical students. Methods A cross-sectional study was conducted at Faculty of Medicine, Ramathibodi Hospital. Participants were first- to fifth-year medical students who agreed to participate in this study. Demographic characteristics and stress-related factors were derived from self-rated questionnaires. Depression was assessed using the Thai version of Patient Health Questionnaire (PHQ-9). A total score of five or greater derived from the Thai version of Young Diagnostic Questionnaire for Internet Addiction was classified as “possible IA”. Then chi-square test and logistic regression were used to evaluate the associations between possible IA, depression and associated factors. Results From 705 participants, 24.4% had possible IA and 28.8% had depression. There was statistically significant association between possible IA and depression (odds ratio (OR) 1.92, 95% confidence interval (CI): 1.34–2.77, P-value <0.001). Logistic regression analysis illustrated that the odds of depression in possible IA group was 1.58 times of the group of normal Internet use (95% CI: 1.04–2.38, P-value = 0.031). Academic problems were found to be a significant predictor of both possible IA and depression. Conclusion IA was likely to be a common psychiatric problem among Thai medical students. The research has also shown that possible IA was associated with depression and academic problems. We suggest that surveillance of IA should be considered in medical schools. PMID:28319167

  7. Association between Internet addiction and depression in Thai medical students at Faculty of Medicine, Ramathibodi Hospital.

    PubMed

    Boonvisudhi, Thummaporn; Kuladee, Sanchai

    2017-01-01

    To study the extent of Internet addiction (IA) and its association with depression in Thai medical students. A cross-sectional study was conducted at Faculty of Medicine, Ramathibodi Hospital. Participants were first- to fifth-year medical students who agreed to participate in this study. Demographic characteristics and stress-related factors were derived from self-rated questionnaires. Depression was assessed using the Thai version of Patient Health Questionnaire (PHQ-9). A total score of five or greater derived from the Thai version of Young Diagnostic Questionnaire for Internet Addiction was classified as "possible IA". Then chi-square test and logistic regression were used to evaluate the associations between possible IA, depression and associated factors. From 705 participants, 24.4% had possible IA and 28.8% had depression. There was statistically significant association between possible IA and depression (odds ratio (OR) 1.92, 95% confidence interval (CI): 1.34-2.77, P-value <0.001). Logistic regression analysis illustrated that the odds of depression in possible IA group was 1.58 times of the group of normal Internet use (95% CI: 1.04-2.38, P-value = 0.031). Academic problems were found to be a significant predictor of both possible IA and depression. IA was likely to be a common psychiatric problem among Thai medical students. The research has also shown that possible IA was associated with depression and academic problems. We suggest that surveillance of IA should be considered in medical schools.

  8. Natural Language Processing Versus Content-Based Image Analysis for Medical Document Retrieval

    PubMed Central

    Névéol, Aurélie; Deserno, Thomas M.; Darmoni, Stéfan J.; Güld, Mark Oliver; Aronson, Alan R.

    2009-01-01

    One of the most significant recent advances in health information systems has been the shift from paper to electronic documents. While research on automatic text and image processing has taken separate paths, there is a growing need for joint efforts, particularly for electronic health records and biomedical literature databases. This work aims at comparing text-based versus image-based access to multimodal medical documents using state-of-the-art methods of processing text and image components. A collection of 180 medical documents containing an image accompanied by a short text describing it was divided into training and test sets. Content-based image analysis and natural language processing techniques are applied individually and combined for multimodal document analysis. The evaluation consists of an indexing task and a retrieval task based on the “gold standard” codes manually assigned to corpus documents. The performance of text-based and image-based access, as well as combined document features, is compared. Image analysis proves more adequate for both the indexing and retrieval of the images. In the indexing task, multimodal analysis outperforms both independent image and text analysis. This experiment shows that text describing images can be usefully analyzed in the framework of a hybrid text/image retrieval system. PMID:19633735

  9. Natural Language Processing Versus Content-Based Image Analysis for Medical Document Retrieval.

    PubMed

    Névéol, Aurélie; Deserno, Thomas M; Darmoni, Stéfan J; Güld, Mark Oliver; Aronson, Alan R

    2008-09-18

    One of the most significant recent advances in health information systems has been the shift from paper to electronic documents. While research on automatic text and image processing has taken separate paths, there is a growing need for joint efforts, particularly for electronic health records and biomedical literature databases. This work aims at comparing text-based versus image-based access to multimodal medical documents using state-of-the-art methods of processing text and image components. A collection of 180 medical documents containing an image accompanied by a short text describing it was divided into training and test sets. Content-based image analysis and natural language processing techniques are applied individually and combined for multimodal document analysis. The evaluation consists of an indexing task and a retrieval task based on the "gold standard" codes manually assigned to corpus documents. The performance of text-based and image-based access, as well as combined document features, is compared. Image analysis proves more adequate for both the indexing and retrieval of the images. In the indexing task, multimodal analysis outperforms both independent image and text analysis. This experiment shows that text describing images can be usefully analyzed in the framework of a hybrid text/image retrieval system.

  10. Increased adolescent overweight and obesity documentation through a simple electronic medical record intervention.

    PubMed

    Bode, David V; Roberts, Timothy A; Johnson, Christine

    2013-01-01

    The purpose of this project was to improve provider documentation of adolescent overweight and obesity through body mass index percentile (BMI%) documentation in the military's electronic medical record (EMR). Using the FOCUS-PDCA (Find-Organize-Clarify-Understand-Select-Plan-Do-Check-Act) model, we developed an intervention to improve rates of diagnosis of overweight/obesity in our adolescent medicine clinic. Medical technicians documented the patient's BMI% and growth chart in the EMR. Pre- and postintervention chart reviews of approximately 300 consecutive patient encounters compared the rates of overweight/obesity with provider-documented diagnosis. A total of 333 pre- and 328 postintervention clinic encounters were reviewed. The rate of obesity calculated was similar between pre- and postintervention groups (30% vs. 31%). Correct diagnosis increased from 40% to 64% after the intervention. Females and patients seen by resident physicians were less likely to receive a correct diagnosis at baseline, but these differences were mitigated in the postintervention group. In multivariate analyses, only the intervention and provider type were predictive of an improvement in correct diagnosis. BMI% documentation in our EMR was an effective way to improve documentation of overweight/obese adolescent patients and may be particularly helpful for resident physicians.

  11. A pilot study of the impact of an educational intervention aimed at improving medical record documentation.

    PubMed

    Farzandipour, M; Meidani, Z; Rangraz Jeddi, F; Gilasi, H; Shokrizadeh Arani, L; Fakharian, E; Saddik, B

    2013-01-01

    Studies have shown the importance of medical staff education in improving chart documentation and accuracy of medical coding. This study aimed to examine the effect of an educational intervention on recording medical diagnoses among a sample of medical residents based at Kashan University of Medical Sciences. This pilot study was conducted in 2010 and involved 19 residents in different specialties (internal medicine, obstetrics and gynecology, and surgery). Guidelines for recording diagnostic information related to surgery, obstetrics and internal medicine were taught at a five-hour lecture. Five medical records from each resident from before and after the educational intervention were assessed using a checklist based on relevant diagnostic information related to each discipline. Data were analysed using a paired t-test and Wilcoxson signed rank test. There was no improvement in the quality and accuracy of the recording of obstetric diagnoses (type, place, outcome and complications of delivery) after the training. There was also no effect on the documentation of underlying causes and clinical manifestations of disease by internal medicine and surgery residents (p=0.285 and p=0.584, respectively). The single education session did not improve recording of diagnoses among residents. The gathering and recording of complete, accurate and high quality medical records requires interaction between the hospital management, health information management professionals and healthcare providers. It is therefore essential to develop a more sophisticated portfolio of strategies that involves these key stakeholders.

  12. Systemic lupus erythematosus and cardiac risk factors: medical record documentation and patient adherence.

    PubMed

    Bengtsson, C; Bengtsson, Aa; Costenbader, Kh; Jönsen, A; Rantapää-Dahlqvist, S; Sturfelt, G; Nived, O

    2011-10-01

    This study explores patients' knowledge of cardiac risk factors (CRFs), analyses how information and advice about CRFs are documented in clinical practice, and assesses patient adherence to received instructions to decrease CRFs. Systemic lupus erythematosus (SLE) patients with ≥ 4 ACR criteria participated through completing a validated cardiovascular health questionnaire (CHQ). Kappa statistics were used to compare medical records with the self-reported CHQ (agreement) and to evaluate adherence. Two hundred and eleven (72%) of the known patients with SLE participated. The mean age of the patients was 55 years. More than 70% of the SLE patients considered hypertension, obesity, smoking and hypercholesterolaemia to be very important CRFs. The agreement between medical record documentation and patients' reports was moderate for hypertension, overweight and hypercholesterolaemia (kappa 0.42-0.60) but substantial for diabetes (kappa 0.66). Patients' self-reported adherence to advice they had received regarding medication was substantial to perfect (kappa 0.65-1.0). For lifestyle changes in patients with hypertension and overweight, adherence was only fair to moderate (kappa 0.13-0.47). Swedish SLE patients' awareness of traditional CRFs was good in this study. However, the agreement between patients' self-reports and medical record documentation of CRF profiles, and patients' adherence to medical advice to CRF profiles, could be improved.

  13. Enabling joint commission medication reconciliation objectives with the HL7 / ASTM Continuity of Care Document standard.

    PubMed

    Dolin, Robert H; Giannone, Gay; Schadow, Gunther

    2007-10-11

    We sought to determine how well the HL7/ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common source of medication errors. These transition points are the focus of communication standards, suggesting that CCD can support and enable medication related patient safety initiatives. Data elements needed to support the Joint Commission recommendations were identified and mapped to CCD, and a detailed clinical scenario was constructed. The mapping identified minor gaps, and identified fields present in CCD not specifically identified by Joint Commission, but useful nonetheless when managing medications across transitions of care, suggesting that a closer collaboration between the Joint Commission and standards organizations will be mutually beneficial. The nationally recognized CCD specification provides a standards-based solution for enabling Joint Commission medication reconciliation objectives.

  14. Enabling Joint Commission Medication Reconciliation Objectives with the HL7 / ASTM Continuity of Care Document Standard

    PubMed Central

    Dolin, Robert H.; Giannone, Gay; Schadow, Gunther

    2007-01-01

    We sought to determine how well the HL7 / ASTM Continuity of Care Document (CCD) standard supports the requirements underlying the Joint Commission medication reconciliation recommendations. In particular, the Joint Commission emphasizes that transition points in the continuum of care are vulnerable to communication breakdowns, and that these breakdowns are a common source of medication errors. These transition points are the focus of communication standards, suggesting that CCD can support and enable medication related patient safety initiatives. Data elements needed to support the Joint Commission recommendations were identified and mapped to CCD, and a detailed clinical scenario was constructed. The mapping identified minor gaps, and identified fields present in CCD not specifically identified by Joint Commission, but useful nonetheless when managing medications across transitions of care, suggesting that a closer collaboration between the Joint Commission and standards organizations will be mutually beneficial. The nationally recognized CCD specification provides a standards-based solution for enabling Joint Commission medication reconciliation objectives. PMID:18693823

  15. Documentation of Contraception and Pregnancy When Prescribing Potentially Teratogenic Medications for Reproductive-Age Women

    PubMed Central

    Schwarz, Eleanor Bimla; Postlethwaite, Debbie A.; Hung, Yun-Yi; Armstrong, Mary Anne

    2010-01-01

    Background Certain medications are identified by the U.S. Food and Drug Administration (FDA) as class D or X because they increase the risk for birth defects if used during pregnancy. Objective To assess pregnancy rates and the frequency of contraceptive counseling documented with prescriptions for class D or X drugs filled by women of reproductive age. Design Description of prescriptions filled in 2001. Setting A large health maintenance organization in northern California in 2001. Patients 488 175 women age 15 to 44 years who filled a total of 1 011 658 class A, B, D, or X prescriptions. Measurements Medications dispensed, contraceptive counseling, and pregnancy testing. Results A class D or X prescription was filled by 1 of every 6 women studied. Women who filled a prescription for class D or X medications were no more likely than women who filled prescriptions for safer, class A or B medications to have received contraceptive counseling, filled a contraceptive prescription, or been sterilized (48% vs. 51% of prescriptions). There was little variation by clinical indication in rates of contraceptive counseling with class D or X prescriptions, except for isotretinoin. Women who filled a class D or X prescription were only slightly less likely to have a pregnancy documented within 3 months than women filling a class A or B prescription (1.0% vs. 1.4% of prescriptions). Limitations International Classification of Diseases, Ninth Revision, codes underestimate contraceptive counseling. Documentation of a positive pregnancy test after filling a prescription may overestimate medication use in early pregnancy. Women who filled several prescriptions are overrepresented in prescription analyses. Conclusion Prescriptions for potentially teratogenic medications are frequently filled by women of childbearing age without documentation of contraceptive counseling. PMID:17876020

  16. Evacuation support system for improved medical documentation and information flow in the field.

    PubMed

    Walderhaug, Ståle; Meland, Per Håkon; Mikalsen, Marius; Sagen, Terje; Brevik, John Ivar

    2008-02-01

    Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care

  17. Wearable Devices in Medical Internet of Things: Scientific Research and Commercially Available Devices

    PubMed Central

    Thurow, Kerstin; Stoll, Regina

    2017-01-01

    Objectives Wearable devices are currently at the heart of just about every discussion related to the Internet of Things. The requirement for self-health monitoring and preventive medicine is increasing due to the projected dramatic increase in the number of elderly people until 2020. Developed technologies are truly able to reduce the overall costs for prevention and monitoring. This is possible by constantly monitoring health indicators in various areas, and in particular, wearable devices are considered to carry this task out. These wearable devices and mobile apps now have been integrated with telemedicine and telehealth efficiently, to structure the medical Internet of Things. This paper reviews wearable health care devices both in scientific papers and commercial efforts. Methods MIoT is demonstrated through a defined architecture design, including hardware and software dealing with wearable devices, sensors, smart phones, medical application, and medical station analyzers for further diagnosis and data storage. Results Wearables, with the help of improved technology have been developed greatly and are considered reliable tools for long-term health monitoring systems. These are applied in the observation of a large variety of health monitoring indicators in the environment, vital signs, and fitness. Conclusions Wearable devices are now used for a wide range of healthcare observation. One of the most important elements essential in data collection is the sensor. During recent years with improvement in semiconductor technology, sensors have made investigation of a full range of parameters closer to realization. PMID:28261526

  18. Medical validation and CBIR of spine x-ray images over the Internet

    NASA Astrophysics Data System (ADS)

    Antani, Sameer; Cheng, Jing; Long, Jonathan; Long, L. Rodney; Thoma, George R.

    2006-01-01

    As found in the literature, most Internet-based prototype Content-Based Image Retrieval (CBIR) systems focus on stock photo collections and do not address challenges of large specialized image collections and topics such as medical information retrieval by image content. Even fewer have medically validated data to evaluate retrieval quality in terms of precision and relevance. To date, our research has reported over 75% relevant spine X-ray image retrieval tested on 888 validated vertebral shapes from 207 images using our prototype CBIR system operating within our local network. As a next step, we have designed and developed an Internet-based medical validation tool and a CBIR retrieval tool in MATLAB and JAVA that can remotely connect to our database. The retrieval tool supports hybrid text and image queries and also provides partial shape annotation for pathology-specific querying. These tools are initially developed for domain experts, such as radiologists and educators, to identify design issues for improved workflow. This article describes the tools and design considerations in their development.

  19. Wearable Devices in Medical Internet of Things: Scientific Research and Commercially Available Devices.

    PubMed

    Haghi, Mostafa; Thurow, Kerstin; Stoll, Regina

    2017-01-01

    Wearable devices are currently at the heart of just about every discussion related to the Internet of Things. The requirement for self-health monitoring and preventive medicine is increasing due to the projected dramatic increase in the number of elderly people until 2020. Developed technologies are truly able to reduce the overall costs for prevention and monitoring. This is possible by constantly monitoring health indicators in various areas, and in particular, wearable devices are considered to carry this task out. These wearable devices and mobile apps now have been integrated with telemedicine and telehealth efficiently, to structure the medical Internet of Things. This paper reviews wearable health care devices both in scientific papers and commercial efforts. MIoT is demonstrated through a defined architecture design, including hardware and software dealing with wearable devices, sensors, smart phones, medical application, and medical station analyzers for further diagnosis and data storage. Wearables, with the help of improved technology have been developed greatly and are considered reliable tools for long-term health monitoring systems. These are applied in the observation of a large variety of health monitoring indicators in the environment, vital signs, and fitness. Wearable devices are now used for a wide range of healthcare observation. One of the most important elements essential in data collection is the sensor. During recent years with improvement in semiconductor technology, sensors have made investigation of a full range of parameters closer to realization.

  20. Applying Multiple Methods to Assess the Readability of a Large Corpus of Medical Documents

    PubMed Central

    Wu, Danny T.Y.; Hanauer, David A.; Mei, Qiaozhu; Clark, Patricia M.; An, Lawrence C.; Lei, Jianbo; Proulx, Joshua; Zeng-Treitler, Qing; Zheng, Kai

    2017-01-01

    Medical documents provided to patients at the end of an episode of care, such as discharge summaries and referral letters, serve as an important vehicle to convey critical information to patients and families. Increasingly, healthcare institutions are also experimenting with granting patients direct electronic access to other types of clinical narratives that are not typically shared unless explicitly requested, such as progress notes. While these efforts have great potential to improve information transparency, their value can be severely diminished if patients are unable to read and thus unable to properly interpret the medical documents shared to them. In this study, we approached the problem by contrasting the ‘readability’ of two types of medical documents: referral letters vs. other genres of narrative clinician notes not explicitly intended for direct viewing by patients. To establish a baseline for comparison, we also computed readability scores of MedlinePlus articles—exemplars of fine patient education materials carefully crafted for lay audiences. We quantified document readability using four different measures. Differences in the results obtained through these measures are also discussed. PMID:23920636

  1. Cyberchondria and intolerance of uncertainty: examining when individuals experience health anxiety in response to Internet searches for medical information.

    PubMed

    Fergus, Thomas A

    2013-10-01

    Individuals frequently use the Internet to search for medical information. However, for some individuals, searching for medical information on the Internet is associated with an exacerbation of health anxiety. Researchers have termed this phenomenon as cyberchondria. The present research sought to shed further light onto the phenomenology of cyberchondria. In particular, the moderating effect of intolerance of uncertainty (IU) on the relationship between the frequency of Internet searches for medical information and health anxiety was examined using a large sample of medically healthy community adults located in the United States (N=512). The purported moderating effect of IU was supported. More specifically, the relationship between the frequency of Internet searches for medical information and health anxiety grew increasingly stronger as IU increased. This moderating effect of IU was not attributable to general distress. These results suggest that IU is important for better understanding the exacerbation of health anxiety in response to Internet searches for medical information. Conceptual and therapeutic implications of these results are discussed.

  2. Factors Associated with Word Memory Test Performance in Persons with Medically Documented Traumatic Brain Injury.

    PubMed

    Sherer, Mark; Davis, Lynne C; Sander, Angelle M; Nick, Todd G; Luo, Chunqiao; Pastorek, Nicholas; Hanks, Robin

    2015-01-01

    (1) To examine the rate of poor performance validity in a large, multicenter, prospectively accrued cohort of community dwelling persons with medically documented traumatic brain injury (TBI), (2) to identify factors associated with Word Memory Test (WMT) performance in persons with TBI. This was a prospective cohort, observational study of 491 persons with medically documented TBI. Participants were administered a battery of cognitive tests, questionnaires on emotional distress and post-concussive symptoms, and a performance validity test (WMT). Additional data were collected by interview and review of medical records. One hundred and seventeen participants showed poor performance validity using the standard cutoff. Variable cluster analysis was conducted as a data reduction strategy. Findings revealed that the 10 cognitive tests and questionnaires could be summarized as 4 indices of emotional distress, speed of cognitive processing, verbal memory, and verbal fluency. Regression models revealed that verbal memory, emotional distress, age, and injury severity (time to follow commands) made unique contribution to prediction of poor performance validity. Poor performance validity was common in a research sample of persons with medically documented TBI who were not evaluated in conjunction with litigation, compensation claims, or current report of symptoms. Poor performance validity was associated with poor performance on cognitive tests, greater emotional distress, lower injury severity, and greater age. Many participants expected to have residual deficits based on initial injury severity showed poor performance validity.

  3. The differing privacy concerns regarding exchanging electronic medical records of internet users in Taiwan.

    PubMed

    Hwang, Hsin-Ginn; Han, Hwai-En; Kuo, Kuang-Ming; Liu, Chung-Feng

    2012-12-01

    This study explores whether Internet users have different privacy concerns regarding the information contained in electronic medical records (EMRs) according to gender, age, occupation, education, and EMR awareness. Based on the Concern for Information Privacy (CFIP) scale developed by Smith and colleagues in 1996, we conducted an online survey using 15 items in four dimensions, namely, collection, unauthorized access, secondary use, and errors, to investigate Internet users' concerns regarding the privacy of EMRs under health information exchanges (HIE). We retrieved 213 valid questionnaires. The results indicate that the respondents had substantial privacy concerns regarding EMRs and their educational level and EMR awareness significantly influenced their privacy concerns regarding unauthorized access and secondary use of EMRs. This study recommends that the Taiwanese government organizes a comprehensive EMR awareness campaign, emphasizing unauthorized access and secondary use of EMRs. Additionally, to cultivate the public's understanding of EMRs, the government should employ various media, especially Internet channels, to promote EMR awareness, thereby enabling the public to accept the concept and use of EMRs. People who are highly educated and have superior EMR awareness should be given a comprehensive explanation of how hospitals protect patients' EMRs from unauthorized access and secondary use to address their concerns. Thus, the public can comprehend, trust, and accept the use of EMRs, reducing their privacy concerns, which should facilitate the future implementation of HIE.

  4. Using Internet search engines to obtain medical information: a comparative study.

    PubMed

    Wang, Liupu; Wang, Juexin; Wang, Michael; Li, Yong; Liang, Yanchun; Xu, Dong

    2012-05-16

    The Internet has become one of the most important means to obtain health and medical information. It is often the first step in checking for basic information about a disease and its treatment. The search results are often useful to general users. Various search engines such as Google, Yahoo!, Bing, and Ask.com can play an important role in obtaining medical information for both medical professionals and lay people. However, the usability and effectiveness of various search engines for medical information have not been comprehensively compared and evaluated. To compare major Internet search engines in their usability of obtaining medical and health information. We applied usability testing as a software engineering technique and a standard industry practice to compare the four major search engines (Google, Yahoo!, Bing, and Ask.com) in obtaining health and medical information. For this purpose, we searched the keyword breast cancer in Google, Yahoo!, Bing, and Ask.com and saved the results of the top 200 links from each search engine. We combined nonredundant links from the four search engines and gave them to volunteer users in an alphabetical order. The volunteer users evaluated the websites and scored each website from 0 to 10 (lowest to highest) based on the usefulness of the content relevant to breast cancer. A medical expert identified six well-known websites related to breast cancer in advance as standards. We also used five keywords associated with breast cancer defined in the latest release of Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) and analyzed their occurrence in the websites. Each search engine provided rich information related to breast cancer in the search results. All six standard websites were among the top 30 in search results of all four search engines. Google had the best search validity (in terms of whether a website could be opened), followed by Bing, Ask.com, and Yahoo!. The search results highly overlapped between the

  5. A model for indexing medical documents combining statistical and symbolic knowledge.

    PubMed

    Avillach, Paul; Joubert, Michel; Fieschi, Marius

    2007-10-11

    To develop and evaluate an information processing method based on terminologies, in order to index medical documents in any given documentary context. We designed a model using both symbolic general knowledge extracted from the Unified Medical Language System (UMLS) and statistical knowledge extracted from a domain of application. Using statistical knowledge allowed us to contextualize the general knowledge for every particular situation. For each document studied, the extracted terms are ranked to highlight the most significant ones. The model was tested on a set of 17,079 French standardized discharge summaries (SDSs). The most important ICD-10 term of each SDS was ranked 1st or 2nd by the method in nearly 90% of the cases. The use of several terminologies leads to more precise indexing. The improvement achieved in the models implementation performances as a result of using semantic relationships is encouraging.

  6. A Model for Indexing Medical Documents Combining Statistical and Symbolic Knowledge.

    PubMed Central

    Avillach, Paul; Joubert, Michel; Fieschi, Marius

    2007-01-01

    OBJECTIVES: To develop and evaluate an information processing method based on terminologies, in order to index medical documents in any given documentary context. METHODS: We designed a model using both symbolic general knowledge extracted from the Unified Medical Language System (UMLS) and statistical knowledge extracted from a domain of application. Using statistical knowledge allowed us to contextualize the general knowledge for every particular situation. For each document studied, the extracted terms are ranked to highlight the most significant ones. The model was tested on a set of 17,079 French standardized discharge summaries (SDSs). RESULTS: The most important ICD-10 term of each SDS was ranked 1st or 2nd by the method in nearly 90% of the cases. CONCLUSIONS: The use of several terminologies leads to more precise indexing. The improvement achieved in the model’s implementation performances as a result of using semantic relationships is encouraging. PMID:18693792

  7. Secure Internet video conferencing for assessing acute medical problems in a nursing facility.

    PubMed

    Weiner, M; Schadow, G; Lindbergh, D; Warvel, J; Abernathy, G; Dexter, P; McDonald, C J

    2001-01-01

    Although video-based teleconferencing is becoming more widespread in the medical profession, especially for scheduled consultations, applications for rapid assessment of acute medical problems are rare. Use of such a video system in a nursing facility may be especially beneficial, because physicians are often not immediately available to evaluate patients. We have assembled and tested a portable, wireless conferencing system to prepare for a randomized trial of the system s influence on resource utilization and satisfaction. The system includes a rolling cart with video conferencing hardware and software, a remotely controllable digital camera, light, wireless network, and battery. A semi-automated paging system informs physicians of patient s study status and indications for conferencing. Data transmission occurs wirelessly in the nursing home and then through Internet cables to the physician s home. This provides sufficient bandwidth to support quality motion images. IPsec secures communications. Despite human and technical challenges, this system is affordable and functional.

  8. Secure Internet video conferencing for assessing acute medical problems in a nursing facility.

    PubMed Central

    Weiner, M.; Schadow, G.; Lindbergh, D.; Warvel, J.; Abernathy, G.; Dexter, P.; McDonald, C. J.

    2001-01-01

    Although video-based teleconferencing is becoming more widespread in the medical profession, especially for scheduled consultations, applications for rapid assessment of acute medical problems are rare. Use of such a video system in a nursing facility may be especially beneficial, because physicians are often not immediately available to evaluate patients. We have assembled and tested a portable, wireless conferencing system to prepare for a randomized trial of the system s influence on resource utilization and satisfaction. The system includes a rolling cart with video conferencing hardware and software, a remotely controllable digital camera, light, wireless network, and battery. A semi-automated paging system informs physicians of patient s study status and indications for conferencing. Data transmission occurs wirelessly in the nursing home and then through Internet cables to the physician s home. This provides sufficient bandwidth to support quality motion images. IPsec secures communications. Despite human and technical challenges, this system is affordable and functional. Images Figure 1 PMID:11825286

  9. Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia

    PubMed Central

    Klinar, Ivana; Balažin, Ana; Baršić, Bruno; Tiljak, Hrvoje

    2011-01-01

    Aim To identify users’ reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service ‘Your Questions.’ Methods Users of a free internet medical consultation service ‘Your Questions’ (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). Results The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, P < 0.001). Conclusion The factors associated with the use of internet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician’s office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults. PMID:21853551

  10. Identification of general characteristics, motivation, and satisfaction of internet-based medical consultation service users in Croatia.

    PubMed

    Klinar, Ivana; Balazin, Ana; Barsić, Bruno; Tiljak, Hrvoje

    2011-08-15

    To identify users' reasons to look for physician consultation on the internet instead of visiting a physician and to explore their general characteristics, motivation, and satisfaction with internet medical consultation service 'Your Questions.' Users of a free internet medical consultation service 'Your Questions' (www.plivazdravlje.hr) were invited to participate in a web-based survey designed to explore their general characteristics (age, sex, etc), reasons for using the service, the nature of their health problem or question, and their satisfaction with the service. Respondents were divided into two groups: users who consulted an internet physician only (Group I) and users who used internet consulting before or after visiting a physician (Group II). The response rate was 38% (1036/2747), with 79% female respondents. A fifth of the respondents (21%) consulted an internet physician only (Group I). Multivariate analysis revealed that the respondents in Group I were younger (median 24 vs 28 years in Group II), more interested into questions about pregnancy (odds ratio [OR], 1.984; 95% confidence interval [CI], 1.203-3.272), more often embarrassed to talk to a physician in person (OR, 1.828; 95% CI, 1.119-2.989), and more motivated to protect their privacy (OR, 1.727; 95% CI, 1.252-2.380). They also had greater satisfaction with the service (77% vs 60%, P<0.001). The factors associated with the use of internet-based medical consultation services were younger age, need for privacy protection, avoidance of embarrassment at the physician's office, and having a question related to pregnancy. This reveals the internet medical consultation service as a useful health promotion supplement that is particularly applicable for the population of young adults.

  11. [English translation of the title of ancient Chinese medical books and documents].

    PubMed

    Zeng, Fang; Shao, Xin; Zhang, Pei-Hai

    2008-11-01

    The title of a book is, generally, the high concentration of the writer's intention and the theme of content. Translate the title of an ancient Chinese medical book or document accurately and plainly is meaningful for exhibiting the style of the book, also for promoting the international communication of TCM. The principle should be followed is to choose the translating terms accurately to reveal the theme of content and express the cultural connotation of the book perfectly.

  12. Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

    PubMed

    Laws, A; Patsalides, B

    1997-01-01

    Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

  13. 75 FR 64749 - Request for Comments on the Use of Electronic Signatures for NRC Documents Related to the Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-20

    ... the use of electronic signatures on documents related to the medical use of byproduct material which... COMMISSION Request for Comments on the Use of Electronic Signatures for NRC Documents Related to the Medical Use of Byproduct Material Maintained at Licensees' Facilities AGENCY: Nuclear Regulatory...

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

    PubMed Central

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

    2008-01-01

    Background Comorbidity is an important adjustment measure in research focusing on outcomes such as health status and mortality. One recurrent methodological issue concerns the concordance of comorbidity data obtained from different reporting sources. The purpose of these prospectively planned analyses was to examine the concordance of comorbidity data obtained from patient self-report survey interviews and hospital medical record documentation. Methods Comorbidity data were obtained using survey interviews and medical record entries from 525 hospitalized Acute Coronary Syndrome patients. Frequencies and descriptive statistics of individual and composite comorbidity data from both sources were completed. Individual item agreement was evaluated with simple and weighted kappas, Spearman Rho coefficients for composite scores. Results On average, patients reported more comorbidities during their patient survey interviews (mean = 1.78, SD = 1.99) than providers had documented in medical records (mean = 1.27, SD = 1.43). Higher proportions of positive responses were obtained from self-reports compared to medical records for all conditions except congestive heart failure and renal disease. Older age and higher depressive symptom levels were significantly associated with poorer levels of data concordance. Conclusion These results demonstrate that survey comorbidity data from ACS patients may not be entirely concordat with medical record documentation. In the absence of a gold standard, it is possible that hospital records did not include all pre-admission comorbidities and these patient survey interview methods may need to be refined. Self-report methods to facilitate some patients' complete recall of comorbid conditions may need to be refined by health services researchers. Trial Registration ClinicalTrials.gov NCT00416026. PMID:18416841

  15. Some Benchmark Searches for Testing Search Capabilities and Medical Coverage of Internet Discovery Tools

    PubMed Central

    2000-01-01

    The past few years have seen a proliferation of search engines for the World Wide Web (WWW), as well as a growing number of specialized subject directories geared to the needs of health care professionals. Yet documentation on scope, coverage, and search features is often uneven at best; and even documented search features may not perform as advertised. This paper will present a group of sample searches to assist users in gauging database size, determining default search operators, and testing for the presence of advanced search features such as case sensitivity, stemming, and concept mapping for medical topics on English-language web sites. PMID:11720942

  16. Some benchmark searches for testing search capabilities and medical coverage of internet discovery tools.

    PubMed

    Johnson, E D

    2000-01-01

    The past few years have seen a proliferation of search engines for the World Wide Web (WWW), as well as a growing number of specialized subject directories geared to the needs of health care professionals. Yet documentation on scope, coverage, and search features is often uneven at best; and even documented search features may not perform as advertised. This paper will present a group of sample searches to assist users in gauging database size, determining default search operators, and testing for the presence of advanced search features such as case sensitivity, stemming, and concept mapping for medical topics on English-language web sites.

  17. Use of incident reports by physicians and nurses to document medical errors in pediatric patients.

    PubMed

    Taylor, James A; Brownstein, Dena; Christakis, Dimitri A; Blackburn, Susan; Strandjord, Thomas P; Klein, Eileen J; Shafii, Jaleh

    2004-09-01

    To describe the proportion and types of medical errors that are stated to be reported via incident report systems by physicians and nurses who care for pediatric patients and to determine attitudes about potential interventions for increasing error reports. A survey on use of incident reports to document medical errors was sent to a random sample of 200 physicians and nurses at a large children's hospital. Items on the survey included proportion of medical errors that were reported, reasons for underreporting medical errors, and attitudes about potential interventions for increasing error reports. In addition, the survey contained scenarios about hypothetical medical errors; the physicians and nurses were asked how likely they were to report each of the events described. Differences in use of incident reports for documenting medical errors between nurses and physicians were assessed with chi(2) tests. Logistic regression was used to determine the association between health care profession type and likelihood of reporting medical errors. A total of 140 surveys were returned, including 74 from physicians and 66 by nurses. Overall, 34.8% of respondents indicated that they had reported <20% of their perceived medical errors in the previous 12 months, and 32.6% had reported <40% of perceived errors committed by colleagues. After controlling for potentially confounding variables, nurses were significantly more likely to report >or=80% of their own medical errors than physicians (odds ratio: 2.8; 95% confidence interval: 1.3-6.0). Commonly listed reasons for underreporting included lack of certainty about what is considered an error (indicated by 40.7% of respondents) and concerns about implicating others (37%). Potential interventions that would lead to increased reporting included education about which errors should be reported (listed by 65.4% of respondents), feedback on a regular basis about the errors reported (63.8%) and about individual events (51.2%), evidence of

  18. Bar-code medication administration system for anesthetics: effects on documentation and billing.

    PubMed

    Nolen, Agatha L; Rodes, W Dyer

    2008-04-01

    The effects of using a new bar-code medication administration (BCMA) system for anesthetics to automate documentation of drug administration by anesthesiologists were studied. From October 1, 2004, to September 15, 2005, all medications administered to patients undergoing cardiac surgery were documented with a BCMA system at a large acute care facility. Drug claims data for 12 targeted anesthetics in diagnosis-related groups (DRGs) 104-111 were analyzed to determine the quantity of drugs charged and the revenue generated. Those data were compared with claims data for a historical case-control group (October 1, 2003, to September 15, 2004, for the same DRGs) for which medication use was documented manually. From October 1, 2005, to October 1, 2006, anesthesiologists for cardiac surgeries either voluntarily used the automated system or completed anesthesia records manually. A total of 870 cardiac surgery cases for which the BCMA system was used were evaluated. There were 961 cardiac surgery cases in the historical control group. The BCMA system increased the quantity of drugs documented per case by 21.7% and drug revenue captured per case by 18.8%. The time needed by operating-room pharmacy staff to process an anesthesia record for billing decreased by eight minutes per case. After two years, anesthesiologists voluntarily used the new technology on 100% of cardiac surgery patients. Implementation of a BCMA system for anesthetic use in cardiac surgery increased the quantity of drugs charged by 21.7% per case and drug revenue per case by 18.8%. Anesthesiologists continued to use the automated system on a voluntary basis after conclusion of the initial study.

  19. Mass Gathering Medical Care: Resource Document for the National Association of EMS Physicians Position Statement.

    PubMed

    Schwartz, Brian; Nafziger, Sarah; Milsten, Andrew; Luk, Jeffrey; Yancey, Arthur

    2015-01-01

    Mass gatherings are heterogeneous in terms of size, duration, type of event, crowd behavior, demographics of the participants and spectators, use of recreational substances, weather, and environment. The goals of health and medical services should be the provision of care for participants and spectators consistent with local standards of care, protection of continuing medical service to the populations surrounding the event venue, and preparation for surge to respond to extraordinary events. Pre-event planning among jurisdictional public health and EMS, acute care hospitals, and event EMS is essential, but should also include, at a minimum, event security services, public relations, facility maintenance, communications technicians, and the event planners and organizers. Previous documented experience with similar events has been shown to most accurately predict future needs. Future work in and guidance for mass gathering medical care should include the consistent use and further development of universally accepted consistent metrics, such as Patient Presentation Rate and Transfer to Hospital Rate. Only by standardizing data collection can evaluations be performed that link interventions with outcomes to enhance evidence-based EMS services at mass gatherings. Research is needed to evaluate the skills and interventions required by EMS providers to achieve desired outcomes. The event-dedicated EMS Medical Director is integral to acceptable quality medical care provided at mass gatherings; hence, he/she must be included in all aspects of mass gathering medical care planning, preparations, response, and recovery. Incorporation of jurisdictional EMS and community hospital medical leadership, and emergency practitioners into these processes will ensure that on-site care, transport, and transition to acute care at appropriate receiving facilities is consistent with, and fully integrated into the community's medical care system, while fulfilling the needs of event

  20. Where teachers are few: documenting available faculty in five Tanzanian medical schools

    PubMed Central

    Mkony, Charles A.; Kaaya, Ephata E.; Goodell, Alex J.; Macfarlane, Sarah B.

    2016-01-01

    Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members. Results The five schools reported 366 appointed faculty members (excluding visiting, part-time, or honorary appointments) for an estimated total enrolled student capacity of 3,275. Thirty-eight percent of these faculty were senior lecturers or higher. Twenty-seven percent of the appointments were in basic science, 51% in clinical science, and 21% in public health departments. The most populated disciplines (more than 20 faculty members across the five institutions) were biochemistry and molecular biology, medicine, obstetrics and gynecology, pediatrics, and surgery; the least populated disciplines (less than 10 faculty members) were anesthesiology, behavioral sciences, dermatology, dental surgery, emergency medicine, hematology, ophthalmology, orthopedics, otorhinolaryngology, oncology and radiology, psychiatry. These figures are only indicative of faculty numbers because of differences in the way the schools published their faculty lists. Conclusions Universities are not recruiting faculty at the same rate that they are admitting students, and there is an imbalance in the distribution of faculty across disciplines. Although there are differences among the universities, all are struggling to recruit and retain staff. If Tanzanian universities, the government, donors, and international partners commit resources

  1. Heart Failure Medications Detection and Prescription Status Classification in Clinical Narrative Documents

    PubMed Central

    Meystre, Stéphane M.; Kim, Youngjun; Heavirland, Julia; Williams, Jenifer; Bray, Bruce E.; Garvin, Jennifer

    2016-01-01

    Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin II Receptor Blockers (ARB) are two common medication classes used for heart failure treatment. The ADAHF (Automated Data Acquisition for Heart Failure) project aimed at automatically extracting heart failure treatment performance metrics from clinical narrative documents, and these medications are an important component of the performance metrics. We developed two different systems to detect these medications, rule-based and machine learning-based. The rule-based system uses dictionary lookups with fuzzy string searching and showed successful performance even if our corpus contains various misspelled medications. The machine learning-based system uses lexical and morphological features and produced similar results. The best performance was achieved when combining the two methods, reaching 99.3% recall and 98.8% precision. To determine the prescription status of each medication (i.e., active, discontinued, or negative), we implemented a SVM classifier with lexical features and achieved good performance, reaching 95.49% accuracy, in a five-fold cross validation evaluation. PMID:26262123

  2. Easing semantically enriched information retrieval-An interactive semi-automatic annotation system for medical documents.

    PubMed

    Gschwandtner, Theresia; Kaiser, Katharina; Martini, Patrick; Miksch, Silvia

    2010-06-01

    Mapping medical concepts from a terminology system to the concepts in the narrative text of a medical document is necessary to provide semantically accurate information for further processing steps. The MetaMap Transfer (MMTx) program is a semantic annotation system that generates a rough mapping of concepts from the Unified Medical Language System (UMLS) Metathesaurus to free medical text, but this mapping still contains erroneous and ambiguous bits of information. Since manually correcting the mapping is an extremely cumbersome and time-consuming task, we have developed the MapFace editor.The editor provides a convenient way of navigating the annotated information gained from the MMTx output, and enables users to correct this information on both a conceptual and a syntactical level, and thus it greatly facilitates the handling of the MMTx program. Additionally, the editor provides enhanced visualization features to support the correct interpretation of medical concepts within the text. We paid special attention to ensure that the MapFace editor is an intuitive and convenient tool to work with. Therefore, we recently conducted a usability study in order to create a well founded background serving as a starting point for further improvement of the editor's usability.

  3. Easing semantically enriched information retrieval—An interactive semi-automatic annotation system for medical documents

    PubMed Central

    Gschwandtner, Theresia; Kaiser, Katharina; Martini, Patrick; Miksch, Silvia

    2010-01-01

    Mapping medical concepts from a terminology system to the concepts in the narrative text of a medical document is necessary to provide semantically accurate information for further processing steps. The MetaMap Transfer (MMTx) program is a semantic annotation system that generates a rough mapping of concepts from the Unified Medical Language System (UMLS) Metathesaurus to free medical text, but this mapping still contains erroneous and ambiguous bits of information. Since manually correcting the mapping is an extremely cumbersome and time-consuming task, we have developed the MapFace editor. The editor provides a convenient way of navigating the annotated information gained from the MMTx output, and enables users to correct this information on both a conceptual and a syntactical level, and thus it greatly facilitates the handling of the MMTx program. Additionally, the editor provides enhanced visualization features to support the correct interpretation of medical concepts within the text. We paid special attention to ensure that the MapFace editor is an intuitive and convenient tool to work with. Therefore, we recently conducted a usability study in order to create a well founded background serving as a starting point for further improvement of the editor’s usability. PMID:20582249

  4. Integration of internet-based genetic databases into the medical school pre-clinical and clinical curriculum.

    PubMed

    Waggoner, Darrel J; Martin, Christa Lese

    2006-06-01

    Over the past several years, the field of medical genetics has continued to expand and is now impacting a broad range of medical care, mainly due to rapid advances in genetic technology and information generated by the Human Genome Project. Physicians from multiple disciplines will need to become familiar with genetic principles, and the availability of genetic databases on the internet is a valuable resource for medical students and physicians. To integrate these tools into medical student training, the University of Chicago Pritzker School of Medicine set out to develop multiple, interactive, case-based, educational sessions in the pre-clinical and clinical curriculum, designed to reinforce basic principles taught in the pre-clinical genetics class and demonstrate the usefulness of genetic information accessible via the internet in the clinical setting. Two interactive sessions and a self-assessment exercise were developed. The sessions took place in a computer classroom where each student had access to the internet and could work independently. The sessions used case-based scenarios to help students become familiar with internet based resources and demonstrate how genetic information can affect medical care. The sessions were well received by the student participants with 99% agreeing that the material was useful and important to clinical medicine. In a follow-up questionnaire 1/3 of the students reported using the databases presented during class in a clinical setting.

  5. Use of the electronic medical record for trauma resuscitations: how does this impact documentation completeness?

    PubMed

    Bilyeu, Pam; Eastes, Lynn

    2013-01-01

    Although many trauma centers across the country have implemented electronic medical records (EMRs) for inpatient documentation, they have avoided the use of EMR during the fast-paced trauma resuscitations. The objective of this study was to determine whether documenting electronically during trauma resuscitations has resulted in improvement or degradation of the completeness of data recorded. Forty critical data points were evaluated in 100 pre-EMR charts and 100 post-EMR charts. There was improvement in completeness of charting in 25% of the electronic records reviewed and degradation of completeness of charting in 18% of the records, for a net improvement in completeness of charting of 7% in the electronic records reviewed.

  6. Use of the Internet by print medical journals in 2003 to 2009: a longitudinal observational study.

    PubMed

    Schriger, David L; Chehrazi, Ariana C; Merchant, Rashida M; Altman, Douglas G

    2011-02-01

    To determine how a sample of medical journals use the Internet to provide additional content and features to readers and how this has changed since 2003. In 2005, we surveyed 2003 and 2005 issues of 138 high-impact print medical journals to determine to what extent they were using the Internet to provide online-only articles and supplementary content to print articles (sampled 28 journals), and electronic space for the postpublication critique of their articles (sampled all 138 journals). We used the same methodology to determine what kinds of Web-only supplementary material were provided with each print article in March 2007 and 2009 issues of the same 28 journals used for the 2003 to 2005 study. As before, we also determined which of the 138 journals offered rapid response pages and how those pages were being used. The proportion of the 28 journals providing Web-only supplementary material increased from 32% (2003) to 50% (2005) to 61% (2007) to 64% (2009), and the percentage of articles that contained supplementary material increased from 7% to 14% to 20% to 25%, respectively. We observed a marked increase in the number of video supplements. In contrast, journals offering online postpublication review decreased from 17 of 138 (12%) to 12 of 138 (9%) to 11 of 138 (8%) from 2005 to 2007 to 2009, and the percentage of articles with no responses was unchanged at 82%. The use of online-only articles and online-only supplements by print journals continues to increase. Postpublication critique of articles in online pages provided by the journal does not seem to be taking hold. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  7. Using Internet Search Engines to Obtain Medical Information: A Comparative Study

    PubMed Central

    Wang, Liupu; Wang, Juexin; Wang, Michael; Li, Yong; Liang, Yanchun

    2012-01-01

    Background The Internet has become one of the most important means to obtain health and medical information. It is often the first step in checking for basic information about a disease and its treatment. The search results are often useful to general users. Various search engines such as Google, Yahoo!, Bing, and Ask.com can play an important role in obtaining medical information for both medical professionals and lay people. However, the usability and effectiveness of various search engines for medical information have not been comprehensively compared and evaluated. Objective To compare major Internet search engines in their usability of obtaining medical and health information. Methods We applied usability testing as a software engineering technique and a standard industry practice to compare the four major search engines (Google, Yahoo!, Bing, and Ask.com) in obtaining health and medical information. For this purpose, we searched the keyword breast cancer in Google, Yahoo!, Bing, and Ask.com and saved the results of the top 200 links from each search engine. We combined nonredundant links from the four search engines and gave them to volunteer users in an alphabetical order. The volunteer users evaluated the websites and scored each website from 0 to 10 (lowest to highest) based on the usefulness of the content relevant to breast cancer. A medical expert identified six well-known websites related to breast cancer in advance as standards. We also used five keywords associated with breast cancer defined in the latest release of Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) and analyzed their occurrence in the websites. Results Each search engine provided rich information related to breast cancer in the search results. All six standard websites were among the top 30 in search results of all four search engines. Google had the best search validity (in terms of whether a website could be opened), followed by Bing, Ask.com, and Yahoo!. The search

  8. Appropriate and safe utilization of helicopter emergency medical services: a joint position statement with resource document.

    PubMed

    Floccare, Douglas J; Stuhlmiller, David F E; Braithwaite, Sabina A; Thomas, Stephen H; Madden, John F; Hankins, Daniel G; Dhindsa, Harinder; Millin, Michael G

    2013-01-01

    This position statement with accompanying resource document is the result of a collaborative effort of a writing group comprised of members of the Air Medical Physician Association (AMPA), the American College of Emergency Physicians (ACEP), the National Association of EMS Physicians (NAEMSP), and the American Academy of Emergency Medicine (AAEM). This document has been jointly approved by the boards of all four organizations. Patients benefit from the appropriate utilization of helicopter emergency medical services (HEMS). EMS and regional health care systems must have and follow guidelines for HEMS utilization to facilitate proper patient selection and ensure clinical benefit. Clinical benefit can be provided by Meaningfully shortening the time to delivery of definitive care to patients with time-sensitive medical conditions Providing necessary specialized medical expertise or equipment to patients before and/or during transport Providing transport to patients inaccessible by other means of transport The decision to use HEMS is a medical decision, separate from the aviation determination whether a transport can be completed safely. Physicians with specialized training and experience in EMS and air medical transport must be integral to HEMS utilization decisions, including guideline development and quality improvement activities. Safety management systems must be developed, adopted, and adhered to by air medical operators when making decisions to accept and continue every HEMS transport. HEMS must be fully integrated within the local, regional, and state emergency health care systems. HEMS programs cannot operate independently of the surrounding health care environment. The EMS and health care systems must be involved in the determination of the number of HEMS assets necessary to provide appropriate coverage for their region. Excessive resources may lead to competitive practices that can affect utilization and negatively impact safety. Inadequate resources will

  9. The "Profiles" document: a modern revision of the objectives of undergraduate medical studies in Switzerland.

    PubMed

    Michaud, Pierre-André; Jucker-Kupper, Patrick; The Profiles Working Group

    2016-01-01

    The Joint Commission of the Swiss Medical Schools (SMIFK/CIMS) decided in 2000 to establish a Swiss Catalogue of Learning Objectives (SCLO) for undergraduate medical training, which was adapted from a similar Dutch blueprint. A second version of the SCLO was developed and launched in 2008. The catalogue is a prerequisite for the accreditation of the curricula of the six Swiss medical faculties and defines the contents of the Federal Licensing Examination (FLE). Given the evolution of the field of medicine and of medical education, the SMIFK/CIMS has decided to embark on a total revision of the SCLO. This article presents the proposed structure and content of Profiles, a new document which, in the future, will direct the format of undergraduate studies and of the FLE. Profiles stands for the Principal Relevant Objectives for Integrative Learning and Education in Switzerland. It is currently being developed by a group of experts from the six Swiss faculties as well as representatives of other institutions involved in these developments. The foundations of Profiles are grounded in the evolution of medical practice and of public health and are based on up-to-date teaching concepts, such as EPAs (entrustable professional activities). An introduction will cover the concepts and a tutorial will be displayed. Three main chapters will provide a description of the seven 2015 CanMEDS roles, a list of core EPAs and a series of ≈250 situations embracing the most frequent and current conditions affecting health. As Profiles is still a work in progress, it is hoped that this paper will attract the interest of all individuals involved in the training of medical students.

  10. A Comparison of Internet-Based Learning and Traditional Classroom Lecture to Learn CPR for Continuing Medical Education

    ERIC Educational Resources Information Center

    Hemmati, Nima; Omrani, Soghra; Hemmati, Naser

    2013-01-01

    The purpose of this study was to compare the satisfaction and effectiveness of Internet-based learning (IBL) and traditional classroom lecture (TCL) for continuing medical education (CME) programs by comparing final resuscitation exam results of physicians who received the newest cardiopulmonary resuscitation (CPR) curriculum guidelines training…

  11. Medical Individualism or Medical Familism? A Critical Analysis of China's New Guidelines for Informed Consent: The Basic Norms of the Documentation of the Medical Record.

    PubMed

    Bian, Lin

    2015-08-01

    Modern Western medical individualism has had a significant impact on health care in China. This essay demonstrates the ways in which such Western-style individualism has been explicitly endorsed in China's 2010 directive: The Basic Norms of the Documentation of the Medical Record. The Norms require that the patient himself, rather than a member of his family, sign each informed consent form. This change in clinical practice indicates a shift toward medical individualism in Chinese healthcare legislation. Such individualism, however, is incompatible with the character of Chinese familism that is deeply rooted in the Chinese ethical tradition. It also contradicts family-based patterns of health care in China. Moreover, the requirement for individual informed consent is incompatible with numerous medical regulations promulgated in the past two decades. This essay argues that while Chinese medical legislation should learn from relevant Western ideas, it should not simply copy such practices by importing medical individualism into Chinese health care. Chinese healthcare policy is properly based on Chinese medical familist resources. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. On the Ottoman consent documents for medical interventions and the modern concept of informed consent.

    PubMed

    Kara, Mahmut A; Aksoy, Sahin

    2006-09-01

    Information for patients prior to medical intervention is one of the principles of modern medical practice. In this study, we looked at an earlier practice of this principle. Ottoman judges had record books called sicil. One of the categories in sicils was the consent documents called riza senedi, which was a patient-physician contract approved by the courts. These contracts were especially for the protection of physicians from punishment if the patient dies. It is not clear whether patients were informed properly or not. Consent for minors was obtained from parents. However, a situation where an adult does not have the capacity to consent, was not clear in these documents. Any sign of free withdrawal of consent was not found in these records. Due to the legal system of Ottoman State, these contracts were related to Islamic law rather than modern civil law. We aim, in this paper, to present a legal practice, which is possible to consider as an early example of the informed consent practice.

  13. Narrative text in structured documentation of medication risks and side effects.

    PubMed

    Jylhä, Virpi; Saranto, Kaija

    2009-01-01

    Electronic patient records enable the use of patient data for clinical, administrative and research purposes. However, utilising electronic data requires a structured documentation model in which standardised nursing classifications are used. Finnish Care Classification (FinCC) is based on the Clinical Care Classification. FinCC version 1.1 used in this study contains Finnish Classification of Nursing Diagnosis and Interventions. This study aims to analyse how nurses have used narrative text to complement the documentation of medication risks and side effects when the Finnish Care Classification is used. The results of this study show that content of narrative text does not always correspond with the FinCC codes used. The content of narrative text does not follow the nursing process. Especially the use of nursing diagnosis seems to be difficult. This study indicates a need for continuing education about structured documentation. Further research is needed to analyse the relationship between nursing diagnosis and interventions as well as how other components are complemented with narrative text.

  14. Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

    PubMed

    Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

    2012-03-01

    The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  15. The use of interactive graphical maps for browsing medical/health Internet information resources.

    PubMed

    Boulos, Maged N Kamel

    2003-01-10

    As online information portals accumulate metadata descriptions of Web resources, it becomes necessary to develop effective ways for visualising and navigating the resultant huge metadata repositories as well as the different semantic relationships and attributes of described Web resources. Graphical maps provide a good method to visualise, understand and navigate a world that is too large and complex to be seen directly like the Web. Several examples of maps designed as a navigational aid for Web resources are presented in this review with an emphasis on maps of medical and health-related resources. The latter include HealthCyberMap maps http://healthcybermap.semanticweb.org/, which can be classified as conceptual information space maps, and the very abstract and geometric Visual Net maps of PubMed http://pubmed.antarcti.ca/start. Information resources can be also organised and navigated based on their geographic attributes. Some of the maps presented in this review use a Kohonen Self-Organising Map algorithm, and only HealthCyberMap uses a Geographic Information System to classify Web resource data and render the maps. Maps based on familiar metaphors taken from users' everyday life are much easier to understand. Associative and pictorial map icons that enable instant recognition and comprehension are preferred to geometric ones and are key to successful maps for browsing medical/health Internet information resources.

  16. The use of interactive graphical maps for browsing medical/health Internet information resources

    PubMed Central

    Boulos, Maged N Kamel

    2003-01-01

    As online information portals accumulate metadata descriptions of Web resources, it becomes necessary to develop effective ways for visualising and navigating the resultant huge metadata repositories as well as the different semantic relationships and attributes of described Web resources. Graphical maps provide a good method to visualise, understand and navigate a world that is too large and complex to be seen directly like the Web. Several examples of maps designed as a navigational aid for Web resources are presented in this review with an emphasis on maps of medical and health-related resources. The latter include HealthCyberMap maps , which can be classified as conceptual information space maps, and the very abstract and geometric Visual Net maps of PubMed (for demos). Information resources can be also organised and navigated based on their geographic attributes. Some of the maps presented in this review use a Kohonen Self-Organising Map algorithm, and only HealthCyberMap uses a Geographic Information System to classify Web resource data and render the maps. Maps based on familiar metaphors taken from users' everyday life are much easier to understand. Associative and pictorial map icons that enable instant recognition and comprehension are preferred to geometric ones and are key to successful maps for browsing medical/health Internet information resources. PMID:12556244

  17. Accuracy of medication documentation in hospital discharge summaries: A retrospective analysis of medication transcription errors in manual and electronic discharge summaries.

    PubMed

    Callen, Joanne; McIntosh, Jean; Li, Julie

    2010-01-01

    Medication errors in hospital discharge summaries have the potential to cause serious harm to patients. These errors are generally associated with manual transcription of medications between medication charts and discharge summaries. Studies also show junior doctors are more likely to contribute to discharge medication error rates. Electronic discharge summaries have the potential to reduce discharge medication errors to ensure the safe handover of care to the primary care provider. (1) Quantify and compare the medication transcription error rate from handwritten medications on manual discharge summaries to typed medications on electronic discharge summaries, and (2) examine the quality of medication documentation according to the level of medical training of the doctors who created the discharge summaries. A retrospective examination of 966 handwritten and 842 electronically generated discharge summaries was conducted in an Australian metropolitan hospital. The electronic discharge summaries at the study site were not integrated with an electronic medication management system and hence discharge medications were typed into the electronic discharge summary by the doctor. The discharge medication documentation in both types of summaries was transcribed, either handwritten or typed, from inpatient medication charts in paper-based medical records. Documentation differences between medications in discharge summaries and inpatient medication charts constituted medication errors. 12.1% of handwritten and 13.3% of electronic summaries contained medication errors. The highest number of errors occurred with cardiovascular drugs. Medication omission was the commonest error. The confidence intervals of all odds ratios indicate handwritten and electronic summaries were similar for all areas of medication error. Error rates regarding all 13,566 individual medications for the 1808 summaries were similar by doctor medical training level (intern, resident, and registrar). Similar

  18. Internet-based medical education: a realist review of what works, for whom and in what circumstances

    PubMed Central

    2010-01-01

    Background Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. We aimed to produce theory driven criteria to guide the development and evaluation of Internet-based medical courses. Methods Realist review - a qualitative systematic review method whose goal is to identify and explain the interaction between context, mechanism and outcome. We searched 15 electronic databases and references of included articles, seeking to identify theoretical models of how the Internet might support learning from empirical studies which (a) used the Internet to support learning, (b) involved doctors or medical students; and (c) reported a formal evaluation. All study designs and outcomes were considered. Using immersion and interpretation, we tested theories by considering how well they explained the different outcomes achieved in different educational contexts. Results 249 papers met our inclusion criteria. We identified two main theories of the course-in-context that explained variation in learners' satisfaction and outcomes: Davis's Technology Acceptance Model and Laurillard's model of interactive dialogue. Learners were more likely to accept a course if it offered a perceived advantage over available non-Internet alternatives, was easy to use technically, and compatible with their values and norms. 'Interactivity' led to effective learning only if learners were able to enter into a dialogue - with a tutor, fellow students or virtual tutorials - and gain formative feedback. Conclusions Different modes of course delivery suit different learners in different contexts. When designing or choosing an Internet-based course, attention must be given to the fit between its technical attributes and learners' needs and priorities; and to ways of

  19. Internet-based medical education: a realist review of what works, for whom and in what circumstances.

    PubMed

    Wong, Geoff; Greenhalgh, Trisha; Pawson, Ray

    2010-02-02

    Educational courses for doctors and medical students are increasingly offered via the Internet. Despite much research, course developers remain unsure about what (if anything) to offer online and how. Prospective learners lack evidence-based guidance on how to choose between the options on offer. We aimed to produce theory driven criteria to guide the development and evaluation of Internet-based medical courses. Realist review - a qualitative systematic review method whose goal is to identify and explain the interaction between context, mechanism and outcome. We searched 15 electronic databases and references of included articles, seeking to identify theoretical models of how the Internet might support learning from empirical studies which (a) used the Internet to support learning, (b) involved doctors or medical students; and (c) reported a formal evaluation. All study designs and outcomes were considered. Using immersion and interpretation, we tested theories by considering how well they explained the different outcomes achieved in different educational contexts. 249 papers met our inclusion criteria. We identified two main theories of the course-in-context that explained variation in learners' satisfaction and outcomes: Davis's Technology Acceptance Model and Laurillard's model of interactive dialogue. Learners were more likely to accept a course if it offered a perceived advantage over available non-Internet alternatives, was easy to use technically, and compatible with their values and norms. 'Interactivity' led to effective learning only if learners were able to enter into a dialogue - with a tutor, fellow students or virtual tutorials - and gain formative feedback. Different modes of course delivery suit different learners in different contexts. When designing or choosing an Internet-based course, attention must be given to the fit between its technical attributes and learners' needs and priorities; and to ways of providing meaningful interaction. We offer a

  20. Textractor: a hybrid system for medications and reason for their prescription extraction from clinical text documents.

    PubMed

    Meystre, Stéphane M; Thibault, Julien; Shen, Shuying; Hurdle, John F; South, Brett R

    2010-01-01

    OBJECTIVE To describe a new medication information extraction system-Textractor-developed for the 'i2b2 medication extraction challenge'. The development, functionalities, and official evaluation of the system are detailed. Textractor is based on the Apache Unstructured Information Management Architecture (UMIA) framework, and uses methods that are a hybrid between machine learning and pattern matching. Two modules in the system are based on machine learning algorithms, while other modules use regular expressions, rules, and dictionaries, and one module embeds MetaMap Transfer. The official evaluation was based on a reference standard of 251 discharge summaries annotated by all teams participating in the challenge. The metrics used were recall, precision, and the F(1)-measure. They were calculated with exact and inexact matches, and were averaged at the level of systems and documents. The reference metric for this challenge, the system-level overall F(1)-measure, reached about 77% for exact matches, with a recall of 72% and a precision of 83%. Performance was the best with route information (F(1)-measure about 86%), and was good for dosage and frequency information, with F(1)-measures of about 82-85%. Results were not as good for durations, with F(1)-measures of 36-39%, and for reasons, with F(1)-measures of 24-27%. The official evaluation of Textractor for the i2b2 medication extraction challenge demonstrated satisfactory performance. This system was among the 10 best performing systems in this challenge.

  1. The Documentation of Health Problems in Relation to Prescribed Medication in People with Profound Intellectual and Multiple Disabilities

    ERIC Educational Resources Information Center

    van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

    2009-01-01

    Background: Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed. Method: Persons with PIMD with an…

  2. The Documentation of Health Problems in Relation to Prescribed Medication in People with Profound Intellectual and Multiple Disabilities

    ERIC Educational Resources Information Center

    van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

    2009-01-01

    Background: Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed. Method: Persons with PIMD with an…

  3. Taking aim at medical identity theft. Document security key element to comply with government regulations.

    PubMed

    Raymond, Colette

    2010-01-01

    Sensitive paper documents, such as patient records, customer data, and legal information, must be securely stored and destroyed when no longer needed. This is not only a good business practice that reduces costs and protects reputations, but also a legal and regulatory imperative. According to some experts, medical identity theft is the fastest-growing form of identity theft in North America. The Federal Trade Commission's Red Flags Rule, due to take effect June 1, 2010, requires banks; credit card companies; and, in some situations, retailers, hospitals, insurance companies, health clinics, and other organizations to store confidential personal information that can expose consumers to significant identity theft risks. This also includes healthcare providers and other organizations that are considered creditors according to their billing/payment procedures. This article highlights the steps healthcare providers must take to ensure data security.

  4. A novel classification and online platform for planning and documentation of medical applications of additive manufacturing.

    PubMed

    Tuomi, Jukka; Paloheimo, Kaija-Stiina; Vehviläinen, Juho; Björkstrand, Roy; Salmi, Mika; Huotilainen, Eero; Kontio, Risto; Rouse, Stephen; Gibson, Ian; Mäkitie, Antti A

    2014-12-01

    Additive manufacturing technologies are widely used in industrial settings and now increasingly also in several areas of medicine. Various techniques and numerous types of materials are used for these applications. There is a clear need to unify and harmonize the patterns of their use worldwide. We present a 5-class system to aid planning of these applications and related scientific work as well as communication between various actors involved in this field. An online, matrix-based platform and a database were developed for planning and documentation of various solutions. This platform will help the medical community to structurally develop both research innovations and clinical applications of additive manufacturing. The online platform can be accessed through http://www.medicalam.info. © The Author(s) 2014.

  5. Multi-agent system as a platform for management of medical documentation.

    PubMed

    Lhotska, Lenka

    2007-01-01

    The paper is focused on description of an ongoing project of a pilot study and implementation of a multi-agent system for management of medical documentation in a hospital. First we analyzed the problem and divided it into four groups of tasks: storing and retrieving stored data, user interaction, data archiving, and system security. All these tasks are performed by corresponding agents, namely user interface agent, database agent, archive agent, and security agent. Communication between the agents is a crucial point of the system operation. The system has been designed as an open system and we assume that it will be extended by additional agents with new functions, e.g. decision support, biomedical signal evaluation, laboratory test evaluation.

  6. A Cross-Sectional Study on the Prevalence, Risk Factors, and Ill Effects of Internet Addiction Among Medical Students in Northeastern India.

    PubMed

    Nath, Kamal; Naskar, Subrata; Victor, Robin

    2016-01-01

    To evaluate Internet addiction among medical students in northeastern India and gain detailed knowledge about the prevalence, risk factors, and ill effects commonly associated with the disorder. The cross-sectional study sample comprised 188 medical students from Silchar Medical College and Hospital (Silchar, Assam, India). Students completed a sociodemographic form and an Internet use questionnaire, both created for this study, and the Young's 20-Item Internet Addiction Test after they received brief instructions. Data were collected during a10-day period in June 2015. Of the 188 medical students, 46.8% were at increased risk of Internet addiction. Those who were found to be at increased risk had longer years of Internet exposure (P = .046) and always online status (P = .033). Also, among this group, the men were more prone to develop an online relationship. Excessive Internet usage also led to poor performance in college (P < .0001) and feeling moody, anxious, and depressed (P < .0001). The ill effects of Internet addiction include withdrawal from real-life relationships, deterioration in academic activities, and a depressed and nervous mood. Internet use for nonacademic purposes is increasing among students, thus there is an immediate need for strict supervision and monitoring at the institutional level. The possibility of becoming addicted to the Internet should be emphasized to students and their parents through awareness campaigns so that interventions and restrictions can be implemented at the individual and family levels.

  7. A Cross-Sectional Study on the Prevalence, Risk Factors, and Ill Effects of Internet Addiction Among Medical Students in Northeastern India

    PubMed Central

    Nath, Kamal; Naskar, Subrata; Victor, Robin

    2016-01-01

    Objective To evaluate Internet addiction among medical students in northeastern India and gain detailed knowledge about the prevalence, risk factors, and ill effects commonly associated with the disorder. Method The cross-sectional study sample comprised 188 medical students from Silchar Medical College and Hospital (Silchar, Assam, India). Students completed a sociodemographic form and an Internet use questionnaire, both created for this study, and the Young’s 20-Item Internet Addiction Test after they received brief instructions. Data were collected during a10-day period in June 2015. Results Of the 188 medical students, 46.8% were at increased risk of Internet addiction. Those who were found to be at increased risk had longer years of Internet exposure (P = .046) and always online status (P = .033). Also, among this group, the men were more prone to develop an online relationship. Excessive Internet usage also led to poor performance in college (P < .0001) and feeling moody, anxious, and depressed (P < .0001). Conclusions The ill effects of Internet addiction include withdrawal from real-life relationships, deterioration in academic activities, and a depressed and nervous mood. Internet use for nonacademic purposes is increasing among students, thus there is an immediate need for strict supervision and monitoring at the institutional level. The possibility of becoming addicted to the Internet should be emphasized to students and their parents through awareness campaigns so that interventions and restrictions can be implemented at the individual and family levels. PMID:27486546

  8. Examining patterns in medication documentation of trade and generic names in an academic family practice training centre.

    PubMed

    Summers, Alexander; Ruderman, Carly; Leung, Fok-Han; Slater, Morgan

    2017-09-22

    Studies in the United States have shown that physicians commonly use brand names when documenting medications in an outpatient setting. However, the prevalence of prescribing and documenting brand name medication has not been assessed in a clinical teaching environment. The purpose of this study was to describe the use of generic versus brand names for a select number of pharmaceutical products in clinical documentation in a large, urban academic family practice centre. A retrospective chart review of the electronic medical records of the St. Michael's Hospital Academic Family Health Team (SMHAFHT). Data for twenty commonly prescribed medications were collected from the Cumulative Patient Profile as of August 1, 2014. Each medication name was classified as generic or trade. Associations between documentation patterns and physician characteristics were assessed. Among 9763 patients prescribed any of the twenty medications of interest, 45% of patient charts contained trade nomenclature exclusively. 32% of charts contained only generic nomenclature, and 23% contained a mix of generic and trade nomenclature. There was large variation in use of generic nomenclature amongst physicians, ranging from 19% to 93%. Trade names in clinical documentation, which likely reflect prescribing habits, continue to be used abundantly in the academic setting. This may become part of the informal curriculum, potentially facilitating undue bias in trainees. Further study is needed to determine characteristics which influence use of generic or trade nomenclature and the impact of this trend on trainees' clinical knowledge and decision-making.

  9. The transition to electronic documentation on a teaching hospital medical service.

    PubMed

    Payne, Thomas H; Perkins, Monica; Kalus, Robert; Reilly, Dom

    2006-01-01

    The transition to electronic medical records (EMRs) often includes the transition from paper to electronic documentation, a topic less well described in the literature than other aspects of EMR adoption. As part of a broader EMR project, we have participated in the transition to electronic notes on the Medicine service of a teaching hospital affiliated with the University of Washington. During a one year period beginning in February 2005 we adopted the use of semi-structured documentation templates permitting both encoded and narrative text components for admission, progress, and procedure notes, and for some discharge summaries. Currently over 1400 notes are entered each week. Fifty eight percent are entered by residents, 20% by attending physicians, and the remainder by other trainees and staff. The period of greatest change from paper to electronic notes occurred (by design) during the late spring and summer. Leadership, application functionality, speed, note writing time requirements, data availability, training needs, and other factors influenced adoption of this important part of our EMR.

  10. Digital documentation of the physical examination: moving the clinical breast exam to the electronic medical record.

    PubMed

    Kaufman, Cary S; Jacobson, Leslie; Bachman, Barbara A; Kaufman, Lauren B

    2006-10-01

    Documentation of the clinical breast examination (CBE) has consisted of simple hand-drawings and stick figures without a common lexicon. There is a need for a device that can accurately depict the CBE in digital format while being objective, reproducible over time, and useable in the electronic medical record. This new device is called palpation imaging (PI). We examined 110 patients with a complaint of a breast mass using PI. This laptop-sized device creates a real-time digital display of the palpable area in both video and still formats. The size, hardness, shape, homogeneity, and mass location may be extracted from the image. Of those with a true mass, PI identified the mass in 94% while physical examination identified 86%. The positive predictive value (PPV) for breast cancer using PI was 94% and 78% for physical examination. A survey of primary care physicians revealed the inclusion of the PI record in a consultation note implied competence, experience, and skill by the surgeon. PI documented the CBE in a timely, efficient, and accurate manner. A reproducible record allows objective review by multiple examiners at varied times. Continued work will optimize examination methods.

  11. If you did not document it, it did not happen: rates of documentation of discussion of infertility risk in adolescent and young adult oncology patients' medical records.

    PubMed

    Quinn, Gwendolyn P; Block, Rebecca G; Clayman, Marla L; Kelvin, Joanne; Arvey, Sarah R; Lee, Ji-Hyun; Reinecke, Joyce; Sehovic, Ivana; Jacobsen, Paul B; Reed, Damon; Gonzalez, Luis; Vadaparampil, Susan T; Laronga, Christine; Lee, M Catherine; Pow-Sang, Julio; Eggly, Susan; Franklin, Anna; Shah, Bijal; Fulp, William J; Hayes-Lattin, Brandon

    2015-03-01

    The adolescent and young adult (AYA) population is underserved because of unique late-effect issues, particularly future fertility. This study sought to establish rates of documentation of discussion of risk of infertility, fertility preservation (FP) options, and referrals to fertility specialists in AYA patients' medical records at four cancer centers. All centers reviewed randomized records within the top four AYA disease sites (breast, leukemia/lymphoma, sarcoma, and testicular). Eligible records included those of patients: diagnosed in 2011, with no prior receipt of gonadotoxic therapy; age 18 to 45 years; with no multiple primary cancers; and for whom record was not second opinion. Quality Oncology Practice Initiative methods were used to evaluate documentation of discussion of risk of infertility, discussion of FP options, and referral to a fertility specialist. Of 231 records, 26% documented infertility risk discussion, 24% documented FP option discussion, and 13% documented referral to a fertility specialist. Records were less likely to contain evidence of infertility risk and FP option discussions for female patients (P = .030 and .004, respectively) and those with breast cancer (P = .021 and < .001, respectively). Records for Hispanic/Latino patients were less likely to contain evidence of infertility risk discussion (P = .037). Records were less likely to document infertility risk discussion, FP option discussion, and fertility specialist referral for patients age ≥ 40 years (P < .001, < .001, and .002, respectively) and those who already had children (all P < .001). The overall rate of documentation of discussion of FP is low, and results show disparities among specific groups. Although greater numbers of discussions may be occurring, there is a need to create interventions to improve documentation. Copyright © 2014 by American Society of Clinical Oncology.

  12. A Novel Internet Based Geriatric Education Program for Emergency Medical Services Providers

    PubMed Central

    Shah, Manish N.; Swanson, Peter A.; Nobay, Flavia; Peterson, Lars-Kristofer N.; Caprio, Thomas V.; Karuza, Jurgis

    2012-01-01

    Despite caring for large numbers of older adults, prehospital emergency medical services (EMS) providers receive minimal geriatrics-specific training while obtaining their certification. Studies have shown that they desire further training to improve their comfort level and knowledge in caring for older adults. However, continuing education programs to address these needs must account for each EMS provider's specific needs, consider each provider's learning styles, and provide an engaging, interactive experience. We developed and implemented a novel, internet-based, video podcast-based geriatric continuing education program for EMS providers and evaluated their perceived value of the program. They found this resource to be highly valuable and were strongly supportive of both the modality and the specific training provided. Technical challenges were reported by some as a barrier, as well as the inability to engage in a discussion to clarify topics. Both were felt to be addressable through programmatic and technological revisions. This study demonstrates the proof of concept of video podcast training to address deficiencies in EMS education regarding the care for older patients. However, further work is needed to demonstrate the educational impact of video podcasts on the knowledge and skills of trainees. PMID:22906239

  13. A novel internet-based geriatric education program for emergency medical services providers.

    PubMed

    Shah, Manish N; Swanson, Peter A; Nobay, Flavia; Peterson, Lars-Kristofer N; Caprio, Thomas V; Karuza, Jurgis

    2012-09-01

    Despite caring for large numbers of older adults, prehospital emergency medical services (EMS) providers receive minimal geriatrics-specific training while obtaining their certification. Studies have shown that they desire further training to improve their comfort level and knowledge in caring for older adults, but continuing education programs to address these needs must account for each EMS provider's specific needs, consider each provider's learning styles, and provide an engaging, interactive experience. A novel, Internet-based, video podcast-based geriatric continuing education program was developed and implemented for EMS providers, and their perceived value of the program was evaluated. They found this resource to be highly valuable and were strongly supportive of the modality and the specific training provided. Some reported technical challenges and the inability to engage in a discussion to clarify topics as barriers. It was felt that both of these barriers could be addressed through programmatic and technological revisions. This study demonstrates the proof of concept of video podcast training to address deficiencies in EMS education regarding the care of older adults, although further work is needed to demonstrate the educational effect of video podcasts on the knowledge and skills of trainees.

  14. Medical technology at home: safety-related items in technical documentation.

    PubMed

    Hilbers, Ellen S M; de Vries, Claudette G J C A; Geertsma, Robert E

    2013-01-01

    This study aimed to investigate the technical documentation of manufacturers on issues of safe use of their device in a home setting. Three categories of equipment were selected: infusion pumps, ventilators, and dialysis systems. Risk analyses, instructions for use, labels, and post market surveillance procedures were requested from manufacturers. Additionally, they were asked to fill out a questionnaire on collection of field experience, on incidents, and training activities. Specific risks of device operation by lay users in a home setting were incompletely addressed in the risk analyses. A substantial number of user manuals were designed for professionals, rather than for patients or lay carers. Risk analyses and user information often showed incomplete coherence. Post market surveillance was mainly based on passive collection of field experiences. Manufacturers of infusion pumps, ventilators, and dialysis systems pay insufficient attention to the specific risks of use by lay persons in home settings. It is expected that this conclusion is also applicable for other medical equipment for treatment at home. Manufacturers of medical equipment for home use should pay more attention to use errors, lay use and home-specific risks in design, risk analysis, and user information. Field experiences should be collected more actively. Coherence between risk analysis and user information should be improved. Notified bodies should address these aspects in their assessment. User manuals issued by institutions supervising a specific home therapy should be drawn up in consultation with the manufacturer.

  15. The Value of Internet Tools in Undergraduate Surgical Education: Perspective of Medical Students in a Developing Country.

    PubMed

    Ekenze, S O; Okafor, C I; Ekenze, O S; Nwosu, J N; Ezepue, U F

    2017-03-01

    Advances in information technology (IT) in the past decade present opportunities and challenges in undergraduate surgical education. There may be need to evaluate the knowledge base and the use of Internet tools among medical students in settings where traditional mode of education is preeminent. This may help to establish a conceptual framework for integrating e-learning into the traditional teaching to enhance learning experience. In this study, we evaluated the medical students' knowledge and use of Internet tools, and their opinion on the application of these tools in surgical education. We undertook a cross-sectional survey of 2013 and 2014 graduating medical class of College of Medicine University of Nigeria, Enugu using structured self-administered questionnaire. The survey assessed the knowledge, utility, and application of Internet tools in surgical education using 5-point Likert scale. Overall response rate was 78% (227/291) comprising 151 (66.5%) males and 76 (33.5%) females. The median age was 24 years (range 20-33 years). Although 106 (46.7%) had formal training on information technology, 223 (98.2%) can access Internet, and 162 (71.4%) use one or more of the Internet tools, 90.6% (96/106) of those trained on ICT use Internet for education/learning compared to 88.4% (107/121) of those without ICT training (p = 0.76). Google™ search tool had the highest rating in terms of familiarity and utility for education/learning (mean rating 4.3 on a scale of 5.0), while Skype™ had the least rating (mean 2.0). Overall, 89% of respondents (mean rating 4.5 on a scale of 5.0) indicated that Internet tools could be effectively applied in surgical education specifically in areas of lectures, assignments, real-time procedure demonstration, case discussion, and interaction with surgical experts. The key benefits are utility as a regular self-assessment tool (mean rating = 4.6) and offer of flexible learning schedule (mean rating = 4.0). Fifty-two percent (118

  16. [A security protocol for the exchange of personal medical data via Internet: monitoring treatment and drug effects].

    PubMed

    Viviani, R; Fischer, J; Spitzer, M; Freudenmann, R W

    2004-04-01

    We present a security protocol for the exchange of medical data via the Internet, based on the type/domain model. We discuss two applications of the protocol: in a system for the exchange of data for quality assurance, and in an on-line database of adverse reactions to drug use. We state that a type/domain security protocol can successfully comply with the complex requirements for data privacy and accessibility typical of such applications.

  17. Use of personal computers, electronic medical records and availability of Internet among office based GPs and internists in Austrian province of Styria.

    PubMed

    Rakovac, Ivo; Seereiner, Sabine; Ratz, Birgit; Habacher, Wolfgang; Pieber, Thomas R; Beck, Peter

    2008-11-06

    We conducted a survey of personal computer (PC), electronic medical record (EMR) usage, and Internet accessibility among Austrian office based general practitioners and internists. PCs were available to 97% of responders, and among PC users, 91% used EMRs.

  18. Defense Infrastructure: Documentation Lacking to Fully Support How DOD Determined Specifications for the Landstuhl Replacement Medical Center

    DTIC Science & Technology

    2012-05-01

    receive health care from the center come from within a 55-mile radius of the facility. DOD officials told us that because the replacement medical...minimally documented the data sources, calculations, and estimating methodologies it used in developing the cost estimate. Additionally, DOD... Used to Define Patient Migration to Landstuhl Regional Medical Center 10 Figure 3: DOD Military Installations in Europe with Expected Posture

  19. The development of MML (Medical Markup Language) version 3.0 as a medical document exchange format for HL7 messages.

    PubMed

    Guo, Jinqiu; Takada, Akira; Tanaka, Koji; Sato, Junzo; Suzuki, Muneou; Suzuki, Toshiaki; Nakashima, Yusei; Araki, Kenji; Yoshihara, Hiroyuki

    2004-12-01

    Medical Markup Language (MML), as a set of standards, has been developed over the last 8 years to allow the exchange of medical data between different medical information providers. MML Version 2.21 used XML as a metalanguage and was announced in 1999. In 2001, MML was updated to Version 2.3, which contained 12 modules. The latest version--Version 3.0--is based on the HL7 Clinical Document Architecture (CDA). During the development of this new version, the structure of MML Version 2.3 was analyzed, subdivided into several categories, and redefined so the information defined in MML could be described in HL7 CDA Level One. As a result of this development, it has become possible to exchange MML Version 3.0 medical documents via HL7 messages.

  20. 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…

  1. Impact of Two Types of Internet-based Information on Medical Students’ Performance in an Objective Structured Clinical Exam (OSCE)

    PubMed Central

    Elder, William G.; Dassow, Paul L.; Bruckner, Geza G.; Stratton, Terry D.

    2009-01-01

    Objectives Internet-based information has potential to impact physician-patient relationships. This study examined medical students’ interpretation and response to such information presented during an objective clinical examination. Method Ninety three medical students who had received training for a patient centered response to inquiries about alternative treatments completed a comprehensive examination in their third year. In one of twelve objective structured clinical exams, a SP presented internet-based information on l-theanine – an amino acid available as a supplement. In Condition A, materials were from commercial websites; in Condition B, materials were from the PubMed website. Results Analyses revealed no significant differences between Conditions in student performance or patient (SP) satisfaction. Students in Condition A rated the information less compelling than students in Condition B (z = −1.78, p = .037), and attributed less of the treatment’s action to real vs. placebo effects (z = −1.61, p = .053). Conclusions Students trained in a patient centered response to inquiries about alternative treatment perceived the credibility of the two types of internet-based information differently but were able to respond to the patient without jeopardizing patient satisfaction. Approach to information was superficial. Training in information evaluation may be warranted. PMID:19157760

  2. Taking the physician out of "physician shopping": a case series of clinical problems associated with Internet purchases of medication.

    PubMed

    Lineberry, Timothy W; Bostwick, J Michael

    2004-08-01

    In the United States, psychoactive prescription medications rank second only to marijuana as drugs of abuse (if tobacco and alcohol are discounted). Physician shopping--visiting multiple physicians simply to procure prescriptions--has been a traditional method for acquiring drugs illicitly. As community-based efforts to curtail physician shopping have expanded, drug abusers have turned increasingly to the Internet. Illegal Internet pharmacies, increasing rapidly in number during the past decade and requiring neither prescription nor physician oversight, offer minimal interference to obtaining drugs. With no physician involved, patients cease to be patients. Instead, they become consumers able to buy prescription medications, even controlled substances, from anonymous providers offering no ongoing treatment relationship and taking no responsibility for the drugs dispensed. When complications occur, these consumers become patients, turning back to the traditional medical system to manage overdoses, addictions, and drug adverse effects and interactions. We present a case series illustrating some of the medical problems that resulted from drugs bought on-line illegally.

  3. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    PubMed Central

    2011-01-01

    Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs). Methods Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic blood pressure (SBP) was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend). Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p < 0.001). Also, documentation of repeated assessment was more frequent for low RTS categories of GCS, RR, and SBP (All: p < 0.001). Mechanism of injury was documented in 80% of cases by ground and 92% of cases by air ambulance. Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our

  4. 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.

  5. The quality of medical record documentation and External cause of fall injury coding in a tertiary teaching hospital.

    PubMed

    Cunningham, Janet; Williamson, Dianne; Robinson, Kerin M; Carroll, Rhonda; Buchanan, Ross; Paul, Lindsay

    2014-01-01

    This paper reviews the documentation and coding of External causes of admitted fall cases in a major hospital. Intensive analysis of a random selection of 100 medical records included blind re-coding in the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian Modification (ICD-10-AM), Fifth Edition for External causes to ascertain whether: (i) the medical records contained sufficient information for assignment of specific External cause codes; and (ii) the most appropriate External cause codes were assigned per available documentation. Comparison of the hospital data with the state-wide Victorian Admitted Episodes Database (VAED) data on frequency of use of External cause codes revealed that the index hospital, a major trauma centre, treated comparatively more falls involving steps, stairs and ladders. The hospital sample reflected lower usage, than state-wide, of unspecified External cause codes and Other specified activity codes; otherwise, there was similarity in External cause coding. A comparison of researcher and hospital codes for the falls study sample revealed differences. The ambulance report was identified as the best source of External cause information; only 50% of hospital medical records contained sufficient information for specific code assignation for all three External cause codes, mechanism of injury, place of occurrence and activity at time of injury. Whilst all medical records contained mechanism of falls injury information, 16% contained insufficient details, indicating a deficiency in medical record documentation to underpin external cause coding. This was compounded by flaws in the ICD-10-AM classification.

  6. Validation of the Internet Addiction Test in Students at a Pakistani Medical and Dental School.

    PubMed

    Waqas, Ahmed; Farooq, Faisal; Raza, Mohsin; Javed, Saamia Tahir; Khan, Spogmai; Ghumman, Mahrukh Elahi; Naveed, Sadiq; Haddad, Mark

    2017-08-17

    Despite growing concerns over pathological internet usage, studies based on validated psychometric instruments are still lacking in Pakistan. This study aimed to examine the psychometric properties of the Internet Addiction Test (IAT) in a sample of Pakistani students. A total of 522 students of medicine and dentistry completed the questionnaire, which consisted of four sections: (a) demographics, (b) number of hours spent on the Internet per day, (c) English version of the IAT, and (d) the Defense Style Questionnaire-40. Maximum likelihood analysis and principal axis factoring were used to validate the factor structure of the IAT. Convergent and criterion validity were assessed by correlating IAT scores with number of hours spent online and defense styles. Exploratory and confirmatory factor analysis reflected the goodness of fit of a unidimensional structure of the IAT, with a high alpha coefficient. The IAT had good face and convergent validity and no floor and ceiling effects, and was judged easy to read by participants.

  7. Surgical ward round checklist: does it improve medical documentation? A clinical review of Christchurch general surgical notes.

    PubMed

    Alamri, Yassar; Frizelle, Frank; Al-Mahrouqi, Haitham; Eglinton, Tim; Roberts, Ross

    2016-11-01

    Poor documentation of medical notes and plans not only adversely affects patient management but also has medico-legal implications. A standardized ward round checklist (adhesive proforma sticker, PFS) was introduced at our institution in 2013 to improve documentation by junior doctors. We aimed to examine the current pattern of PFS documentation (2 years after its introduction) and to identify which fields, if any, have been the most problematic to complete. Notes of all current general surgical inpatients admitted to Christchurch Public Hospital on or before the two study days were reviewed. All information written in the PFS, regardless of accuracy, authorship or completeness, was recorded. Documentation of the various PFS fields was classified as well documented (completed in >80% of PFS), inadequate (40-80%) or minimal (<40%). Four hundred and seventy-nine PFS were reviewed. Most fields in the PFS were documented to an adequate level (i.e. >80%). Problematic fields identified were dietary plans, diagnosis, national health index number, estimated date of discharge and the patient's first name. Notes of patients on outlying ward contained significantly fewer PFS compared with home-ward patients' notes (0.71 PFS/day versus 1.21 PFS/day, respectively, P < 0.001). Our study has shown generally adequate patterns of medical note documentation in the General Surgery service. Certain fields remain challenging to document accurately. The proposed modified PFS was designed to help rectify this; electronic data record may be the step forward, however. It is hoped that other institutions in Australasia would benefit from our experience. © 2016 Royal Australasian College of Surgeons.

  8. Medical imaging document sharing solutions for various kinds of healthcare services based on IHE XDS/XDS-I profiles

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Yang, Yuanyuan; Zhang, Kai; Sun, Jianyong; Ling, Tonghui; Wang, Tusheng; Wang, Mingqing; Bak, Peter

    2014-03-01

    One key problem for continuity of patient care is identification of a proper method to share and exchange patient medical records among multiple hospitals and healthcare providers. This paper focuses in the imaging document component of medical record. The XDS-I (Cross- Enterprise Document Sharing - Image) Profile based on the IHE IT-Infrastructure extends and specializes XDS to support imaging "document" sharing in an affinity domain. We present three studies about image sharing solutions based on IHE XDS-I Profile. The first one is to adopt the IHE XDS-I profile as a technical guide to design image and report sharing mechanisms between hospitals for regional healthcare service in Shanghai. The second study is for collaborating image diagnosis in regional healthcare services. The latter study is to investigate the XDS-I based clearinghouse for patient controlled image sharing in the RSNA Image Sharing Network Project. We conclude that the IHE XDS/XDS-I profiles can be used as the foundation to design medical image document sharing for Various Healthcare Services.

  9. Quality improvement in documentation of postoperative care nursing using computer-based medical records.

    PubMed

    Olsen, Susanne Winther

    2013-04-01

    Postanesthesia nursing should be documented with high quality. The purpose of this retrospective case-based study on 49 patients was to analyze the quality of postoperative documentation in the two existing templates and, based on this audit, to suggest a new template for documentation. The audit on the template with quantitative data showed satisfactory documentation of postoperative care nursing in 67% (18% to 92%; mean [min-max]) of the scores. The template for documentation using qualitative descriptions was used by 63% of the nurses, but the keywords were used to a varying degree, that is, from 0% to 63% of records. The analysis also revealed noncompliance with clinical guidelines and multiple duplicate entries. Based on this audit, a new template was constructed, with 10 physiological parameters and drop-down lists with keywords within each parameter. In this way, implicit knowledge could be converted to explicit documentation. Furthermore, the quality of documentation was improved. Copyright © 2013 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. A trial of indication based prescribing of antihypertensive medications during computerized order entry to improve problem list documentation.

    PubMed

    Falck, Suzanne; Adimadhyam, Sruthi; Meltzer, David O; Walton, Surrey M; Galanter, William L

    2013-10-01

    Maintenance of problem lists in electronic medical records is required for the meaningful use incentive and by the Joint Commission. Linking indication with prescribed medications using computerized physician order entry (CPOE) can improve problem list documentation. Prescribing of antihypertensive medications is an excellent target for interventions to improve indication-based prescribing because antihypertensive medications often have multiple indications and are frequently prescribed. To measure the accuracy and completeness of electronic problem list additions using indication-based prescribing of antihypertensives. Clinical decision support (CDS) was implemented so that orders of antihypertensives prompted ordering physicians to select from problem list additions indicated by that medication. An observational analysis of 1000 alerts was performed to determine the accuracy of physicians' selections. At least one accurate problem was placed 57.5% of the time. Inaccurate problems were placed 4.8% of the time. Accuracy was lower in medications with multiple indications and the likelihood of omitted problems was higher compared to medications whose only indication was hypertension. Attending physicians outperformed other clinicians. There was somewhat lower accuracy for inpatients compared to outpatients. CDS using indication-based prescribing of antihypertensives produced accurate problem placement roughly two-thirds of time with fewer than 5% inaccurate problems placed. Performance of alerts was sensitive to the number of potential indications of the medication and attendings vs. other clinicians prescribing. Indication-based prescribing during CPOE can be used for problem list maintenance, but requires optimization. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. [Medical service of the Armed Forces of Great Britain (review of foreign internet-publications)].

    PubMed

    Agapitov, A A; Bolekhan, V N; Ivchenko, E V; Krassiĭ, A B; Nagibovich, O A; Petrov, S V; Rezvantsev, M V

    2012-07-01

    The present review is dedicated to organization and principles of operation of the Medical service of the Armed Forces of Great Britain. At the beginning of the review a brief description of British Armed Forces and their medical service is presented. Then the particular key elements of the medical service such as the medical services of the Armed Forces major components, inpatient care, medical supplies, research, medical care at an operation theater, medical personnel training are considered. The special attention is paid to the Joint Medical Command formed four years ago as a prototype for the future integration and centralization of the whole medical service. The cooperation with the civil health care has played an increasing role in the organization of British military medicine. That is why the review includes the short description of the major structure of the British civil health care system--the National Health Service.

  13. Use of a secure Internet Web site for collaborative medical research.

    PubMed

    Marshall, W W; Haley, R W

    2000-10-11

    Researchers who collaborate on clinical research studies from diffuse locations need a convenient, inexpensive, secure way to record and manage data. The Internet, with its World Wide Web, provides a vast network that enables researchers with diverse types of computers and operating systems anywhere in the world to log data through a common interface. Development of a Web site for scientific data collection can be organized into 10 steps, including planning the scientific database, choosing a database management software system, setting up database tables for each collaborator's variables, developing the Web site's screen layout, choosing a middleware software system to tie the database software to the Web site interface, embedding data editing and calculation routines, setting up the database on the central server computer, obtaining a unique Internet address and name for the Web site, applying security measures to the site, and training staff who enter data. Ensuring the security of an Internet database requires limiting the number of people who have access to the server, setting up the server on a stand-alone computer, requiring user-name and password authentication for server and Web site access, installing a firewall computer to prevent break-ins and block bogus information from reaching the server, verifying the identity of the server and client computers with certification from a certificate authority, encrypting information sent between server and client computers to avoid eavesdropping, establishing audit trails to record all accesses into the Web site, and educating Web site users about security techniques. When these measures are carefully undertaken, in our experience, information for scientific studies can be collected and maintained on Internet databases more efficiently and securely than through conventional systems of paper records protected by filing cabinets and locked doors. JAMA. 2000;284:1843-1849.

  14. The rehabilitation of children and adolescents with severe or medically complicated obesity: an ISPED expert opinion document.

    PubMed

    Grugni, Graziano; Licenziati, Maria Rosaria; Valerio, Giuliana; Crinò, Antonino; Maffeis, Claudio; Tanas, Rita; Morino, Giuseppe Stefano

    2017-03-01

    Severe/medically complicated obesity in childhood, and particularly in adolescence, is a real disability that requires an intensive and continuous approach which should follow the procedures and schedule of rehabilitation medicine. Given the lack of a specific document focusing on children and adolescents, the Childhood Obesity Study Group set out to explore the available evidence for the treatment of severe or medically complicated obesity and to set standards tailored to the specific context of the Italian Health Service. Through a series of meetings and electronic communications, the writing committee (selected from members of the Study Group) selected the key issues, explored the literature and produced a draft document which was submitted to the other experts until the final synthesis was approved by the group. In brief, the following issues were involved: (1) definition and epidemiology; (2) identification of common goals designed to regain functional competence and limit the progression of metabolic and psychological complications; (3) a multi-professional team approach; (4) the care setting. This paper is an expert opinion document on the rehabilitation of severe and medically complicated obesity in children and adolescents produced by experts belonging to the Childhood Obesity Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED).

  15. Google Glass for Documentation of Medical Findings: Evaluation in Forensic Medicine

    PubMed Central

    2014-01-01

    Background Google Glass is a promising premarket device that includes an optical head-mounted display. Several proof of concept reports exist, but there is little scientific evidence regarding its use in a medical setting. Objective The objective of this study was to empirically determine the feasibility of deploying Glass in a forensics setting. Methods Glass was used in combination with a self-developed app that allowed for hands-free operation during autopsy and postmortem examinations of 4 decedents performed by 2 physicians. A digital single-lens reflex (DSLR) camera was used for image comparison. In addition, 6 forensic examiners (3 male, 3 female; age range 23-48 years, age mean 32.8 years, SD 9.6; mean work experience 6.2 years, SD 8.5) were asked to evaluate 159 images for image quality on a 5-point Likert scale, specifically color discrimination, brightness, sharpness, and their satisfaction with the acquired region of interest. Statistical evaluations were performed to determine how Glass compares with conventionally acquired digital images. Results All images received good (median 4) and very good ratings (median 5) for all 4 categories. Autopsy images taken by Glass (n=32) received significantly lower ratings than those acquired by DSLR camera (n=17) (region of interest: z=–5.154, P<.001; sharpness: z=–7.898, P<.001; color: z=–4.407, P<.001, brightness: z=–3.187, P=.001). For 110 images of postmortem examinations (Glass: n=54, DSLR camera: n=56), ratings for region of interest (z=–8.390, P<.001) and brightness (z=–540, P=.007) were significantly lower. For interrater reliability, intraclass correlation (ICC) values were good for autopsy (ICC=.723, 95% CI .667-.771, P<.001) and postmortem examination (ICC=.758, 95% CI .727-.787, P<.001). Postmortem examinations performed using Glass took 42.6 seconds longer than those done with the DSLR camera (z=–2.100, P=.04 using Wilcoxon signed rank test). The battery charge of Glass quickly decreased

  16. Google Glass for documentation of medical findings: evaluation in forensic medicine.

    PubMed

    Albrecht, Urs-Vito; von Jan, Ute; Kuebler, Joachim; Zoeller, Christoph; Lacher, Martin; Muensterer, Oliver J; Ettinger, Max; Klintschar, Michael; Hagemeier, Lars

    2014-02-12

    Google Glass is a promising premarket device that includes an optical head-mounted display. Several proof of concept reports exist, but there is little scientific evidence regarding its use in a medical setting. The objective of this study was to empirically determine the feasibility of deploying Glass in a forensics setting. Glass was used in combination with a self-developed app that allowed for hands-free operation during autopsy and postmortem examinations of 4 decedents performed by 2 physicians. A digital single-lens reflex (DSLR) camera was used for image comparison. In addition, 6 forensic examiners (3 male, 3 female; age range 23-48 years, age mean 32.8 years, SD 9.6; mean work experience 6.2 years, SD 8.5) were asked to evaluate 159 images for image quality on a 5-point Likert scale, specifically color discrimination, brightness, sharpness, and their satisfaction with the acquired region of interest. Statistical evaluations were performed to determine how Glass compares with conventionally acquired digital images. All images received good (median 4) and very good ratings (median 5) for all 4 categories. Autopsy images taken by Glass (n=32) received significantly lower ratings than those acquired by DSLR camera (n=17) (region of interest: z=-5.154, P<.001; sharpness: z=-7.898, P<.001; color: z=-4.407, P<.001, brightness: z=-3.187, P=.001). For 110 images of postmortem examinations (Glass: n=54, DSLR camera: n=56), ratings for region of interest (z=-8.390, P<.001) and brightness (z=-540, P=.007) were significantly lower. For interrater reliability, intraclass correlation (ICC) values were good for autopsy (ICC=.723, 95% CI .667-.771, P<.001) and postmortem examination (ICC=.758, 95% CI .727-.787, P<.001). Postmortem examinations performed using Glass took 42.6 seconds longer than those done with the DSLR camera (z=-2.100, P=.04 using Wilcoxon signed rank test). The battery charge of Glass quickly decreased; an average 5.5% (SD 1.85) of its battery capacity

  17. Results of the 10 HON survey on health and medical internet use.

    PubMed

    Pletneva, Natalia; Cruchet, Sarah; Simonet, Maria-Ana; Kajiwara, Maki; Boyer, Célia

    2011-01-01

    The Internet is increasingly being used as a means to search and communicate health information. As the mission of Health on the Net Foundation (HON) is to guide healthcare consumers and professionals to trustworthy online information, we have been interested in seeing the trend of the attitudes towards Internet use for health purposes since 1996. This article presents the results of the 10th HON survey conducted in July-August 2010 (in English and French). It was hosted on the HON site with links from Facebook and Twitter and from HONcode certified web sites. There were 524 participants coming mainly from France (28%), the UK (18%) and the USA (18%). 65% of participants represented the "general public", while the remaining 35% were professionals. Information quality remains the main barrier users encounter while looking for health information online; at the same time, 79% believe they critically assess online content. Both patients and physicians consider the Internet to be helpful in facilitating their communication during consultations, although professionals are more sceptic than the general public. These results justify the continuing efforts of HON to raise public awareness regarding online health information and the ethical, quality and transparency issues, and to educate and guide users towards trustworthy health information.

  18. In the words of the medical tourist: an analysis of Internet narratives by health travelers to Turkey.

    PubMed

    Ozan-Rafferty, Margaret E; Johnson, James A; Shah, Gulzar H; Kursun, Attila

    2014-02-06

    Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers' actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals' treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients' health travel. This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists' written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to identify characteristics and themes

  19. In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey

    PubMed Central

    2014-01-01

    Background Patients regularly travel to the West for advanced medical care, but now the trend is also shifting in the opposite direction. Many people from Western countries now seek care outside of their country. This phenomenon has been labeled medical tourism or health travel. Information regarding health travelers’ actual outcomes, experiences, and perceptions is lacking or insufficient. However, advanced Internet technology and apps provide information on medical tourism and are a vehicle for patients to share their experiences. Turkey has a large number of internationally accredited hospitals, is a top tourism destination, and is positioning itself to attract international patients. Objective The objective of this research was to identify the important individual characteristics of health travelers, outline the push and pull factors for seeking health care in Turkey, identify satisfaction with the outcomes and the results of these individuals’ treatments, and note positive and negative factors influencing their perceptions and overall experiences about patients’ health travel. Methods This research uses qualitative data from Internet narratives of medical tourists to Turkey. Ethical considerations of using Internet narratives were reviewed. Narratives for analysis were obtained by using the Google search engine and using multiple search terms to obtain publicly posted blogs and discussion board postings of health travelers via purposeful sampling. Narratives were included if they were written in English, described travel to Turkey for health care, and were publicly accessible. Exclusion criteria included narratives that were on medical tourism facilitator or provider promotional websites, not in English, and did not describe an experience of a medical tourist. Medical tourists’ written words were analyzed in an iterative analytic process using narrative analysis theory principles. Three stages of coding (open, axial, and selective) were conducted to

  20. Providing Internet access to Los Alamos National Laboratory technical reports: A case history in providing public access to previously restricted documents

    SciTech Connect

    Collins, K.A.

    1996-12-31

    The Los Alamos National Laboratory (LANL) Research Library recently fulfilled a strategic goal of providing worldwide desktop access via the Internet to full-image files of the complete unclassified holdings of Los Alamos technical reports in its Report Collection. This effort began in late 1994 with the scanning of paper and microfiche format reports. Concurrently, the Research Library helped to initiate shifting the model for publishing new technical reports from paper to electronic; the files could then be directly mounted on the Research Library`s Web server. Providing desktop access to these reports was instrumental in expediting the development of internal policies that would better define what documents, previously restricted to the general public, could be publicly released. Undoubtedly, the most significant category of such reports were previously classified reports that had been declassified, but had not gone through a further review for public release. Collaboration with LANL`s Classification Group led to approval for public release of 97% of these reports. The LANL Research Library`s Web site now offers unique and unprecedented access to the world of a huge body of technical reports never available before anywhere in any form. This paper discusses the issues and steps involved in this achievement.

  1. 10 years experience with pioneering open access publishing in health informatics: the Journal of Medical Internet Research (JMIR).

    PubMed

    Eysenbach, Gunther

    2010-01-01

    Peer-reviewed journals remain important vehicles for knowledge transfer and dissemination in health informatics, yet, their format, processes and business models are changing only slowly. Up to the end of last century, it was common for individual researchers and scientific organizations to leave the business of knowledge transfer to professional publishers, signing away their rights to the works in the process, which in turn impeded wider dissemination. Traditional medical informatics journals are poorly cited and the visibility and uptake of articles beyond the medical informatics community remain limited. In 1999, the Journal of Medical Internet Research (JMIR; http://www.jmir.org) was launched, featuring several innovations including 1) ownership and copyright retained by the authors, 2) electronic-only, "lean" non-for-profit publishing, 3) openly accessible articles with a reversed business model (author pays instead of reader pays), 4) technological innovations such as automatic XML tagging and reference checking, on-the-fly PDF generation from XML, etc., enabling wide distribution in various bibliographic and full-text databases. In the past 10 years, despite limited resources, the journal has emerged as a leading journal in health informatics, and is presently ranked the top journal in the medical informatics and health services research categories by impact factor. The paper summarizes some of the features of the Journal, and uses bibliometric and access data to compare the influence of the Journal on the discipline of medical informatics and other disciplines. While traditional medical informatics journals are primarily cited by other Medical Informatics journals (33%-46% of citations), JMIR papers are to a more often cited by "end-users" (policy, public health, clinical journals), which may be partly attributable to the "open access advantage".

  2. Basic Internet Software Toolkit.

    ERIC Educational Resources Information Center

    Buchanan, Larry

    1998-01-01

    Once schools are connected to the Internet, the next step is getting network workstations configured for Internet access. This article describes a basic toolkit comprising software currently available on the Internet for free or modest cost. Lists URLs for Web browser, Telnet, FTP, file decompression, portable document format (PDF) reader,…

  3. Basic Internet Software Toolkit.

    ERIC Educational Resources Information Center

    Buchanan, Larry

    1998-01-01

    Once schools are connected to the Internet, the next step is getting network workstations configured for Internet access. This article describes a basic toolkit comprising software currently available on the Internet for free or modest cost. Lists URLs for Web browser, Telnet, FTP, file decompression, portable document format (PDF) reader,…

  4. [The procedure for documentation of digital images in forensic medical histology].

    PubMed

    Putintsev, V A; Bogomolov, D V; Fedulova, M V; Gribunov, Iu P; Kul'bitskiĭ, B N

    2012-01-01

    This paper is devoted to the novel computer technologies employed in the studies of histological preparations. These technologies allow to visualize digital images, structurize the data obtained and store the results in computer memory. The authors emphasize the necessity to properly document digital images obtained during forensic-histological studies and propose the procedure for the formulation of electronic documents in conformity with the relevant technical and legal requirements. It is concluded that the use of digital images as a new study object permits to obviate the drawbacks inherent in the work with the traditional preparations and pass from descriptive microscopy to their quantitative analysis.

  5. mJustice: Preliminary Development of a Mobile App for Medical-Forensic Documentation of Sexual Violence in Low-Resource Environments and Conflict Zones.

    PubMed

    Mishori, Ranit; Anastario, Michael; Naimer, Karen; Varanasi, Sucharita; Ferdowsian, Hope; Abel, Dori; Chugh, Kevin

    2017-03-24

    Digital health development and use has been expansive and operationalized in a variety of settings and modalities around the world, including in low- and middle-income countries. Mobile applications have been developed for a variety of health professionals and frontline health workers including physicians, midwives, nurses, and community health workers. However, there are no published studies on the development and use of digital health related to human rights fieldwork and to our knowledge no mobile health platforms exist specifically for use by frontline health workers to forensically and clinically document sexual violence. We describe a participatory development and user design process with Congolese end-users of a novel human rights app for clinicians intended to standardize the documentation of sexual violence evidence for forensic and legal purposes, called MediCapt. The app, yet to be launched and still in the future proofing phase, has included several development phases: (1) initial needs assessment conducted in 2011, (2) prototype development and field-testing in 2014 with 8 Congolese physicians, (3) prototype refinement and field-testing in 2015 with 9 clinicians. Feedback from the first field-testing phase was incorporated into the design of the second prototype; key features that were added to MediCapt include the ability for users to take photographs and draw on a pictogram to include as part of the evidence package, as well as the ability to print a form with the completed data. Questionnaires and key-informant interviews during the second and third field-testing phases revealed overall positive attitudes about MediCapt, but multiple perceived and actual barriers to implementation were identified, from personal behaviors, such as individual clinicians' comfort with new technology, to more systemic and infrastructure factors, such as strong cultural preferences for print documentation of evidence and limited Internet connectivity. Next phases of

  6. mJustice: Preliminary Development of a Mobile App for Medical-Forensic Documentation of Sexual Violence in Low-Resource Environments and Conflict Zones

    PubMed Central

    Mishori, Ranit; Anastario, Michael; Naimer, Karen; Varanasi, Sucharita; Ferdowsian, Hope; Abel, Dori; Chugh, Kevin

    2017-01-01

    ABSTRACT Digital health development and use has been expansive and operationalized in a variety of settings and modalities around the world, including in low- and middle-income countries. Mobile applications have been developed for a variety of health professionals and frontline health workers including physicians, midwives, nurses, and community health workers. However, there are no published studies on the development and use of digital health related to human rights fieldwork and to our knowledge no mobile health platforms exist specifically for use by frontline health workers to forensically and clinically document sexual violence. We describe a participatory development and user design process with Congolese end-users of a novel human rights app for clinicians intended to standardize the documentation of sexual violence evidence for forensic and legal purposes, called MediCapt. The app, yet to be launched and still in the future proofing phase, has included several development phases: (1) initial needs assessment conducted in 2011, (2) prototype development and field-testing in 2014 with 8 Congolese physicians, (3) prototype refinement and field-testing in 2015 with 9 clinicians. Feedback from the first field-testing phase was incorporated into the design of the second prototype; key features that were added to MediCapt include the ability for users to take photographs and draw on a pictogram to include as part of the evidence package, as well as the ability to print a form with the completed data. Questionnaires and key-informant interviews during the second and third field-testing phases revealed overall positive attitudes about MediCapt, but multiple perceived and actual barriers to implementation were identified, from personal behaviors, such as individual clinicians' comfort with new technology, to more systemic and infrastructure factors, such as strong cultural preferences for print documentation of evidence and limited Internet connectivity. Next

  7. EFFECTS OF MEDICAL DISPUTES ON INTERNET COMMUNICATIONS OF NEGATIVE EMOTIONS AND NEGATIVE ONLINE WORD-OF-MOUTH.

    PubMed

    Lee, Yi-Chih; Wu, Wei-Li

    2015-08-01

    Emotions play an important role in human behavior. Negative emotions resulting from medical disputes are problems for medical personnel to solve but also have a significant impact on a hospital's reputation and people's trust in the hospital. One medical dispute case was chosen from an Internet news source to assess the correlation between people's negative emotions and negative online word-of-mouth. Convenience sampling was used in school faculties and university students who had shared their medical treatment experiences online were the research participants. A total of 221 Taiwanese participants volunteered (158 women, 63 men; ages: 26.7% under 19, 22.6% 20-29, 30.8% 30-39,19.9% over 40). Four negative emotions were measured using rating scales: uncertainty, anger, disappointment, and sadness. Four negative online word-of-mouth measures were: venting, advice search, helping receiver, and revenge. A modeled relationship was assessed by partial least square method (PLS). Then, people's positive emotions were further analyzed to assess changes after spreading negative word-of-mouth. The results showed that uncertainty had a positive effect on venting and advice search. People who felt anger or regret spread word-of-mouth in order to help the receiver. Disappointment may trigger the revenge behavior of negative word-of-mouth. Negative emotions could be relieved after engaging in the behavior of helping the receiver.

  8. An internet survey on self-reported food allergy in Greece: clinical aspects and lack of appropriate medical consultation.

    PubMed

    Kalogeromitros, D; Makris, M P; Chliva, C; Sergentanis, T N; Church, M K; Maurer, M; Psaltopoulou, T

    2013-05-01

    Food allergy (FA) represents a common and worldwide disorder but in publications referring to FA the reported diagnosis is rarely confirmed. Consequently, the subjectively assessed FA may negatively affect the quality of life of patients and their families. We have conducted this internet survey in order to estimate the self-reported perception of FA in Greece. A standard anonymous questionnaire was posted for a 3-month period on http://www.in.gr, a Greek popular Internet portal. Each individual could participate only once. Participants were screened for the presence or history of FA by a key question and were then asked to provide information on symptoms, course and management. A total of 3673 adult subjects (mean age 34.2 years, range 18-74, females 61.3%), reporting FA were included in analysis. Most reported reactions were related to fruits (14.9%), seafood (10.7%) and nuts (9.2%). The first episode occurred principally during the second (29.2%) and third (30.9%) decade within 3 h from consumption (82.2%). Predominant symptoms were urticaria and oral allergy syndrome (almost 25% each one). Nearly half of the participants sought no medical advice, while 31.4% asked for an allergist's consultation. Almost 21% of reactors were hospitalized; nuts, severity of symptoms (lower respiratory and/or cardiovascular), onset in lower age, previous exercise and concomitant alcohol and/or aspirin intake were positively associated with hospitalization. Although FA causes severe anaphylactic episodes, almost 50% of individuals who experience symptoms perceived as FA do not seek medical advice. Awareness programmes must be carried out in order to increase consciousness about this potentially fatal medical condition. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  9. The meaning of behavioral medicine in the public health field-a review of documents related to medical education in Japan.

    PubMed

    Inoue, Shigeru

    2016-01-01

    International standardization of medical education requires Japanese medical schools to restructure their curricula to include "behavioral science." Two influential documents for Japanese medical education, the "Model Core Curriculum for Medical Education in Japan" and the "Scope of the Japanese National Examination for Medical Doctors" include some key terms regarding behavioral science. However, they are not systematic and the phrase "behavioral science" itself could not be found in these documents. The new global standards for medical education, the "Basic Medical Education WFME Global Standards," require medical schools to include behavioral science in their curricula. The definition of "behavioral science" in the global standards emphasizes social aspects and determinants of health, which is also a key concept of public health. From the view point of public health, it is hoped that the systematic introduction of behavioral science into Japanese medical education will strengthen the public health mindset of medical doctors, which in turn will support the healthcare system in communities.

  10. Medical Data Mining on the Internet: Research on a Cancer Information System

    DTIC Science & Technology

    1999-01-01

    data mining algorithms and techniques that we have developed at the University of Arizona Artificial Intelligence Lab. We have implemented these algorithms and techniques into several prototypes, one of which focuses on medical information developed in cooperation with the National Cancer Institute (NCI) and the University of Illinois at Urbana-Champaign. We propose an architecture for medical knowledge information systems that will permit data mining across several medical information sources and discuss a... data mining tools

  11. Making environmental health interesting for medical students-internet assisted facilitated collaborative learning approach.

    PubMed

    Sudharsanam, Manni Balasubramaniam

    2014-01-01

    Topics on environmental health are usually neglected by students and it is necessary for them to learn this area with a public health perspective as environment plays a vital role in multi-factorial causation of diseases. Hence there is a need for alternative teaching/learning methods to facilitate students in acquiring the required knowledge. To increase the student interest and enhance their participation in acquiring knowledge in public health perspective of environmental health. Teaching Objectives/Learning Were: At the end of the session students should know the importance of air as an environmental factor in disease causation in special reference to public health hazards, the major sources of air pollution, major pollutants causing the health hazards, the way to measure pollutants and control them. The whole class of students was divided into two batches and one session was planned for each batch. Each batch was divided into six small groups. The groups were given task of exploring the internet on the different topics mentioned in the learning objectives. All the students were asked to explore, compile information and collectively prepare a presentation and present their findings based on their reviews. Students' feedback was collected at the end of each session. Eighty five percent of them were clear about the learning objectives and interested about internet learning. Most of them gave a positive opinion about the newer teaching learning method. Internet assisted group study served as a valuable alternative, innovative, and interesting tool to teach and learn the environmental health as revealed by students' feedback.

  12. DMHRSwhy? The Value of the Defense Medical Human Resource System-Internet (DMHRSi) to the Military Health System (MHS)

    DTIC Science & Technology

    2015-02-01

    hospital , and medical center locations in a variety of student, staff, instructor, and leadership positions, and has deployed twice in support of...many of these benefits not being realized. Interviews with four MTF MEPRS managers (two hospitals and two clinics) from the three Services revealed...Manpower Document accuracy, and identify patient safety, provider quality-of-life, and staff overwork issues.33) The DMHRSi-based LCA process is

  13. Advice from a Medical Expert through the Internet on Queries about AIDS and Hepatitis: Analysis of a Pilot Experiment

    PubMed Central

    Marco, Javier; Barba, Raquel; Losa, Juan E; de la Serna, Carlos Martínez; Sainz, María; Lantigua, Isabel Fernández; de la Serna, Jose Luis

    2006-01-01

    Background Advice from a medical expert on concerns and queries expressed anonymously through the Internet by patients and later posted on the Web, offers a new type of patient–doctor relationship. The aim of the current study was to perform a descriptive analysis of questions about AIDS and hepatitis made to an infectious disease expert and sent through the Internet to a consumer-oriented Web site in the Spanish language. Methods and Findings Questions were e-mailed and the questions and answers were posted anonymously in the “expert-advice” section of a Web site focused on AIDS and hepatitis. We performed a descriptive study and a temporal analysis of the questions received in the first 12 months after the launch of the site. A total of 899 questions were received from December 2003 to November 2004, with a marked linear growth pattern. Questions originated in Spain in 68% of cases and 32% came from Latin America (the Caribbean, Central America, and South America). Eighty percent of the senders were male. Most of the questions concerned HIV infection (79%) with many fewer on hepatitis (17%) . The highest numbers of questions were submitted just after the weekend (37% of questions were made on Mondays and Tuesdays). Risk factors for contracting HIV infection were the most frequent concern (69%), followed by the window period for detection (12.6%), laboratory results (5.9%), symptoms (4.7%), diagnosis (2.7%), and treatment (2.2%). Conclusions Our results confirm a great demand for this type of “ask-the-expert” Internet service, at least for AIDS and hepatitis. Factors such as anonymity, free access, and immediate answers have been key factors in its success. PMID:16796404

  14. [Different uses of Fagopyrum esculentum Moench (buckwheat) in Japan and China: what ancient medical documents reveal].

    PubMed

    Tatsumi, Nami; Marui, Eiji

    2012-03-01

    The purpose of this thesis is to demonstrate that buckwheat has been recognized, both in Japan and China, as a crop that is useful in many ways: as an agricultural crop, and for the healing powers and properties that, according to traditional Chinese medicine, it has. A comparative study of ancient documents pertaining to medicine in these countries has made it clear that this is the case. Buckwheat, however, has been used quite differently in each country. As is shown in some ancient Chinese documents pertaining to medicine, China has treated buckwheat primarily as a medicine for clinical use rather than as an edible crop. Nowadays, buckwheat is eaten only in some regions of China. Although it came to Japan from China as a medicine, in Japan buckwheat gradually became a popular food crop. It has become an important component of traditional Japanese cuisine thanks in part to government support and the strong demand that developed in Japanese society.

  15. Human Rights, Humanitarianism, and State Violence: Medical Documentation of Torture in Turkey.

    PubMed

    Can, Başak

    2016-09-01

    State authorities invested in developing official expert discourses and practices to deny torture in post-1980 coup d'état Turkey. Documentation of torture was therefore crucial for the incipient human rights movement there in the 1980s. Human rights physicians used their expertise not only to treat torture victims but also to document torture and eventually found the Human Rights Foundation of Turkey (HRFT) in 1990. Drawing on an ethnographic and archival research at the HRFT, this article examines the genealogy of anti-torture struggles in Turkey and argues that locally mediated intimacies and/or hostilities between victims of state violence, human rights physicians, and official forensics reveal the limitations of certain universal humanitarian and human rights principles. It also shows that locally mediated long-term humanitarian encounters around the question of political violence challenge forensic denial of violence and remake the legitimate levels of state violence. © 2015 by the American Anthropological Association.

  16. Renal function tests for windows--a model for the development and distribution of medical software on the Internet.

    PubMed

    Fong, B C; Doyle, D J

    1995-09-01

    A computer application (Renal Function Tests for Windows) was developed to calculate and sort data for quantitative renal function testing using the Microsoft Visual Basic for Windows programming language. The following diagnostic indices are computed: Measured creatinine clearance--The rate at which serum is cleared of creatinine. Standardized clearance--Creatinine clearance scaled by body surface area. Estimated creatinine clearance--Renal creatinine clearance estimated from serum creatinine Renal failure index--To distinguish prerenal azotemia from oliguric acute renal failure. Renal free water clearance--Net volume per min of free water excreted by the kidneys. Fractional excretion of filtered sodium--To distinguish prerenal azotemia from acute renal failure. Renal Function Tests for Windows (RFT) allows the user to choose to enter only the data that is available. The program will then calculate all the possible results from the given data. Upon request, the program will also inform the user of data that is missing for those results that cannot be calculated. The flexibility of this program allows the user to perform 'what if' analysis through the manipulation of input data. Distribution of this program was accomplished using the Internet File Transfer Protocol (FTP) service. The effectiveness of mode of distributing medical software awaits feedback from users on the Internet.

  17. Automatically Detecting Medications and the Reason for their Prescription in Clinical Narrative Text Documents

    PubMed Central

    Meystre, Stéphane M.; Thibault, Julien; Shen, Shuying; Hurdle, John F.; South, Brett R.

    2011-01-01

    An important proportion of the information about the medications a patient is taking is mentioned only in narrative text in the electronic health record. Automated information extraction can make this information accessible for decision-support, research, or any other automated processing. In the context of the “i2b2 medication extraction challenge,” we have developed a new NLP application called Textractor to automatically extract medications and details about them (e.g., dosage, frequency, reason for their prescription). This application and its evaluation with part of the reference standard for this “challenge” are presented here, along with an analysis of the development of this reference standard. During this evaluation, Textractor reached a system-level overall F1-measure, the reference metric for this challenge, of about 77% for exact matches. The best performance was measured with medication routes (F1-measure 86.4%), and the worst with prescription reasons (F1-measure 29%). These results are consistent with the agreement observed between human annotators when developing the reference standard, and with other published research. PMID:20841823

  18. Documenting Nursing and Medical Students' Stereotypes about Hispanic and American Indian Patients.

    PubMed

    Bean, Meghan G; Focella, Elizabeth S; Covarrubias, Rebecca; Stone, Jeff; Moskowitz, Gordon B; Badger, Terry A

    2014-10-01

    Hispanic Americans and American Indians face significant health disparities compared with White Americans. Research suggests that stereotyping of minority patients by members of the medical community is an important antecedent of race and ethnicity-based health disparities. This work has primarily focused on physicians' perceptions, however, and little research has examined the stereotypes healthcare personnel associate with Hispanic and American Indian patients. The present study assesses: 1) the health-related stereotypes both nursing and medical students hold about Hispanic and American Indian patients, and 2) nursing and medical students' motivation to treat Hispanic and American Indian patients in an unbiased manner. Participants completed a questionnaire assessing their awareness of stereotypes that healthcare professionals associate with Hispanic and American Indian patients then completed measures of their motivation to treat Hispanics and American Indians in an unbiased manner. Despite being highly motivated to treat Hispanic and American Indian individuals fairly, the majority of participants reported awareness of stereotypes associating these patient groups with noncompliance, risky health behavior, and difficulty understanding and/or communicating health-related information. This research provides direct evidence for negative health-related stereotypes associated with two understudied minority patient groups-Hispanics and American Indians-among both nursing and medical personnel.

  19. Use of Patient Encounter Documentation (Log) Systems at Three Medical Schools.

    ERIC Educational Resources Information Center

    Vanek, Eugenia P.; And Others

    1993-01-01

    The use of patient encounter recordkeeping systems in four medical programs at three universities (Case Western Reserve University, Ohio; University of Colorado; and University of Rochester, New York) is described and compared. Uses for curriculum evaluation and development, psychometric uses, and administrative issues are discussed. (MSE)

  20. Access to medical care for documented and undocumented Latinos in a southern California county.

    PubMed Central

    Hubbell, F. A.; Waitzkin, H.; Mishra, S. I.; Dombrink, J.; Chavez, L. R.

    1991-01-01

    To determine local access to medical care among Latinos, we conducted telephone interviews with residents of Orange County, California. The survey replicated on a local level the national access surveys sponsored by the Robert Wood Johnson Foundation. We compared access among Latino citizens of the United States (including permanent legal residents), undocumented Latinos, and Anglos, and analyzed predictors of access. Among the sample of 958 respondents were 137 Latino citizens, 54 undocumented Latinos, and 680 Anglos. Compared with Anglos, Latino citizens and undocumented immigrants had less access to medical care by all measures used in the survey. Although undocumented Latinos were less likely than Latino citizens to have health insurance, by most other measures their access did not differ significantly. By multivariate analysis, health insurance status and not ethnicity was the most important predictor of access. Because access to medical care is limited for both Latino citizens and undocumented immigrants, policy proposals to improve access for Latinos should consider current barriers faced by these groups and local differences in access to medical care. PMID:1877182

  1. Documenting Nursing and Medical Students’ Stereotypes about Hispanic and American Indian Patients

    PubMed Central

    Bean, Meghan G.; Focella, Elizabeth S.; Covarrubias, Rebecca; Stone, Jeff; Moskowitz, Gordon B.; Badger, Terry A.

    2015-01-01

    Objective Hispanic Americans and American Indians face significant health disparities compared with White Americans. Research suggests that stereotyping of minority patients by members of the medical community is an important antecedent of race and ethnicity-based health disparities. This work has primarily focused on physicians’ perceptions, however, and little research has examined the stereotypes healthcare personnel associate with Hispanic and American Indian patients. The present study assesses: 1) the health-related stereotypes both nursing and medical students hold about Hispanic and American Indian patients, and 2) nursing and medical students’ motivation to treat Hispanic and American Indian patients in an unbiased manner. Design Participants completed a questionnaire assessing their awareness of stereotypes that healthcare professionals associate with Hispanic and American Indian patients then completed measures of their motivation to treat Hispanics and American Indians in an unbiased manner. Results Despite being highly motivated to treat Hispanic and American Indian individuals fairly, the majority of participants reported awareness of stereotypes associating these patient groups with noncompliance, risky health behavior, and difficulty understanding and/or communicating health-related information. Conclusion This research provides direct evidence for negative health-related stereotypes associated with two understudied minority patient groups—Hispanics and American Indians—among both nursing and medical personnel. PMID:26504671

  2. Conducting a study of Internet-based video conferencing for assessing acute medical problems in a nursing facility.

    PubMed

    Weiner, Michael; Schadow, Gunther; Lindbergh, Donald; Warvel, Jill; Abernathy, Greg; Perkins, Susan M; Dexter, Paul R; McDonald, Clement J

    2002-01-01

    We expect the use of real-time, interactive video conferencing to grow, due to more affordable technology and new health policies. Building and implementing portable systems to enable conferencing between physicians and patients requires durable equipment, committed staff, reliable service, and adequate protection and capture of data. We are studying the use of Internet-based conferencing between on-call physicians and patients residing in a nursing facility. We describe the challenges we experienced in constructing the study. Initiating and orchestrating unscheduled conferences needs to be easy, and requirements for training staff in using equipment should be minimal. Studies of health outcomes should include identification of medical conditions most amenable to benefit from conferencing, and outcomes should include positive as well as negative effects.

  3. Conducting a study of Internet-based video conferencing for assessing acute medical problems in a nursing facility.

    PubMed Central

    Weiner, Michael; Schadow, Gunther; Lindbergh, Donald; Warvel, Jill; Abernathy, Greg; Perkins, Susan M.; Dexter, Paul R.; McDonald, Clement J.

    2002-01-01

    We expect the use of real-time, interactive video conferencing to grow, due to more affordable technology and new health policies. Building and implementing portable systems to enable conferencing between physicians and patients requires durable equipment, committed staff, reliable service, and adequate protection and capture of data. We are studying the use of Internet-based conferencing between on-call physicians and patients residing in a nursing facility. We describe the challenges we experienced in constructing the study. Initiating and orchestrating unscheduled conferences needs to be easy, and requirements for training staff in using equipment should be minimal. Studies of health outcomes should include identification of medical conditions most amenable to benefit from conferencing, and outcomes should include positive as well as negative effects. PMID:12463950

  4. User satisfaction survey and usage of an electronic desktop document delivery service at an academic medical library.

    PubMed

    Sayed, Ellen N; Murray, Sarah D

    2003-01-01

    In June 2000, the Biomedical Library at the University of South Alabama introduced Prospero, an electronic desktop document delivery service. From June 2000 to November 2002, Prospero delivered 28% of interlibrary loan requests and 72% of document delivery requests. In November 2002, the library conducted a user satisfaction survey of the Prospero service. Forty-two surveys were used. Fifteen responses were received from affiliated faculty, staff, and students, who generally expressed satisfaction with the service. Twenty-seven responses were received from unaffiliated users, comprised of medical libraries, individual users, and businesses. Based on the survey results, the library deemed the Prospero service a success. To better support users, the library's Web page was updated to include hardware and software requirements for successful use of the Prospero service, as well as screen shots of the Prospero process.

  5. Migration path for structured documentation systems including standardized medical device data.

    PubMed

    Kock, Ann-Kristin; Ingenerf, Josef; Halkaliev, Stoyan; Handels, Heinz

    2012-01-01

    A standardized end-to-end solution has been implemented with the aim of supporting the semantic integration of clinical content in institution spanning applications. The approach outlined is a proof-of-concept design. It has shown that the standards chosen are suitable to integrate device data into forms, to document the results consistently and finally enable semantic interoperability. In detail the implementation includes a standardized device interface, a standardized representation of data entry forms and enables the communication of structured data via HL7 CDA. Because the proposed method applies a combination of standards semantic interoperability and the possibility of a contextual interpretation at each stage can be ensured.

  6. End-to-end performance measurement of Internet based medical applications.

    PubMed Central

    Dev, P.; Harris, D.; Gutierrez, D.; Shah, A.; Senger, S.

    2002-01-01

    We present a method to obtain an end-to-end characterization of the performance of an application over a network. This method is not dependent on any specific application or type of network. The method requires characterization of network parameters, such as latency and packet loss, between the expected server or client endpoints, as well as characterization of the application's constraints on these parameters. A subjective metric is presented that integrates these characterizations and that operates over a wide range of applications and networks. We believe that this method may be of wide applicability as research and educational applications increasingly make use of computation and data servers that are distributed over the Internet. PMID:12463816

  7. Medical Data GRIDs as approach towards secure cross enterprise document sharing (based on IHE XDS).

    PubMed

    Wozak, Florian; Ammenwerth, Elske; Breu, Micheal; Penz, Robert; Schabetsberger, Thomas; Vogl, Raimund; Wurz, Manfred

    2006-01-01

    Quality and efficiency of health care services is expected to be improved by the electronic processing and trans-institutional availability of medical data. A prototype architecture based on the IHE-XDS profile is currently being developed. Due to legal and organizational requirements specific adaptations to the IHE-XDS profile have been made. In this work the services of the health@net reference architecture are described in details, which have been developed with focus on compliance to both, the IHE-XDS profile and the legal situation in Austria. We expect to gain knowledge about the development of a shared electronic health record using Medical Data Grids as an Open Source reference implementation and how proprietary Hospital Information systems can be integrated in this environment.

  8. The Role of Usability Testing and Documentation in Medical Device Safety

    DTIC Science & Technology

    2001-10-25

    to the design, development, and use of a function al neuromuscular ( cough ) stimulator and the accompanying docu mentation. The purpo se of the user...aspect of hazard reduction in the development of a medical device, our team designed, developed and user tested a cough stimulator for quadriplegics...to induce a physiologic cough . It is important for people to cough , not only to clean their lungs and throat but to supplement ciliary action in

  9. Documenting clinical performance problems among medical students: feedback for learner remediation and curriculum enhancement.

    PubMed

    Mavis, Brian E; Wagner, Dianne P; Henry, Rebecca C; Carravallah, Laura; Gold, Jon; Maurer, Joel; Mohmand, Asad; Osuch, Janet; Roskos, Steven; Saxe, Andrew; Sousa, Aron; Prins, Vince Winkler

    2013-01-01

    Introduction We operationalized the taxonomy developed by Hauer and colleagues describing common clinical performance problems. Faculty raters pilot tested the resulting worksheet by observing recordings of problematic simulated clinical encounters involving third-year medical students. This approach provided a framework for structured feedback to guide learner improvement and curricular enhancement. Methods Eighty-two problematic clinical encounters from M3 students who failed their clinical competency examination were independently rated by paired clinical faculty members to identify common problems related to the medical interview, physical examination, and professionalism. Results Eleven out of 26 target performance problems were present in 25% or more encounters. Overall, 37% had unsatisfactory medical interviews, with 'inadequate history to rule out other diagnoses' most prevalent (60%). Seventy percent failed because of physical examination deficiencies, with missing elements (69%) and inadequate data gathering (69%) most common. One-third of the students did not introduce themselves to their patients. Among students failing based on standardized patient (SP) ratings, 93% also failed to demonstrate competency based on the faculty ratings. Conclusions Our review form allowed clinical faculty to validate pass/fail decisions based on standardized patient ratings. Detailed information about performance problems contributes to learner feedback and curricular enhancement to guide remediation planning and faculty development.

  10. [Clinical Research VII. Systematic search: how to look for medical documents].

    PubMed

    Rivas-Ruiz, Rodolfo; Talavera, Juan O

    2012-01-01

    In the process of responding to questions generated during medical care, the number of articles appearing in the search is so vast that a strategy must be considered. This article describes the process to find and select the information to help us respond the needs of our patients. The judgment of the quality and relevance of the answer depends on each reader. Initially you have to look in places where there is medical arbitration for publications, reasons why we recommend PubMed. Start the search once the acronym PICO breakdown, where P is for patients, I intervention, C comparator and O outcome or result; these words are used as MeSH (Medical Subject Headings) and are linked with Boolean terms (and, or, and not). The acronym PICO shares components with the classical model of the Architecture of the Research described by Dr. Alvan R. Feinstein. A good search should participate in the response to our question in the first 20 articles, if it does not happen, the search must be more specific with the use of filters.

  11. [Pre-operative documentation of individual in-patient therapy goals : A medical staff questionnaire].

    PubMed

    Umgelter, K; Landscheidt, J; Jäger, K; Blobner, M; Kochs, E

    2016-07-01

    Perioperative care demands consideration of individual treatment goals. We evaluated the attitudes of medical staff towards a short standardized advance directive (SSAD) as a means of improving patient-orientated care at the transition from operating theater to general or intensive care wards. Multicenter anonymized standardized multiple-choice questionnaire among physicians and nurses from various operative and anesthesiology departments. Questions addressing demographic parameters and attitudes towards advance directives in acute care settings (eleven 4‑stepped Likert items). Univariate analysis of group comparisons using the chi-square and Kruskal-Wallis rank-sum test. Multivariable analysis of significant differences employing ordinal logistic regression. The overall return rate was 28.2 % (169 questionnaires). Of these, 19.5 % said that existing advance directives were regularly reassessed preoperatively. SSAD was expected to provide improved emergency care by 82.3 and 76.6 % thought that it would help to better focus intensive care resources according to patients' needs. Our study shows the dilemma of insufficiently structured directives for changing treatment goals as well as a high number of legal procedures to obtain proxy decisions due to missing out-patient advance health planning. From a medical staff perspective there is strong support for the concept of SSAD based on medical, ethical, economic and organizational reasons.

  12. The effects of an electronic medical record on the completeness of documentation in the anesthesia record.

    PubMed

    Jang, Junghwa; Yu, Seung Hum; Kim, Chun-Bae; Moon, Youngkyu; Kim, Sukil

    2013-08-01

    The purpose of this study is to evaluate the completeness of anesthesia recording before and after the introduction of an electronic anesthesia record. The study was conducted in a Korean teaching hospital where the EMR was implemented in October 2008. One hundred paper anesthesia records from July to September 2008 and 150 electronic anesthesia records during the same period in 2009 were randomly sampled. Thirty-four essential items were selected out of all the anesthesia items and grouped into automatically transferred items and manual entry items. 1, .5 and 0 points were given for each item of complete entry, incomplete entry and no entry respectively. The completeness of documentation was defined as the sum of the scores. The influencing factors on the completeness of documentation were evaluated in total and by the groups. The average completeness score of the electronic anesthesia records was 3.15% higher than that of the paper records. A multiple regression model showed the type of the anesthesia record was a significant factor on the completeness of anesthesia records in all items (β=.98, p<.05) and automatically transferred items (β=.56, p<.01). The type of the anesthesia records had no influence on the completeness in manual entry items. The completeness of an anesthesia record was improved after the implementation of the electronic anesthesia record. The reuse of the data from the EMR was the main contributor to the improved completeness. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. Using Computer Agents to Explain Medical Documents to Patients with Low Health Literacy

    PubMed Central

    Bickmore, Timothy W.; Pfeifer, Laura M.; Paasche-Orlow, Michael K.

    2009-01-01

    Objective Patients are commonly presented with complex documents that they have difficulty understanding. The objective of this study was to design and evaluate an animated computer agent to explain research consent forms to potential research participants. Methods Subjects were invited to participate in a simulated consent process for a study involving a genetic repository. Explanation of the research consent form by the computer agent was compared to explanation by a human and a self-study condition in a randomized trial. Responses were compared according to level of health literacy. Results Participants were most satisfied with the consent process and most likely to sign the consent form when it was explained by the computer agent, regardless of health literacy level. Participants with adequate health literacy demonstrated the highest level of comprehension with the computer agent-based explanation compared to the other two conditions. However, participants with limited health literacy showed poor comprehension levels in all three conditions. Participants with limited health literacy reported several reasons, such as lack of time constraints, ability to re-ask questions, and lack of bias, for preferring the computer agent-based explanation over a human-based one. Conclusion Animated computer agents can perform as well as or better than humans in the administration of informed consent. Practice Implications Animated computer agents represent a viable method for explaining health documents to patients. PMID:19297116

  14. Admission Control Over Internet of Vehicles Attached With Medical Sensors for Ubiquitous Healthcare Applications.

    PubMed

    Lin, Di; Labeau, Fabrice; Yao, Yuanzhe; Vasilakos, Athanasios V; Tang, Yu

    2016-07-01

    Wireless technologies and vehicle-mounted or wearable medical sensors are pervasive to support ubiquitous healthcare applications. However, a critical issue of using wireless communications under a healthcare scenario rests at the electromagnetic interference (EMI) caused by radio frequency transmission. A high level of EMI may lead to a critical malfunction of medical sensors, and in such a scenario, a few users who are not transmitting emergency data could be required to reduce their transmit power or even temporarily disconnect from the network in order to guarantee the normal operation of medical sensors as well as the transmission of emergency data. In this paper, we propose a joint power and admission control algorithm to schedule the users' transmission of medical data. The objective of this algorithm is to minimize the number of users who are forced to disconnect from the network while keeping the EMI on medical sensors at an acceptable level. We show that a fixed point of proposed algorithm always exists, and at the fixed point, our proposed algorithm can minimize the number of low-priority users who are required to disconnect from the network. Numerical results illustrate that the proposed algorithm can achieve robust performance against the variations of mobile hospital environments.

  15. Use of dietary supplements among people living with HIV/AIDS is associated with vulnerability to medical misinformation on the internet

    PubMed Central

    2012-01-01

    Background Use of dietary supplements is common among people living with HIV/AIDS. Because dietary supplements are used in the context of other health behaviors, they may have direct and indirect health benefits. However, supplements may also be associated with vulnerability to medical misinformation and unfounded health claims. We examined use of dietary supplements among people living with HIV/AIDS (PLWH) and the association between use of dietary supplements and believing medical misinformation. Methods A convenience sample of 268 men and 76 women living with HIV was recruited from AIDS services and clinics in Atlanta, GA. Participants completed measures of demographic and health characteristics, dietary supplement use, beliefs about dietary supplements, internet use, and an internet evaluation task designed to assess vulnerability to medical misinformation. Results One out of four PLWH currently used at least one dietary supplement product excluding vitamins. Dietary supplement use was associated with higher education and greater use of the internet for health-related information. Dietary supplement users also endorsed greater believability and trust in unfounded claims for HIV cures. Conclusions Dietary supplement use is common among PLWH and is associated with a broad array of health information seeking behaviors. Interventions are needed to reduce the vulnerability of PLWH, particularly dietary supplement users, to medical misinformation propagated on the internet. PMID:22233928

  16. [Research and implementation of a real-time monitoring system for running status of medical monitors based on the internet of things].

    PubMed

    Li, Yiming; Qian, Mingli; Li, Long; Li, Bin

    2014-07-01

    This paper proposed a real-time monitoring system for running status of medical monitors based on the internet of things. In the aspect of hardware, a solution of ZigBee networks plus 470 MHz networks is proposed. In the aspect of software, graphical display of monitoring interface and real-time equipment failure alarm is implemented. The system has the function of remote equipment failure detection and wireless localization, which provides a practical and effective method for medical equipment management.

  17. A workshop on developing risk assessment methods for medical use of radioactive material. Volume 2: Supporting documents

    SciTech Connect

    Tortorelli, J.P.

    1995-08-01

    A workshop was held at the Idaho National Engineering Laboratory, August 16--18, 1994 on the topic of risk assessment on medical devices that use radioactive isotopes. Its purpose was to review past efforts to develop a risk assessment methodology to evaluate these devices, and to develop a program plan and a scoping document for future methodology development. This report contains presentation material and a transcript of the workshop. Participants included experts in the fields of radiation oncology, medical physics, risk assessment, human-error analysis, and human factors. Staff from the US Nuclear Regulatory Commission (NRC) associated with the regulation of medical uses of radioactive materials and with research into risk-assessment methods participated in the workshop. The workshop participants concurred in NRC`s intended use of risk assessment as an important technology in the development of regulations for the medical use of radioactive material and encouraged the NRC to proceed rapidly with a pilot study. Specific recommendations are included in the executive summary and the body of this report.

  18. Medical student self-reported confidence in obstetrics and gynaecology: development of a core clinical competencies document

    PubMed Central

    2013-01-01

    Background Clinical competencies in obstetrics and gynaecology have not been clearly defined for Australian medical students, the growing numbers of which may impact clinical teaching. Our aim was to administer and validate a competencies list, for self-evaluation by medical students of their confidence to manage common clinical tasks in obstetrics and gynaecology; to evaluate students’ views on course changes that may result from increasing class sizes. Methods A draft list of competencies was peer-reviewed, and discussed at two student focus groups. The resultant list was administered as part of an 81 item online survey. Results Sixty-eight percent (N = 172) of those eligible completed the survey. Most respondents (75.8%) agreed or strongly agreed that they felt confident and well equipped to recognise and manage most common and important obstetric and gynaecological conditions. Confidence was greater for women, and for those who received a higher assessment grade. Free-text data highlight reasons for lack of clinical experience that may impact perceived confidence. Conclusions The document listing competencies for medical students and educators is useful for discussions around a national curriculum in obstetrics and gynaecology in medical schools, including the best methods of delivery, particularly in the context of increasing student numbers. PMID:23634953

  19. [Medical research in the US armed Forces (review of foreign internet-publications)].

    PubMed

    Agapitov, A A; Aleĭnikov, S I; Bolekhan, V I; Ivchenko, E V; Krassiĭ, A B; Nagibovich, O A; Petrov, S V; Rezvantsev, M V; Soldatov, E A; Shalakhin, R A; Sheppli, E V

    2012-10-01

    The present review is dedicated to organization and management of medical research in the US Armed Forces. At the beginning of the review a brief description of the US Armed Forces and their medical services is presented. Then.the main research organizations are successively presented: in the first part--from the Office of the Secretary of Defense, in the second--from the Office of the Assistant Secretary of Defense for Health Affairs, in the third through fifth--from the US Army, US Navy, US Air Force and US Coast Guard. In conclusion the current state of the US Armed Forces scientific research is appraised.

  20. Structured clinical documentation in the electronic medical record to improve quality and to support practice-based research in epilepsy.

    PubMed

    Narayanan, Jaishree; Dobrin, Sofia; Choi, Janet; Rubin, Susan; Pham, Anna; Patel, Vimal; Frigerio, Roberta; Maurer, Darryck; Gupta, Payal; Link, Lourdes; Walters, Shaun; Wang, Chi; Ji, Yuan; Maraganore, Demetrius M

    2017-01-01

    Using the electronic medical record (EMR) to capture structured clinical data at the point of care would be a practical way to support quality improvement and practice-based research in epilepsy. We describe our stepwise process for building structured clinical documentation support tools in the EMR that define best practices in epilepsy, and we describe how we incorporated these toolkits into our clinical workflow. These tools write notes and capture hundreds of fields of data including several score tests: Generalized Anxiety Disorder-7 items, Neurological Disorders Depression Inventory for Epilepsy, Epworth Sleepiness Scale, Quality of Life in Epilepsy-10 items, Montreal Cognitive Assessment/Short Test of Mental Status, and Medical Research Council Prognostic Index. The tools summarize brain imaging, blood laboratory, and electroencephalography results, and document neuromodulation treatments. The tools provide Best Practices Advisories and other clinical decision support when appropriate. The tools prompt enrollment in a DNA biobanking study. We have thus far enrolled 231 patients for initial visits and are starting our first annual follow-up visits and provide a brief description of our cohort. We are sharing these EMR tools and captured data with other epilepsy clinics as part of a Neurology Practice Based Research Network, and are using the tools to conduct pragmatic trials using subgroup-based adaptive designs. © 2016 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy.

  1. HelpfulMed: Intelligent Searching for Medical Information over the Internet.

    ERIC Educational Resources Information Center

    Chen, Hsinchun; Lally, Ann M.; Zhu, Bin; Chau, Michael

    2003-01-01

    Discussion of the information needs of medical professionals and researchers focuses on the architecture of a Web portal designed to integrate advanced searching and indexing algorithms, an automatic thesaurus, and self-organizing map technologies to provide searchers with fine-grained results. Reports results of evaluation of spider algorithms…

  2. HelpfulMed: Intelligent Searching for Medical Information over the Internet.

    ERIC Educational Resources Information Center

    Chen, Hsinchun; Lally, Ann M.; Zhu, Bin; Chau, Michael

    2003-01-01

    Discussion of the information needs of medical professionals and researchers focuses on the architecture of a Web portal designed to integrate advanced searching and indexing algorithms, an automatic thesaurus, and self-organizing map technologies to provide searchers with fine-grained results. Reports results of evaluation of spider algorithms…

  3. Distributing medical images with internet technologies: a DICOM web server and a DICOM java viewer.

    PubMed

    Fernàndez-Bayó, J; Barbero, O; Rubies, C; Sentís, M; Donoso, L

    2000-01-01

    With the advent of filmless radiology, it becomes important to be able to distribute radiologic images digitally throughout an entire hospital. A new approach based on World Wide Web technologies was developed to accomplish this objective. This approach involves a Web server that allows the query and retrieval of images stored in a Digital Imaging and Communications in Medicine (DICOM) archive. The images can be viewed inside a Web browser with use of a small Java program known as the DICOM Java Viewer, which is executed inside the browser. The system offers several advantages over more traditional picture archiving and communication systems (PACS): It is easy to install and maintain, is platform independent, allows images to be manipulated and displayed efficiently, and is easy to integrate with existing systems that are already making use of Web technologies. The system is user-friendly and can easily be used from outside the hospital if a security policy is in place. The simplicity and flexibility of Internet technologies makes them highly preferable to the more complex PACS workstations. The system works well, especially with magnetic resonance and computed tomographic images, and can help improve and simplify interdepartmental relationships in a filmless hospital environment.

  4. Evaluating aspects of online medication safety in long-term follow-up of 136 Internet pharmacies: illegal rogue online pharmacies flourish and are long-lived.

    PubMed

    Fittler, Andras; Bősze, Gergely; Botz, Lajos

    2013-09-10

    A growing number of online pharmacies have been established worldwide. Among them are numerous illegal websites selling medicine without valid medical prescriptions or distributing substandard or counterfeit drugs. Only a limited number of studies have been published on Internet pharmacies with regard to patient safety, professionalism, long-term follow-up, and pharmaceutical legitimacy verification. In this study, we selected, evaluated, and followed 136 Internet pharmacy websites aiming to identify indicators of professional online pharmacy service and online medication safety. An Internet search was performed by simulating the needs of potential customers of online pharmacies. A total of 136 Internet pharmacy websites were assessed and followed for four years. According to the LegitScript database, relevant characteristics such as longevity, time of continuous operation, geographical location, displayed contact information, prescription requirement, medical information exchange, and pharmaceutical legitimacy verification were recorded and evaluated. The number of active Internet pharmacy websites decreased; 23 of 136 (16.9%) online pharmacies ceased operating within 12 months and only 67 monitored websites (49.3%) were accessible at the end of the four-year observation period. However, not all operated continuously, as about one-fifth (31/136) of all observed online pharmacy websites were inaccessible provisionally. Thus, only 56 (41.2%) Internet-based pharmacies were continuously operational. Thirty-one of the 136 online pharmacies (22.8%) had not provided any contact details, while only 59 (43.4%) displayed all necessary contact information on the website. We found that the declared physical location claims did not correspond to the area of domain registration (according to IP address) for most websites. Although the majority (120/136, 88.2%) of the examined Internet pharmacies distributed various prescription-only medicines, only 9 (6.6%) requested prior

  5. Evaluating Aspects of Online Medication Safety in Long-Term Follow-Up of 136 Internet Pharmacies: Illegal Rogue Online Pharmacies Flourish and Are Long-Lived

    PubMed Central

    2013-01-01

    Background A growing number of online pharmacies have been established worldwide. Among them are numerous illegal websites selling medicine without valid medical prescriptions or distributing substandard or counterfeit drugs. Only a limited number of studies have been published on Internet pharmacies with regard to patient safety, professionalism, long-term follow-up, and pharmaceutical legitimacy verification. Objective In this study, we selected, evaluated, and followed 136 Internet pharmacy websites aiming to identify indicators of professional online pharmacy service and online medication safety. Methods An Internet search was performed by simulating the needs of potential customers of online pharmacies. A total of 136 Internet pharmacy websites were assessed and followed for four years. According to the LegitScript database, relevant characteristics such as longevity, time of continuous operation, geographical location, displayed contact information, prescription requirement, medical information exchange, and pharmaceutical legitimacy verification were recorded and evaluated. Results The number of active Internet pharmacy websites decreased; 23 of 136 (16.9%) online pharmacies ceased operating within 12 months and only 67 monitored websites (49.3%) were accessible at the end of the four-year observation period. However, not all operated continuously, as about one-fifth (31/136) of all observed online pharmacy websites were inaccessible provisionally. Thus, only 56 (41.2%) Internet-based pharmacies were continuously operational. Thirty-one of the 136 online pharmacies (22.8%) had not provided any contact details, while only 59 (43.4%) displayed all necessary contact information on the website. We found that the declared physical location claims did not correspond to the area of domain registration (according to IP address) for most websites. Although the majority (120/136, 88.2%) of the examined Internet pharmacies distributed various prescription

  6. Fog Computing and Edge Computing Architectures for Processing Data From Diabetes Devices Connected to the Medical Internet of Things.

    PubMed

    Klonoff, David C

    2017-07-01

    The Internet of Things (IoT) is generating an immense volume of data. With cloud computing, medical sensor and actuator data can be stored and analyzed remotely by distributed servers. The results can then be delivered via the Internet. The number of devices in IoT includes such wireless diabetes devices as blood glucose monitors, continuous glucose monitors, insulin pens, insulin pumps, and closed-loop systems. The cloud model for data storage and analysis is increasingly unable to process the data avalanche, and processing is being pushed out to the edge of the network closer to where the data-generating devices are. Fog computing and edge computing are two architectures for data handling that can offload data from the cloud, process it nearby the patient, and transmit information machine-to-machine or machine-to-human in milliseconds or seconds. Sensor data can be processed near the sensing and actuating devices with fog computing (with local nodes) and with edge computing (within the sensing devices). Compared to cloud computing, fog computing and edge computing offer five advantages: (1) greater data transmission speed, (2) less dependence on limited bandwidths, (3) greater privacy and security, (4) greater control over data generated in foreign countries where laws may limit use or permit unwanted governmental access, and (5) lower costs because more sensor-derived data are used locally and less data are transmitted remotely. Connected diabetes devices almost all use fog computing or edge computing because diabetes patients require a very rapid response to sensor input and cannot tolerate delays for cloud computing.

  7. Accessing and managing open medical resources in Africa over the Internet

    NASA Astrophysics Data System (ADS)

    Hussein, Rada; Khalifa, Aly; Jimenez-Castellanos, Ana; de la Calle, Guillermo; Ramirez-Robles, Maximo; Crespo, Jose; Perez-Rey, David; Garcia-Remesal, Miguel; Anguita, Alberto; Alonso-Calvo, Raul; de la Iglesia, Diana; Barreiro, Jose M.; Maojo, Victor

    2014-10-01

    Recent commentaries have proposed the advantages of using open exchange of data and informatics resources for improving health-related policies and patient care in Africa. Yet, in many African regions, both private medical and public health information systems are still unaffordable. Open exchange over the social Web 2.0 could encourage more altruistic support of medical initiatives. We have carried out some experiments to demonstrate the feasibility of using this approach to disseminate open data and informatics resources in Africa. After the experiments we developed the AFRICA BUILD Portal, the first Social Network for African biomedical researchers. Through the AFRICA BUILD Portal users can access in a transparent way to several resources. Currently, over 600 researchers are using distributed and open resources through this platform committed to low connections.

  8. Inappropriate documentation of heparin allergy in the medical record because of misdiagnosis of heparin-induced thrombocytopenia: frequency and consequences.

    PubMed

    McMahon, C M; Tanhehco, Y C; Cuker, A

    2017-02-01

    Essentials Misdiagnosis of heparin-induced thrombocytopenia (HIT) may be associated with adverse outcomes. We conducted a study of patients with a heparin allergy in the chart due to misdiagnosis of HIT. 42% of patients with a heparin allergy due to suspected HIT were clearly HIT-negative. 68% were unnecessarily treated with an alternative anticoagulant, 66% of whom had major bleeding. Background It is recommended that heparin be added to the allergy list of patients with heparin-induced thrombocytopenia (HIT). Misdiagnosis of HIT could lead to inappropriate documentation of a heparin allergy and adverse outcomes. Objectives To determine the frequency and consequences of inappropriate documentation of a heparin allergy because of misdiagnosis of HIT. Methods We conducted a cohort study of patients with an inappropriate heparin allergy listed in the electronic medical record (EMR) because of misdiagnosis of HIT. We searched the EMR for patients with a new heparin allergy. Patients were eligible if the reason for allergy listing was suspected acute HIT and laboratory testing for HIT was performed within 60 days. Subjects were defined as 'HIT-negative' if they had a 4Ts score of ≤ 3 or negative laboratory test results. Results Of 239 subjects with a new heparin allergy documented because of concern regarding HIT, 100 (42%) met the prespecified definition of HIT-negative. Sixty-eight (68%) HIT-negative subjects unnecessarily received an alternative parenteral anticoagulant for a median duration of 10.5 days. Among these 68 patients, 45 (66%) met criteria for major bleeding. Sixty-eight (68%) of the 100 HIT-negative subjects had an inappropriate allergy to heparin documented that persisted in the EMR for > 3 years beyond the index hospitalization. Conclusions Inappropriate listing of heparin as an allergy in the EMR because of misdiagnosis of HIT is common, is associated with substantial rates of unnecessary alternative anticoagulant use and major bleeding, and tends

  9. An Internet supported workflow for the publication process in UMVF (French Virtual Medical University).

    PubMed

    Renard, Jean-Marie; Bourde, Annabel; Cuggia, Marc; Garcelon, Nicolas; Souf, Nathalie; Darmoni, Stephan; Beuscart, Régis; Brunetaud, Jean-Marc

    2007-01-01

    The " Université Médicale Virtuelle Francophone" (UMVF) is a federation of French medical schools. Its main goal is to share the production and use of pedagogic medical resources generated by academic medical teachers. We developed an Open-Source application based upon a workflow system, which provides an improved publication process for the UMVF. For teachers, the tool permits easy and efficient upload of new educational resources. For web masters it provides a mechanism to easily locate and validate the resources. For librarian it provide a way to improve the efficiency of indexation. For all, the utility provides a workflow system to control the publication process. On the students side, the application improves the value of the UMVF repository by facilitating the publication of new resources and by providing an easy way to find a detailed description of a resource and to check any resource from the UMVF to ascertain its quality and integrity, even if the resource is an old deprecated version. The server tier of the application is used to implement the main workflow functionalities and is deployed on certified UMVF servers using the PHP language, an LDAP directory and an SQL database. The client tier of the application provides both the workflow and the search and check functionalities. A unique signature for each resource, was needed to provide security functionality and is implemented using a Digest algorithm. The testing performed by Rennes and Lille verified the functionality and conformity with our specifications.

  10. [Effects of the Internet on the dissemination of medical information: some thoughts on applied ethics].

    PubMed

    Lucas, Jacques

    2009-10-01

    Learned and professional societies as well as health authorities must attempt to provide free access to their databases for physicians, by a simple repertory of key words and, if necessary, by portals. Although information available for physicians may not be intended to be secret, it often requires some professional training to be interpreted appropriately. The principles of the Code of Medical Ethics, as transcribed in the Public Health Code, apply to all forms and media of information and communication. In public spaces, readers must be guaranteed that information written by physicians corresponds to the state of the art, that it is not advertising or self-promotion or commercial, that it was developed by a process ensuring quality, and that it distinguishes clearly between a popularized description of scientific data and what remains uncertain because research is on-going. The public should be informed about the source of the information they see, the editorial quality of the site, and any potential financial dependence or conflicts of interest. According to the medical association, prudence is recommended for physicians who moderate chat-rooms and discussion lists. List moderation, like any other type of medical activity, must not be improvised; it requires prudence, thought, and training.

  11. Indian Council of Medical Research consensus document for the management of tongue cancer

    PubMed Central

    D’Cruz, Anil K.; Sharma, Shilpi; Agarwal, Jaiprakash P.; Thakar, Alok; Teli, Ashraf; Arya, Supreeta; Desai, Chirag; Chaturvedi, Pankaj; Sebastian, Paul; Verghese, Bipin T.; Kane, Shubhada; Sucharita, V; Kaur, Tanvir; Shukla, D. K.; Rath, Goura Kishor

    2015-01-01

    EXECUTIVE SUMMARY The document is based on consensus among the experts and best available evidence pertaining to Indian population and is meant for practice in India.Early diagnosis is imperative in improving outcomes and preserving quality of life. High index of suspicion is to be maintained for leukoplakia (high risk site).Evaluation of a patient with newly diagnosed tongue cancer should include essential tests: Magnetic resonance imaging (MRI) is investigative modality of choice when indicated. Computed tomography (CT) scan is an option when MRI is unavailable. In early lesions when imaging is not warranted ultrasound may help guide management of the neck.Early stage cancers (stage I & II) require single modality treatment – either surgery or radiotherapy. Surgery is preferred. Adjuvant radiotherapy is indicated for T3/T4 cancers, presence of high risk features [lymphovascular emboli (LVE), perineural invasion (PNI), poorly differentiated, node +, close margins). Adjuvant chemoradiation (CTRT) is indicated for positive margins and extranodal disease.Locally advanced operable cancers (stage III & IVA) require combined multimodality treatment - surgery + adjuvant treatment. Adjuvant treatment is indicated in all and in the presence of high risk features as described above.Locally advanced inoperable cancers (stage IVB) are treated with palliative chemo-radiotherapy, chemotherapy, radiotherapy, or symptomatic treatment depending upon the performance status. Select cases may be considered for neoadjuvant chemotherapy followed by surgical salvage.Metastatic disease (stage IVC) should be treated with a goal for palliation. Chemotherapy may be offered to patients with good performance status. Local treatment in the form of radiotherapy may be added for palliation of symptoms.Intense follow-up every 3 months is required for initial 2 years as most recurrences occur in the first 24 months. After 2nd year follow up is done at 4-6 months interval. At each follow up

  12. 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)

  13. Internet-Based Survey Evaluating Use of Pain Medications and Attitudes of Radiation Oncology Patients Toward Pain Intervention

    SciTech Connect

    Simone, Charles B. Vapiwala, Neha; Hampshire, Margaret K.; Metz, James M.

    2008-09-01

    Purpose: Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy. Methods and Materials: An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at (www.oncolink.org)) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy. Results: Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief. Conclusions: Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.

  14. Mapping the route to medication therapy management documentation and billing standardization and interoperabilility within the health care system: meeting proceedings.

    PubMed

    Millonig, Marsha K

    2009-01-01

    To convene a diverse group of stakeholders to discuss medication therapy management (MTM) documentation and billing standardization and its interoperability within the health care system. More than 70 stakeholders from pharmacy, health information systems, insurers/payers, quality, and standard-setting organizations met on October 7-8, 2008, in Bethesda, MD. The American Pharmacists Association (APhA) organized the invitational conference to facilitate discussion on strategic directions for meeting current market need for MTM documentation and billing interoperability and future market needs for MTM integration into electronic health records (EHRs). APhA recently adopted policy that specifically addresses technology barriers and encourages the use and development of standardized systems for the documentation and billing of MTM services. Day 1 of the conference featured six foundational presentations on health information technology (HIT) trends, perspectives on MTM from the profession and the Centers for Medicare & Medicaid Services, health care quality and medication-related outcome measures, integrating MTM workflow in EHRs, and the current state of MTM operalization in practice. After hearing presentations on day 1 and having the opportunity to pose questions to each speaker, conference participants were divided into three breakout groups on day 2. Each group met three times for 60 minutes each and discussed five questions from the perspective of a patient, provider, or payer. Three facilitators met with each of the groups and led discussion from one perspective (i.e., patient, provider, payer). Participants then reconvened as a complete group to participate in a discussion on next steps. HIT is expected to assist in delivering safe, effective, efficient, coordinated care as health professionals strive to improve the quality of care and outcomes for individual patients. The pharmacy profession is actively contributing to quality patient care through MTM services

  15. Joint source-channel coding: secured and progressive transmission of compressed medical images on the Internet.

    PubMed

    Babel, Marie; Parrein, Benoît; Déforges, Olivier; Normand, Nicolas; Guédon, Jean-Pierre; Coat, Véronique

    2008-06-01

    The joint source-channel coding system proposed in this paper has two aims: lossless compression with a progressive mode and the integrity of medical data, which takes into account the priorities of the image and the properties of a network with no guaranteed quality of service. In this context, the use of scalable coding, locally adapted resolution (LAR) and a discrete and exact Radon transform, known as the Mojette transform, meets this twofold requirement. In this paper, details of this joint coding implementation are provided as well as a performance evaluation with respect to the reference CALIC coding and to unequal error protection using Reed-Solomon codes.

  16. Internet use by endocrinologists.

    PubMed

    Blonde, L; Cook, J L; Dey, J

    1999-01-01

    Endocrinologists, like other physicians, are information managers. They manage both disease-specific and patient-specific information and must integrate both types of information to provide the best possible care for their patients. New technologies offer abundant new approaches to medical information management tasks. Many will focus on computer hardware and software applications; others will seek solutions from video, telecommunications, the marriage of computer and consumer electronics, and other evolving technologies popularly referred to as multimedia and virtual reality. Few innovations in history have had the potential to so profoundly change our lives as the Internet. The incredible growth of the Internet to a vast system of interconnected networks serving more than 75 million users in the United States alone largely has been driven by the growth of newsgroups and e-mail, providing a means of communication among Internet users and particularly the World Wide Web (WWW). Information on web pages can be "linked" so that users can click on a link and navigate to other information on the same page, on other pages of the same document, on other files on the same computer, or on other computers linked to the Internet anywhere in the world. Moreover, the navigation requires no knowledge of arcane, difficult-to-remember commands. Hypertext links have the great utility of allowing users to navigate through information according to their own interests and information needs, as opposed to those of an author. The WWW also allows authors to link to other sources of information, rather than having to recreate it themselves. Increasingly easy access to the WWW has dramatically reduced the barriers to publication of information, since it is much easier and much less expensive to place information on the WWW than it is to publish and distribute it in hard copy form. This ease of publication has led to an incredible proliferation of information on the WWW. Much WWW

  17. The internet

    PubMed Central

    Al-Shahi, R; Sadler, M; Rees, G; Bateman, D

    2002-01-01

    The growing use of email and the world wide web (WWW), by the public, academics, and clinicians—as well as the increasing availability of high quality information on the WWW—make a working knowledge of the internet important. Although this article aims to enhance readers' existing use of the internet and medical resources on the WWW, it is also intelligible to someone unfamiliar with the internet. A web browser is one of the central pieces of software in modern computing: it is a window on the WWW, file transfer protocol sites, networked newsgroups, and your own computer's files. Effective use of the internet for professional purposes requires an understanding of the best strategies to search the WWW and the mechanisms for ensuring secure data transfer, as well as a compendium of online resources including journals, textbooks, medical portals, and sites providing high quality patient information. This article summarises these resources, available to incorporate into your web browser as downloadable "Favorites" or "Bookmarks" from www.jnnp.com, where there are also freely accessible hypertext links to the recommended sites. PMID:12438460

  18. A systematic approach to finding answers over the Internet.

    PubMed

    Potter, L A

    1995-07-01

    New users often are surprised at how chaotic the Internet appears. They have heard so much about it and then find that it is a jumble of menus and resources. Even so, it is possible to find answers to reference questions on the Internet. This paper outlines a method for doing so. The method involves five steps: gather information and tools, learn the terminology, assemble a manual, write a strategy, and make bookmarks. The paper offers medical reference scenarios that illustrate how to search a database, find a program, find a document, and telnet to another site on the Internet.

  19. A systematic approach to finding answers over the Internet.

    PubMed Central

    Potter, L A

    1995-01-01

    New users often are surprised at how chaotic the Internet appears. They have heard so much about it and then find that it is a jumble of menus and resources. Even so, it is possible to find answers to reference questions on the Internet. This paper outlines a method for doing so. The method involves five steps: gather information and tools, learn the terminology, assemble a manual, write a strategy, and make bookmarks. The paper offers medical reference scenarios that illustrate how to search a database, find a program, find a document, and telnet to another site on the Internet. PMID:7581183

  20. Are computer-based educational materials recognized as publications? An analysis of promotion documents at American medical colleges.

    PubMed Central

    Bader, S. A.

    1993-01-01

    A generalized perception exists that faculty will not be properly rewarded for efforts in developing computer-based educational materials. Faculty governed by traditional promotion and tenure systems thus may be reluctant to devote energies towards development of these materials. Recent national panels on educational reform have called for a reexamination of academic reward structures to insure that faculty receive appropriate scholarly recognition for materials developed in these new formats. A study of policy documents from accredited medical colleges in the United States was conducted to determine the extent to which academic health science institutions have adopted policies to grant recognition of computer-based materials equivalent to that accorded traditional print publications. Results revealed that while some progress has been made by leading-edge institutions, in three-quarters of the institutions, development of computer-based educational materials is considered evidence in support of teaching, not the more highly rewarded research or scholarly activity. PMID:8130576

  1. Computer-aided recording of automatic endoscope washing and disinfection processes as an integral part of medical documentation for quality assurance purposes.

    PubMed

    Krakamp, Bernd; Kirschberg, Oliver; Scheding, Andreas; Emmerich, Dieter; Klein, Stefanie; Saers, Thomas

    2010-07-08

    The reprocessing of medical endoscopes is carried out using automatic cleaning and disinfection machines. The documentation and archiving of records of properly conducted reprocessing procedures is the last and increasingly important part of the reprocessing cycle for flexible endoscopes. This report describes a new computer program designed to monitor and document the automatic reprocessing of flexible endoscopes and accessories in fully automatic washer-disinfectors; it does not contain nor compensate the manual cleaning step. The program implements national standards for the monitoring of hygiene in flexible endoscopes and the guidelines for the reprocessing of medical products. No FDA approval has been obtained up to now. The advantages of this newly developed computer program are firstly that it simplifies the documentation procedures of medical endoscopes and that it could be used universally with any washer-disinfector and that it is independent of the various interfaces and software products provided by the individual suppliers of washer-disinfectors. The computer program presented here has been tested on a total of four washer-disinfectors in more than 6000 medical examinations within 9 months. We present for the first time an electronic documentation system for automated washer-disinfectors for medical devices e.g. flexible endoscopes which can be used on any washer-disinfectors that documents the procedures involved in the automatic cleaning process and can be easily connected to most hospital documentation systems.

  2. Offering an American graduate medical HIV course to health care workers in resource-limited settings via the Internet.

    PubMed

    Chung, Michael H; Severynen, Anneleen O; Hals, Matthew P; Harrington, Robert D; Spach, David H; Kim, H Nina

    2012-01-01

    Western accredited medical universities can offer graduate-level academic courses to health care workers (HCWs) in resource-limited settings through the Internet. It is not known whether HCWs are interested in these online courses, whether they can perform as well as matriculated students, or whether such courses are educationally or practically relevant. In 2011, the University of Washington (UW) Schools of Medicine and Nursing offered the graduate course, "Clinical Management of HIV", to HCWs that included a demographic survey, knowledge assessment, and course evaluation. UW faculty delivered HIV clinical topics through ten 2-hour weekly sessions from the perspectives of practicing HIV medicine in developed and developing settings. HCWs viewed lectures through Adobe Acrobat Connect Pro (Adobe Systems, San Jose, CA), and completed online homework on HIV Web Study (http://depts.washington.edu/hivaids/) and online quizzes. HCWs, who met the same passing requirements as UW students by attending 80% lectures, completing ≥90% homework, and achieving a cumulative ≥70% grade on quizzes, were awarded a certificate. 369 HCWs at 33 sites in 21 countries joined the course in 2011, a >15-fold increase since the course was first offered in 2007. The majority of HCWs came from Africa (72%), and most were physicians (41%), nurses (22%), or midlevel practitioners (20%). 298 HCWs (81%) passed all requirements and earned a certificate. In a paired analysis of pre- and post-course HIV knowledge assessments, 56% of HCWs improved their post-course score (p<0.0001) with 27% improving by at least 30%. In the course evaluation, most HCWs rated the course as excellent (53%) or very good (39%). This online HIV course demonstrated that opening a Western graduate medical and nursing curriculum to HCWs in resource-limited settings is feasible, popular, and valuable, and may address logistic and economic barriers to the provision of high quality education in these settings.

  3. Offering an American Graduate Medical HIV Course to Health Care Workers in Resource-Limited Settings via the Internet

    PubMed Central

    Chung, Michael H.; Severynen, Anneleen O.; Hals, Matthew P.; Harrington, Robert D.; Spach, David H.; Kim, H. Nina

    2012-01-01

    Background Western accredited medical universities can offer graduate-level academic courses to health care workers (HCWs) in resource-limited settings through the internet. It is not known whether HCWs are interested in these online courses, whether they can perform as well as matriculated students, or whether such courses are educationally or practically relevant. Methods and Findings In 2011, the University of Washington (UW) Schools of Medicine and Nursing offered the graduate course, “Clinical Management of HIV”, to HCWs that included a demographic survey, knowledge assessment, and course evaluation. UW faculty delivered HIV clinical topics through ten 2-hour weekly sessions from the perspectives of practicing HIV medicine in developed and developing settings. HCWs viewed lectures through Adobe Acrobat Connect Pro (Adobe Systems, San Jose, CA), and completed online homework on HIV Web Study (http://depts.washington.edu/hivaids/) and online quizzes. HCWs, who met the same passing requirements as UW students by attending 80% lectures, completing ≥90% homework, and achieving a cumulative ≥70% grade on quizzes, were awarded a certificate. 369 HCWs at 33 sites in 21 countries joined the course in 2011, a >15-fold increase since the course was first offered in 2007. The majority of HCWs came from Africa (72%), and most were physicians (41%), nurses (22%), or midlevel practitioners (20%). 298 HCWs (81%) passed all requirements and earned a certificate. In a paired analysis of pre- and post-course HIV knowledge assessments, 56% of HCWs improved their post-course score (p<0.0001) with 27% improving by at least 30%. In the course evaluation, most HCWs rated the course as excellent (53%) or very good (39%). Conclusions This online HIV course demonstrated that opening a Western graduate medical and nursing curriculum to HCWs in resource-limited settings is feasible, popular, and valuable, and may address logistic and economic barriers to the provision of high

  4. Service providers and users discover the Internet.

    PubMed Central

    Lacroix, E M; Backus, J E; Lyon, B J

    1994-01-01

    Although the Internet has evolved over more than twenty years, resources useful to health information professionals have become available on the Internet only recently. A survey conducted by the Regional Medical Libraries of the National Network of Libraries of Medicine in the fall of 1993 indicates that libraries at academic institutions are much more likely to have access to the Internet (72%) than are libraries in hospital environments (24%). Health information professionals who take on the challenge and exploit the Internet's resources find rewards for themselves and their clients. The basic electronic mail capability of the Internet allows colleagues to collaborate, communicate, and participate in daily continuing education. Internet terminal and file-transfer capabilities provide improved access to traditional resources and first-time access to new electronic resources. Through the Internet, online catalogs are available worldwide, and document delivery is faster, cheaper, and more reliable than ever before. Institutions can make organizational, full-text, online, and publication information available through Internet tools such as direct file-transfer protocol (FTP), menu-based Gopher, and hypertext-based Mosaic. The National Library of Medicine (NLM) is among organizations finding new ways to provide service through the Internet. NLM now uses electronic mail to communicate with users, FTP service to distribute publications, and tools such as Gopher and Mosaic to distribute publications and graphics and connect users to online services. The Internet allows service providers and health sciences information professionals to work in a rich, new medium whose potential is just beginning to be explored. At the same time, its characteristics--including lack of formal organization, standards, quality control, and permanence--pose a challenge. PMID:7841912

  5. Towards intelligent Internet-roaming agents for mining and inference from medical data.

    PubMed

    Robson, Barry

    2009-01-01

    This paper is effectively subtitled "Considerations of Requirements for Programmable Laws of Probabilistic Higher Order Logical Thought". Why such a need? Issues such as privacy, security, bandwidth, and computational power demand not a central analyzing agency, but roaming agents to analyze the global explosion of medical data in many hundreds of petabytes distributed across many sites. They will send back only the conclusions, not the source data. But how will they reach those conclusions? This future pressing need will driving workers to consider Best Practice in inference. Right now, there are diverse approaches to inference, and it is not clear how to unify them into a self-consistent system. For example, there is not even universal agreement on how to treat probabilistic higher order logic. Quantum mechanics is held by many to be a universal system, but produces bizarre predictions for the everyday world of human experience. However, by rotation of the imaginary number i = square root of (-1) quantum mechanics to the split complex number h such that hh = + 1, quantum mechanics becomes an inference system for higher order probabilistic logic. And the system has interesting emergent properties which may shed light on the nature of thought.

  6. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents § 105.35... electronically serve documents on us. (ii) Serve documents electronically through the Internet at...

  7. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents § 105.35... electronically serve documents on us. (ii) Serve documents electronically through the Internet at...

  8. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HAZARDOUS MATERIALS PROGRAM DEFINITIONS AND GENERAL PROCEDURES General Procedures Serving Documents § 105.35... electronically serve documents on us. (ii) Serve documents electronically through the Internet at...

  9. Improving and measuring inpatient documentation of medical care within the MS-DRG system: education, monitoring, and normalized case mix index.

    PubMed

    Rosenbaum, Benjamin P; Lorenz, Robert R; Luther, Ralph B; Knowles-Ward, Lisa; Kelly, Dianne L; Weil, Robert J

    2014-01-01

    Documentation of the care delivered to hospitalized patients is a ubiquitous and important aspect of medical care. The majority of references to documentation and coding are based on the Centers for Medicare and Medicaid Services (CMS) Medicare Severity Diagnosis Related Group (MS-DRG) inpatient prospective payment system (IPPS). We educated the members of a clinical care team in a single department (neurosurgery) at our hospital. We measured subsequent documentation improvements in a simple, meaningful, and reproducible fashion. We created a new metric to measure documentation, termed the "normalized case mix index," that allows comparison of hospitalizations across multiple unrelated MS-DRG groups. Compared to one year earlier, the traditional case mix index, normalized case mix index, severity of illness, and risk of mortality increased one year after the educational intervention. We encourage other organizations to implement and systematically monitor documentation improvement efforts when attempting to determine the accuracy and quality of documentation achieved.

  10. [Internet: a fundamental tool for the retrieval of the information useful for medical research and health care in oncology].

    PubMed

    Bianciardi, L; D'Agata, A

    2002-02-01

    Internet represents an essential aid for the professional updating of physicians and researches. Also for the research and therapy in oncology, Internet provides important such as bibliographic data, trials and guidelines with full text, as well as epidemiologic and statistical data. Some of the most authoritative sites are indicated.

  11. Transition from in library use of resources to outside library use: the impact of the Internet on information seeking behavior of medical students and faculty.

    PubMed

    Tao, Donghua; Demiris, George; Graves, Rebecca S; Sievert, MaryEllen

    2003-01-01

    Advances in information technology have introduced both new capabilities and interesting challenges in accessing medical literature. More and more information resources exist in electronic format, such as online databases, journals, books, etc. instead of the traditional print format. In late 1998, there were thirty-five journal titles available online; in 2001, the number rose to over 4,000.1 Desk-top access to online resources is changing library use patterns, which challenges libraries to adjust to this transformed information access environment. Studies of the impact of the internet on information seeking behavior of users in medical environments could provide very valuable information for medical libraries seeking to adapt to this rapid and great evolution. This study aims to explore the impact of the Internet on information seeking behavior of medical students and faculty and their medical library use, to address the possible reasons for this change of information seeking behavior, and to identify the measures essential to the transition from traditional in-library use of resources to remote access. This study is conducted in two phases.

  12. Quality of documentation on antibiotic therapy in medical records: evaluation of combined interventions in a teaching hospital by repeated point prevalence survey.

    PubMed

    Vercheval, C; Gillet, M; Maes, N; Albert, A; Frippiat, F; Damas, P; Van Hees, T

    2016-09-01

    This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was conducted by repeated point prevalence survey (PPS) to audit the quality of documentation on antibiotic therapy in the medical records before and after a combined intervention strategy (implementation of guidelines, distribution of educational materials, educational outreach visits, group educational interactive sessions) from the antimicrobial stewardship team (AST) in the academic teaching hospital (CHU) of Liège, Belgium. The primary outcome measure was the documentation rate on three quality indicators in the computerized medical records: (1) indication for treatment, (2) antibiotics prescribed, and (3) duration or review date. Segmented regression analysis was used to analyze the ITS. The medical records of 2306 patients receiving antibiotics for an infection (1177 in the pre-intervention period and 1129 in the post-intervention period) were analyzed. A significant increase in mean percentages in the post-intervention period was observed as compared with the pre-intervention period for the three quality indicators (indication documented 83.4 ± 10.4 % vs. 90.3 ± 6.6 %, p = 0.0013; antibiotics documented 87.9 ± 9.0 % vs. 95.6 ± 5.1 %, p < 0.0001; and duration or review date documented 31.9 ± 15.4 % vs. 67.7 ± 15.2 %, p < 0.0001). The study demonstrated the successful implementation of a combined intervention strategy from the AST. This strategy was associated with significant changes in the documentation rate in the computerized medical records for the three quality indicators.

  13. Data Documentation: Some Principles and Applications in Science and Industry. Proceedings of the Workshop on Data Documentation Organized by the School for Medical Documentation of the University of Ulm.

    ERIC Educational Resources Information Center

    Gaus, Wilhelm, Ed.; Henzler, Rolf, Ed.

    The 13 papers collected here were presented at the Workshop on Data Documentation held at Reisenburg Castle, Federal Republic of Germany, in July 1975. This workshop was a first attempt to identify some of the problems in the field of data documentation, formulate them, and solve them as far as possible. The subject was approached from four…

  14. Security of medical data transfer and storage in Internet. Cryptography, antiviral security and electronic signature problems, which must be solved in nearest future in practical context.

    PubMed

    Kasztelowicz, Piotr; Czubenko, Marek; Zieba, Iwona

    2003-01-01

    The informatical revolution in computer age, which gives significant benefit in transfer of medical information requests to pay still more attention for aspect of network security. All known advantages of network technologies--first of all simplicity of copying, multiplication and sending information to many individuals can be also dangerous, if illegal, not permitted persons get access to medical data bases. Internet is assumed to be as especially "anarchic" medium, therefore in order to use it in professional work any security principles should be bewared. In our presentation we will try to find the optimal security solution in organisational and technological aspects for any medical network. In our opinion the harmonious co-operation between users, medical authorities and network administrators is core of the success.

  15. The accuracy of self-reported medical history: a preliminary analysis of the promise of internet-based research in Inflammatory Bowel Diseases.

    PubMed

    Kelstrup, Anne Mette; Juillerat, Pascal; Korzenik, Joshua

    2014-05-01

    Internet-based surveys provide a potentially important tool for Inflammatory Bowel Disease (IBD) research. The advantages include low cost, large numbers of participants, rapid study completion and less extensive infrastructure than traditional methods. The aim was to determine the accuracy of patient self-reporting in internet-based IBD research and identify predictors of greater reliability. 197 patients from a tertiary care center answered an online survey concerning personal medical history and an evaluation of disease specific knowledge. Self-reported medical details were compared with data abstracted from medical records. Agreement was assessed by kappa (κ) statistics. Participants responded correctly with excellent agreement (κ=0.96-0.97) on subtype of IBD and history of surgery. The agreement was also excellent for colectomy (κ=0.88) and small bowel resection (κ=0.91), moderate for abscesses and fistulas (κ=0.60 and 0.63), but poor regarding partial colectomy (κ=0.39). Time since last colonoscopy was self-reported with better agreement (κ=0.84) than disease activity. For disease location/extent, moderate agreements at κ=69% and 64% were observed for patients with Crohn's disease and ulcerative colitis, respectively. Subjects who scored higher than the average in the IBD knowledge assessment were significantly more accurate about disease location than their complementary group (74% vs. 59%, p=0.02). This study demonstrates that IBD patients accurately report their medical history regarding type of disease and surgical procedures. More detailed medical information is less reliably reported. Disease knowledge assessment may help in identifying the most accurate individuals and could therefore serve as validity criteria. Internet-based surveys are feasible with high reliability about basic disease features only. However, the participants in this study were engaged at a tertiary center, which potentially leads to a bias and compromises generalization to

  16. "Smart Forms" in an Electronic Medical Record: documentation-based clinical decision support to improve disease management.

    PubMed

    Schnipper, Jeffrey L; Linder, Jeffrey A; Palchuk, Matvey B; Einbinder, Jonathan S; Li, Qi; Postilnik, Anatoly; Middleton, Blackford

    2008-01-01

    Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due, in part, to the fact that clinicians do not use CDSS fully. Barriers to clinicians' use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing "Smart Forms" to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions.

  17. “Smart Forms” in an Electronic Medical Record: Documentation-based Clinical Decision Support to Improve Disease Management

    PubMed Central

    Schnipper, Jeffrey L.; Linder, Jeffrey A.; Palchuk, Matvey B.; Einbinder, Jonathan S.; Li, Qi; Postilnik, Anatoly; Middleton, Blackford

    2008-01-01

    Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due, in part, to the fact that clinicians do not use CDSS fully. Barriers to clinicians' use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing “Smart Forms” to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions. PMID:18436911

  18. MorphoSaurus--design and evaluation of an interlingua-based, cross-language document retrieval engine for the medical domain.

    PubMed

    Markó, K; Schulz, S; Hahn, U

    2005-01-01

    We propose an interlingua-based indexing approach to account for the particular challenges that arise in the design and implementation of cross-language document retrieval systems for the medical domain. Documents, as well as queries, are mapped to a language-independent conceptual layer on which retrieval operations are performed. We contrast this approach with the direct translation of German queries to English ones which, subsequently, are matched against English documents. We evaluate both approaches, interlingua-based and direct translation, on a large medical document collection, the OHSUMED corpus. A substantial benefit for interlingua-based document retrieval using German queries on English texts is found, which amounts to 93% of the (monolingual) English baseline. Most state-of-the-art cross-language information retrieval systems translate user queries to the language(s) of the target documents. In contra-distinction to this approach, translating both documents and user queries into a language-independent, concept-like representation format is more beneficial to enhance cross-language retrieval performance.

  19. Expert witness qualifications and ethical guidelines for emergency medical services litigation: resource document for the National Association of EMS Physicians position statement.

    PubMed

    Maggiore, W Ann Winnie; Kupas, Douglas F; Glushak, Cai

    2011-01-01

    The clinical provision of medical care by emergency medical services (EMS) providers in the out-of-hospital environment and the operation of EMS systems to provide that care are unique in the medical arena. There is a substantive difference in the experience of individuals who provide medical care in the out-of-hospital setting and the experience of those who provide similar care in the hospital or other clinical settings. Furthermore, physicians who provide medical direction for EMS personnel have a clinical and oversight relationship with EMS personnel. This relationship uniquely qualifies EMS medical directors to provide expert opinions related to care provided by nonphysician EMS personnel. Physicians without specific EMS oversight experience are not uniformly qualified to provide expert opinion regarding the provision of EMS. This resource document reviews the current issues in expert witness testimony in cases involving EMS as these issues relate to the unique qualifications of the expert witness, the standard of care, and the ethical expectations.

  20. Patients with rare diseases using pharmacists for medication information.

    PubMed

    Carpenter, Delesha M; Blalock, Susan J; DeVellis, Robert F

    2012-01-01

    To determine whether patients with a rare illness (1) use pharmacists for medication information more or less frequently than physicians and the Internet, (2) perceive pharmacists as a more or less credible medical information resource than physicians and the Internet, and (3) obtain different types of medication information from pharmacists, physicians, and the Internet. Cross-sectional survey. Online data collected between 2008 and 2009. Adult, English-proficient vasculitis patients (n = 232) who were taking at least one medication to treat their vasculitis. Administration of online survey. Patient use of pharmacists, physicians, and the Internet for medication information; perceived credibility of pharmacists, physicians, and the Internet as sources of medication information; and types of medication information obtained from pharmacists, physicians, and the Internet. Participants consulted physicians and the Internet more than pharmacists for medication information; only 96 participants (41.4%) ever used pharmacists for vasculitis medication information. Females and participants who used community pharmacies were significantly more likely to consult pharmacists for medication information as compared with males and patients who did not use community pharmacies. Participants perceived pharmacists were a less credible source of medication information than physicians and the Internet. Participants used physicians and/or the Internet more than pharmacists for five of eight types of medication information, including adverse effects and drug effectiveness. Vasculitis patients consulted sources other than pharmacists for medication information. Several factors, including perceived pharmacist credibility and a noncommunity-based pharmacy, may contribute to infrequent patient use of pharmacists as a medication information source. Future qualitative research should document how patients with rare disease perceive and interact with pharmacists to understand why many view

  1. RES6/466: Toward a Discovery Support System Based on Medical and Health Unifying Principles to Formulate Recombinant Hypotheses through Internet Online Databases

    PubMed Central

    Stusser, R.J

    1999-01-01

    Introduction Since the 17-century, scientists have been enquiring for the logical scientific principles of medicine and informatics, among other disciplines, encouraged by the instance of Newtonian physics. In the 20-century, the main principles of informatics were found making possible the development of present computers & Internet. However, very little research has been done seeking medical & health scientific principles, allowing among other functions, assistance in scientific hypotheses formation beside empirical data. One important effort on hypothesis formulation, has been the running of the Arrowsmith system of software and database search strategies at http://kiwi.uchicago.edu (Swanson & Smalheiser, 1997), which evokes hypothesis using the relational structure of the NCBI PubMed Internet on-line database (1966-). Nevertheless, although it uses a powerful logical mathematical method, it does not include any logical scientific principle from experimental or clinical medicine, & public health sciences. The aim of this paper is to give an outline of the design & rationale of an international collaborative research, complementary to Arrowsmith system, whose outcomes would be the logical basis of content seeking a more rational discovery support system. Methods Crucial fragmented information of multiple specialities and cognitive levels, synthesised by an international cross-disciplinary team or teams of experts, through a complex inductive method using Internet research facilities. Expected Results: Medical & health unifying principles that would perfect Arrowsmith target search strategies or other formal discovery computer-assisted systems to formulate recombinant hypotheses, using PubMed on-line database, and even in the future, the NCBI E-Biomed Internet on-line database proposed at http://www.nih.gov/welcome/director/ebiomed/ebiomed.htm (Varmus, Lipman & Brown, 1999). The perfected system will complete then, the premises to receive the benefits of

  2. How To Find Medical Information on the Internet: A Print and Online Tutorial for the Healthcare Professional and Consumer. Internet Workshop Series Number 10.

    ERIC Educational Resources Information Center

    Kovacs, Diane K.; Carlson, Ann L.

    Whether one is a specialist working in any of the fields of health and medicine or someone who wants nontechnical answers to health- or medical-related questions, this book guides users through the search methods to the materials, people, or other resources they seek. Included in this book are step-by-step instructions in finding health and…

  3. Hierarchical Concept Indexing of Full-Text Documents in the Unified Medical Language System Information Sources Map.

    ERIC Educational Resources Information Center

    Wright, Lawrence W.; Nardini, Holly K. Grossetta; Aronson, Alan R.; Rindflesch, Thomas C.

    1999-01-01

    Describes methods for applying natural-language processing for automatic concept-based indexing of full text and methods for exploiting the structure and hierarchy of full-text documents to a large collection of full-text documents drawn from the Health Services/Technology Assessment Text database at the National Library of Medicine. Examines how…

  4. Literature searching and document delivery: organisational issues.

    PubMed

    Perkins, M

    2000-09-01

    An overview of financial, staffing and administrative issues regarding online literature searching and document supply is given in this article. Online literature searching and the requesting of documents have been problematic in the past due to costs and lack of information technology. Electronic document delivery requires better Internet access but MIME compatible e-mail can be used. Institutional issues regarding requests include the question 'who should order?'--the end user or intermediary ordering by the institution, and the need for trained information professionals within medical institutions. Payment mechanisms can be by credit card, institutional subscription, institutional account with the supplying library or by voucher system. Organisational Document Supply Networks (LoansomeDoc) now exist that have set charges for certain services between members or different costs for different member types and with agreed payment mechanisms. An area of increasing importance for document delivery (due to international treaties) is copyright. If such legislation is not to adversely affect information access, professionals must be involved in the creation and amendment of such legislation. Finally, a list of references are given many of which include internet addresses.

  5. [Current internet technology for gynecology--from hypertext transfer protocol to embedded web server].

    PubMed

    Seufert, R; Woernle, F

    2000-01-01

    The scientific and commercial use of the internet has caused a revolution in information technologies and has influenced medical communication and documentation. Web browsers are the becoming universal starting point for all kinds of client-server applications. Many commercial and medical systems--such as information reservation systems--are being shifted towards web-based systems. This paper describes new techniques. Security problems are the main topics for further developments in medical computing.

  6. Evaluation of an internet-based aftercare program to improve vocational reintegration after inpatient medical rehabilitation: study protocol for a cluster-randomized controlled trial.

    PubMed

    Zwerenz, Rüdiger; Gerzymisch, Katharina; Edinger, Jens; Holme, Martin; Knickenberg, Rudolf J; Spörl-Dönch, Sieglinde; Kiwus, Ulrich; Beutel, Manfred E

    2013-01-25

    Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation. Vocationally strained patients (n = 800) aged between 18 and 59 years with private internet access are recruited in psychosomatic, orthopedic and cardiovascular rehabilitation clinics in Germany. During inpatient rehabilitation, participants in stress management group training are cluster-randomized to the intervention or control group. The intervention group (n = 400) is offered an internet-based aftercare with weekly writing tasks and therapeutic feedback, a patient forum, a self-test and relaxation exercises. The control group (n = 400) obtains regular e-mail reminders with links to publicly accessible information about stress management and coping. Assessments are conducted at the beginning of inpatient rehabilitation, the end of inpatient rehabilitation, the end of aftercare, and 9 months later. The primary outcome is a risk score for premature pension, measured by a screening questionnaire at follow-up. Secondary outcome measures include level of vocational stress, physical and mental health, and work capacity at follow-up. We expect the intervention group to stabilize the improvements achieved during inpatient rehabilitation concerning stress management and coping, resulting in an improved vocational reintegration. The study protocol demonstrates the features of internet-based aftercare in rehabilitation. International Standard Randomised Controlled Trial Number Register (ISRCTN:ISRCTN33957202).

  7. 20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for... documentation. (c) If a claimant submits a certified statement, by a person with knowledge of the facts, that...

  8. 20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for... documentation. (c) If a claimant submits a certified statement, by a person with knowledge of the facts, that...

  9. 20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for... documentation. (c) If a claimant submits a certified statement, by a person with knowledge of the facts, that...

  10. 20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for... documentation. (c) If a claimant submits a certified statement, by a person with knowledge of the facts, that...

  11. [The decipher, annotation and textual researches of 7 anti-dysentery prescriptions in the Tangut medical documents unearthed in Khara-Khoto].

    PubMed

    Tang, Xiao-Long; Liu, Jing-Yun; Zhang, Ru-Qing

    2013-05-01

    There were 7 anti-dysentery prescriptions in the Tangut medical documents unearthed in Khara-Khoto, preserved in Russia, which were deciphered, annotated and textually researched based on the Tangut tool books like Wenhai (Word Ocean), Tongyin (Homophones), and Fan han he shi zhang zhong zhu (A Tangut-Chinese Timely Gem Dictionary), combining with classical medical documents and application of knowledge of ancient Chinese language. It can be sure that these prescriptions came from the central plains of China during the Song Dynasty, which were made use of by the prescriptions as they were by the physicians of the Western Xia regime, either made modifications and adjustments or without any change. For example, local foods like local sugar and cheese were added. As for the administration and dosage, again, they were applied by following the original one or changing a little according to the local diet customs.

  12. Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke.

    PubMed

    Flink, Maria; Bertilsson, Ann-Sofie; Johansson, Ulla; Guidetti, Susanne; Tham, Kerstin; von Koch, Lena

    2016-12-01

    The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters. Comparison of medical records. The study is conducted in a context of a randomized controlled trial in Sweden, with 16 post-stroke rehabilitation units cluster randomized to intervention or control group. Occupational therapist documentation in medical records of 279 clients with stroke. The medical records were reviewed for their level of client-centeredness using a protocol developed from the Stewart et al model. The occupational therapists in the intervention groups participated in a workshop training to enhance their client-centeredness. Occupational therapists with training in client-centeredness documented significantly more on goal setting (OR = 4.1; 95% CI, 1.87-8.81), on client participation in goal setting (OR=11.34; 95% CI, 5.97-21.57), on how the goals could be reached (OR=2.8; 95% CI, 1.7-4.62), on client participation in how goals could be reached (OR=4.56; 95% CI, 2.73-7.64), on the follow-up on goals (OR=5.77; 95% CI, 2.78-11-98) and on client participation in follow-up on goals (OR=7.44, 95% CI, 4.33-12.8). This association remained after adjustment for healthcare setting, client socio-demographic variables, and stroke severity. Documentation of goal setting and client participation in goal setting can be influenced by training. © The Author(s) 2015.

  13. Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

    PubMed Central

    Flink, Maria; Bertilsson, Ann-Sofie; Johansson, Ulla; Guidetti, Susanne; Tham, Kerstin; von Koch, Lena

    2015-01-01

    Objective: The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters. Design: Comparison of medical records. Setting: The study is conducted in a context of a randomized controlled trial in Sweden, with 16 post-stroke rehabilitation units cluster randomized to intervention or control group. Subjects: Occupational therapist documentation in medical records of 279 clients with stroke. Main measures: The medical records were reviewed for their level of client-centeredness using a protocol developed from the Stewart et al model. The occupational therapists in the intervention groups participated in a workshop training to enhance their client-centeredness. Results: Occupational therapists with training in client-centeredness documented significantly more on goal setting (OR = 4.1; 95% CI, 1.87-8.81), on client participation in goal setting (OR=11.34; 95% CI, 5.97-21.57), on how the goals could be reached (OR=2.8; 95% CI, 1.7-4.62), on client participation in how goals could be reached (OR=4.56; 95% CI, 2.73-7.64), on the follow-up on goals (OR=5.77; 95% CI, 2.78-11-98) and on client participation in follow-up on goals (OR=7.44, 95% CI, 4.33-12.8). This association remained after adjustment for healthcare setting, client socio-demographic variables, and stroke severity. Conclusion: Documentation of goal setting and client participation in goal setting can be influenced by training. PMID:26647421

  14. [New avenues of communication for continuous medical education: first experiences of live broadcasting of ophthalmologY congresses via Internet].

    PubMed

    Michelson, G; Scibor, M

    1999-11-01

    The usage of the Internet in live-broadcasting ophthalmological lectures might be helpful in the education of eye doctors. The purpose is to report first experiences of a live-broadcasted congress. The congress "Autonomic Innervation and Microcirculation of the Eye--Implications in Glaucoma Pathophysiology", held in the Department of Ophthalmology of the University Erlangen-Nürnberg at the 27th January 1999 was live-broadcasted via Internet by the electronic journal "Online Journal of Ophthalmology" (www.onjoph.com). The congress was organized by the "Sonderforschungsbereich 539, Glaukome, einschliesslich PEX" of the University Erlangen-Nürnberg. The original sound of the lectures was digitized by 8000 Hz and coded with 14 bit. Using the free software "Real-Audio-Player" the user could hear the speech of the lecturer in radio quality. Two live-pictures from two digital video cameras and the digitized slides were available at the screen within two frames. Two weeks before all 6576 ophthalmologists in Germany were informed about the event by conventional mail. The live-broadcasted congress was followed by 899 online-participants (899/6576 = 13.6%). 238 of 899 participants were able to hear the original sound. 154 of 6576 (2.3%) ophthalmologists answered by FAX. 18% of the answering eye doctors have followed the congress by Internet. Mainly all (98%) of them were very interested in live-broadcasted lectures or congresses and wanted to be informed about the next lecture or congress broadcasted by means of Internet. The lectures-on demand of this congress with sound and pictures are now available under the address http:/(/)www.onjoph. com/global/livewrk1/Default.htm. The major part of eye doctors in Germany seems very interested in live-broadcasted lectures for online-education. In the first national-wide trial 899 of 6576 informed eye doctors followed the congress.

  15. 20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for... the medical records containing a diagnosis and date of diagnosis of a covered medical condition no longer exist, then OWCP may consider other evidence to establish a diagnosis and date of diagnosis of...

  16. The Papua New Guinea medical supply system - documenting opportunities and challenges to meet the Millennium Development Goals

    PubMed Central

    2014-01-01

    Objectives Limited human resources are widely recognised as an impediment to achieving the health-related Millennium Development Goals in Pacific Island Countries, with the availability of medical supplies and suitably trained health personnel crucial to ensuring a well-functioning medical supply chain. This paper presents our findings as we seek to answer the research question ‘What factors influence the availability of medical supplies within the health facilities of Papua New Guinea?’ Methods We used a qualitative, triangulated strategy using semi-structured interviews, workplace observation and semi-structured focus groups. The parallel use of the interview tool and workplace observation tool allowed identification of ‘know-do’ gaps between what the interviewee said they did in their work practices, and the actual evidence of these practices. Focus groups provided further opportunities for raising and elaborating issues. Results During 2 weeks of data collection we conducted 17 interviews and 15 observational workplace surveys in 15 facilities. Sixteen health personnel participated in 3 focus groups across 2 provinces and one district. An array of medical supply issues across all levels of the medical supply chain were revealed, including standard operating procedures, facilities, transport, emergency medical kits, the cold chain and record keeping. The influence of health worker training and competency was found to be common across all of these issues. Conclusion The factors influencing the availability of medical supplies in PNG consist of a range of interrelating issues, consisting of both simple and complex problems involving the different levels and cadres of workers within the medical supply chain. Health systems sustainability theory suggests that a coordinated approach which addresses the inter-related nature of these issues, led by the PNG government and supported by suitable development partners, will be required for sustainable health

  17. Is paper-based documentation in an emergency medical service adequate for retrospective scientific analysis? An evaluation of a physician-run service.

    PubMed

    Bergrath, Sebastian; Skorning, Max; Rörtgen, Daniel; Beckers, Stefan Kurt; Brokmann, Jörg Christian; Mutscher, Christina; Rossaint, Rolf

    2011-04-01

    To investigate if paper-based documentation in the authors' emergency medical service (EMS) satisfies scientific requirements. From 1 July 2007 to 28 February 2008, data from all paper-based protocols of a physician-run EMS in Aachen, Germany, were transferred to a SQL database (n=4815). Database queries were conducted after personal data had been anonymised. Documentation ratios of 11 individual parameters were analysed at two points in time (T1, scene; T2, arrival in emergency department). The calculability of the Mainz Emergency Evaluation Score (MEES, embracing seven vital parameters) was investigated. The calculability of the Revised Trauma Score (RTS) was also determined for all trauma patients (n=408). Fisher's exact test was used to compare differences in ratios at T1 versus T2. The documentation ratios of vital parameters ranged from 99.33% (Glasgow Coma Scale, T1) to 40.31% (respiratory rate, T2). The calculability of the MEES was poor (all missions: 28.31%, T1; 22.40%, T2; p<0.001). In missions that required cardiopulmonary resuscitation (n=87), the MEES was calculable in 9.20% of patients at T1 and 29.89% at T2 (p<0.001). In trauma missions, the RTS was calculable in 37.26% at T1 and 27.70% at T2 (p=0.004). Documentation of vital parameters is carried out incompletely, and documentation of respiratory rate is particularly poor, making calculation of accepted emergency scores infeasible for a significant fraction of a given test population. The suitability of paper-based documentation is therefore limited. Electronic documentation that includes real-time plausibility checks might improve data quality. Further research is warranted.

  18. A follow-up investigation on the quality of medical documents from examinations of Basque incommunicado detainees: the role of the medical doctors and national and international authorities in the prevention of ill-treatment and torture.

    PubMed

    Morentin, Benito; Petersen, Hans D; Callado, Luis F; Idoyaga, M Itxaso; Meana, J Javier

    2008-11-20

    According to the United Nations and the European Committee for the Prevention of Torture (CPT), torture and ill-treatment continues to be a problem during incommunicado detentions in Spain. CPT has visited Spain and published recommendations for improvements of preventive medical examinations. However, no scientific assessment of the impact of such recommendations exists. The objectives of this study were to assess the quality of documents from preventive medical examinations and the prevalence of alleged ill-treatment and compare findings with similar data from a previous study. Documents issued by state employed doctors describing medical examination of Basques held incommunicado during 2000-2005 were reviewed. The analysis covered allegations of ill-treatment and existence and quality of information essential for medical appraisal of allegations of ill-treatment. The material was collected by a non-governmental organisation. Of 425 documents concerning 118 persons, 85% had no formal structure and the format recommended by CPT was never used. None of 127 documents, concerning 70 persons with allegations of ill-treatment had an overall conclusion on the likelihood of ill-treatment. Twelve to 68% of necessary data were totally missing, and only 13-38% of existing information was sufficient. There was significant variation between the reporting of individual doctors, but in general the quality was unacceptable, although somewhat higher than in the previous study. The prevalence of allegations of ill-treatment was as high as previously. There were more reports of psychological ill-treatment and procedures of forced physical exhaustion, but fewer reports of beatings. In conclusion, there was no indication that the conditions of incommunicado detainees have improved substantially over the past 15 years and the standard of medical reporting was unacceptable. The Spanish authorities should give clear objectives and guidelines for medical examinations of detainees. An

  19. Evaluation of a Nutrition Care Process-based audit instrument, the Diet-NCP-Audit, for documentation of dietetic care in medical records.

    PubMed

    Lövestam, Elin; Orrevall, Ylva; Koochek, Afsaneh; Karlström, Brita; Andersson, Agneta

    2014-06-01

    Adequate documentation in medical records is important for high-quality health care. Documentation quality is widely studied within nursing, but studies are lacking within dietetic care. The aim of this study was to translate, elaborate and evaluate an audit instrument, based on the four-step Nutrition Care Process model, for documentation of dietetic care in medical records. The audit instrument includes 14 items focused on essential parts of dietetic care and the documentation's clarity and structure. Each item is to be rated 0-1 or 0-2 points, with a maximum total instrument score of 26. A detailed manual was added to facilitate the interpretation and increase the reliability of the instrument. The instrument is based on a similar tool initiated 9 years ago in the United States, which in this study was translated to Swedish and further elaborated. The translated and further elaborated instrument was named Diet-NCP-Audit. Firstly, the content validity of the Diet-NCP-Audit instrument was tested by five experienced dietitians. They rated the relevance and clarity of the included items. After a first rating, minor improvements were made. After the second rating, the Content Validity Indexes were 1.0, and the Clarity Index was 0.98. Secondly, to test the reliability, four dietitians reviewed 20 systematically collected dietetic notes independently using the audit instrument. Before the review, a calibration process was performed. A comparison of the reviews was performed, which resulted in a moderate inter-rater agreement with Krippendorff's α = 0.65-0.67. Grouping the audit results in three levels: lower, medium or higher range, a Krippendorff's α of 0.74 was considered high reliability. Also, an intra-rater reliability test-retest with a 9 weeks interval, performed by one dietitian, showed strong agreement. To conclude, the evaluated audit instrument had high content validity and moderate to high reliability and can be used in auditing documentation of dietetic

  20. A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet.

    PubMed

    Liu, Jiajia; Shimada, Yasuyuki

    2014-01-01

    The aim of the present study was to consider the importance of medical information obtained via the Internet for difficult cases in hospitals, especially in those located in rural areas. We report here a case of congenital arteriovenous fistula (AVF) in the upper extremities. A 30-year-old lady was transported to our hospital by ambulance due to massive bleeding in her left hand. She was seen by our current cardiovascular surgery team for the first time, although she had been diagnosed with congenital AVF of the left arm 9 years previously. Because it was asymptomatic, she was followed up by observation. During 5 years of observation, symptoms such as cyanosis, pain, and refractory ulcers gradually developed. When she was 26 years old, she was referred to a university hospital in Akita, but surgery had already been judged to be impossible. When she was 30 years old, traumatic bleeding in her left hand and hemorrhagic shock led her to be taken to our hospital by ambulance. Using the Internet, we found an institution that had treated a large number of cases of AVF. After controlling the bleeding, we referred her to that institution. However, she could not be treated without an above-elbow amputation. Congenital AVF in the upper extremities is a rare vascular anomaly and has been generally accepted to be an extremely difficult disease to treat. Treatment should be started as early as possible before the presence of any symptoms. When a specialist is not available near the hospital, precise information must be found using the Internet and the patient should be referred without any delay.

  1. A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet

    PubMed Central

    Liu, Jiajia; Shimada, Yasuyuki

    2014-01-01

    Objective: The aim of the present study was to consider the importance of medical information obtained via the Internet for difficult cases in hospitals, especially in those located in rural areas. We report here a case of congenital arteriovenous fistula (AVF) in the upper extremities. Patient: A 30-year-old lady was transported to our hospital by ambulance due to massive bleeding in her left hand. She was seen by our current cardiovascular surgery team for the first time, although she had been diagnosed with congenital AVF of the left arm 9 years previously. Because it was asymptomatic, she was followed up by observation. During 5 years of observation, symptoms such as cyanosis, pain, and refractory ulcers gradually developed. When she was 26 years old, she was referred to a university hospital in Akita, but surgery had already been judged to be impossible. When she was 30 years old, traumatic bleeding in her left hand and hemorrhagic shock led her to be taken to our hospital by ambulance. Using the Internet, we found an institution that had treated a large number of cases of AVF. After controlling the bleeding, we referred her to that institution. However, she could not be treated without an above-elbow amputation. Conclusion: Congenital AVF in the upper extremities is a rare vascular anomaly and has been generally accepted to be an extremely difficult disease to treat. Treatment should be started as early as possible before the presence of any symptoms. When a specialist is not available near the hospital, precise information must be found using the Internet and the patient should be referred without any delay. PMID:25650050

  2. Documentation of study medication dispensing in a prospective large randomized clinical trial: experiences from the ARISTOTLE Trial.

    PubMed

    Alexander, John H; Levy, Elliott; Lawrence, Jack; Hanna, Michael; Waclawski, Anthony P; Wang, Junyuan; Califf, Robert M; Wallentin, Lars; Granger, Christopher B

    2013-09-01

    In ARISTOTLE, apixaban resulted in a 21% reduction in stroke, a 31% reduction in major bleeding, and an 11% reduction in death. However, approval of apixaban was delayed to investigate a statement in the clinical study report that "7.3% of subjects in the apixaban group and 1.2% of subjects in the warfarin group received, at some point during the study, a container of the wrong type." Rates of study medication dispensing error were characterized through reviews of study medication container tear-off labels in 6,520 participants from randomly selected study sites. The potential effect of dispensing errors on study outcomes was statistically simulated in sensitivity analyses in the overall population. The rate of medication dispensing error resulting in treatment error was 0.04%. Rates of participants receiving at least 1 incorrect container were 1.04% (34/3,273) in the apixaban group and 0.77% (25/3,247) in the warfarin group. Most of the originally reported errors were data entry errors in which the correct medication container was dispensed but the wrong container number was entered into the case report form. Sensitivity simulations in the overall trial population showed no meaningful effect of medication dispensing error on the main efficacy and safety outcomes. Rates of medication dispensing error were low and balanced between treatment groups. The initially reported dispensing error rate was the result of data recording and data management errors and not true medication dispensing errors. These analyses confirm the previously reported results of ARISTOTLE. © 2013.

  3. Introducing the Internet.

    PubMed

    Pallen, M

    1995-11-25

    The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rules of behaviour or "netiquette." There are several types of Internet connection and various ways of acquiring a connection. Once connected, you can obtain, free of charge, programs that allow easy use of the Internet's resources and help on how to use these resources; you can access many of these resources through the hypertext references in the on line version of this series (go to http:@www.bmj.com/bmj/ to reach the electronic version). You can then explore the various methods for accessing, manipulating, or disseminating data on the Internet, such as electronic mail, telnet, file transfer protocol, and the world wide web. Results from a search of the world wide web for information on the rare condition of Recklinghausen's neurofibromatosis illustrate the breadth of medical information available on the Internet.

  4. Introducing the Internet.

    PubMed Central

    Pallen, M.

    1995-01-01

    The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rules of behaviour or "netiquette." There are several types of Internet connection and various ways of acquiring a connection. Once connected, you can obtain, free of charge, programs that allow easy use of the Internet's resources and help on how to use these resources; you can access many of these resources through the hypertext references in the on line version of this series (go to http:@www.bmj.com/bmj/ to reach the electronic version). You can then explore the various methods for accessing, manipulating, or disseminating data on the Internet, such as electronic mail, telnet, file transfer protocol, and the world wide web. Results from a search of the world wide web for information on the rare condition of Recklinghausen's neurofibromatosis illustrate the breadth of medical information available on the Internet. Images p1424-a PMID:8520280

  5. Impact of Scientific Versus Emotional Wording of Patient Questions on Doctor-Patient Communication in an Internet Forum: A Randomized Controlled Experiment with Medical Students.

    PubMed

    Bientzle, Martina; Griewatz, Jan; Kimmerle, Joachim; Küppers, Julia; Cress, Ulrike; Lammerding-Koeppel, Maria

    2015-11-25

    Medical expert forums on the Internet play an increasing role in patient counseling. Therefore, it is important to understand how doctor-patient communication is influenced in such forums both by features of the patients or advice seekers, as expressed in their forum queries, and by characteristics of the medical experts involved. In this experimental study, we aimed to examine in what way (1) the particular wording of patient queries and (2) medical experts' therapeutic health concepts (for example, beliefs around adhering to a distinctly scientific understanding of diagnosis and treatment and a clear focus on evidence-based medicine) impact communication behavior of the medical experts in an Internet forum. Advanced medical students (in their ninth semester of medical training) were recruited as participants. Participation in the online forum was part of a communication training embedded in a gynecology course. We first measured their biomedical therapeutic health concept (hereinafter called "biomedical concept"). Then they participated in an online forum where they answered fictitious patient queries about mammography screening that either included scientific or emotional wording in a between-group design. We analyzed participants' replies with regard to the following dimensions: their use of scientific or emotional wording, the amount of communicated information, and their attempt to build a positive doctor-patient relationship. This study was carried out with 117 medical students (73 women, 41 men, 3 did not indicate their sex). We found evidence that both the wording of patient queries and the participants' biomedical concept influenced participants' response behavior. They answered emotional patient queries in a more emotional way (mean 0.92, SD 1.02) than scientific patient queries (mean 0.26, SD 0.55; t74=3.48, P<.001, d=0.81). We also found a significant interaction effect between participants' use of scientific or emotional wording and type of patient

  6. Impact of Scientific Versus Emotional Wording of Patient Questions on Doctor-Patient Communication in an Internet Forum: A Randomized Controlled Experiment with Medical Students

    PubMed Central

    Bientzle, Martina; Griewatz, Jan; Küppers, Julia; Cress, Ulrike; Lammerding-Koeppel, Maria

    2015-01-01

    Background Medical expert forums on the Internet play an increasing role in patient counseling. Therefore, it is important to understand how doctor-patient communication is influenced in such forums both by features of the patients or advice seekers, as expressed in their forum queries, and by characteristics of the medical experts involved. Objective In this experimental study, we aimed to examine in what way (1) the particular wording of patient queries and (2) medical experts’ therapeutic health concepts (for example, beliefs around adhering to a distinctly scientific understanding of diagnosis and treatment and a clear focus on evidence-based medicine) impact communication behavior of the medical experts in an Internet forum. Methods Advanced medical students (in their ninth semester of medical training) were recruited as participants. Participation in the online forum was part of a communication training embedded in a gynecology course. We first measured their biomedical therapeutic health concept (hereinafter called “biomedical concept”). Then they participated in an online forum where they answered fictitious patient queries about mammography screening that either included scientific or emotional wording in a between-group design. We analyzed participants’ replies with regard to the following dimensions: their use of scientific or emotional wording, the amount of communicated information, and their attempt to build a positive doctor-patient relationship. Results This study was carried out with 117 medical students (73 women, 41 men, 3 did not indicate their sex). We found evidence that both the wording of patient queries and the participants’ biomedical concept influenced participants’ response behavior. They answered emotional patient queries in a more emotional way (mean 0.92, SD 1.02) than scientific patient queries (mean 0.26, SD 0.55; t 74=3.48, P<.001, d=0.81). We also found a significant interaction effect between participants’ use of

  7. HealthCyberMap: a semantic visual browser of medical Internet resources based on clinical codes and the human body metaphor.

    PubMed

    Kamel Boulos, Maged N; Roudsari, Abdul V; Carso N, Ewart R

    2002-12-01

    HealthCyberMap (HCM-http://healthcybermap.semanticweb.org) is a web-based service for healthcare professionals and librarians, patients and the public in general that aims at mapping parts of the health information resources in cyberspace in novel ways to improve their retrieval and navigation. HCM adopts a clinical metadata framework built upon a clinical coding ontology for the semantic indexing, classification and browsing of Internet health information resources. A resource metadata base holds information about selected resources. HCM then uses GIS (Geographic Information Systems) spatialization methods to generate interactive navigational cybermaps from the metadata base. These visual cybermaps are based on familiar medical metaphors. HCM cybermaps can be considered as semantically spatialized, ontology-based browsing views of the underlying resource metadata base. Using a clinical coding scheme as a metric for spatialization ('semantic distance') is unique to HCM and is very much suited for the semantic categorization and navigation of Internet health information resources. Clinical codes ensure reliable and unambiguous topical indexing of these resources. HCM also introduces a useful form of cyberspatial analysis for the detection of topical coverage gaps in the resource metadata base using choropleth (shaded) maps of human body systems.

  8. An Internet-Based Method for Extracting Nursing Home Resident Sedative Medication Data From Pharmacy Packing Systems: Descriptive Evaluation

    PubMed Central

    Gee, Peter; Westbury, Juanita; Bindoff, Ivan; Peterson, Gregory

    2017-01-01

    Background Inappropriate use of sedating medication has been reported in nursing homes for several decades. The Reducing Use of Sedatives (RedUSe) project was designed to address this issue through a combination of audit, feedback, staff education, and medication review. The project significantly reduced sedative use in a controlled trial of 25 Tasmanian nursing homes. To expand the project to 150 nursing homes across Australia, an improved and scalable method of data collection was required. This paper describes and evaluates a method for remotely extracting, transforming, and validating electronic resident and medication data from community pharmacies supplying medications to nursing homes. Objective The aim of this study was to develop and evaluate an electronic method for extracting and enriching data on psychotropic medication use in nursing homes, on a national scale. Methods An application uploaded resident details and medication data from computerized medication packing systems in the pharmacies supplying participating nursing homes. The server converted medication codes used by the packing systems to Australian Medicines Terminology coding and subsequently to Anatomical Therapeutic Chemical (ATC) codes for grouping. Medications of interest, in this case antipsychotics and benzodiazepines, were automatically identified and quantified during the upload. This data was then validated on the Web by project staff and a “champion nurse” at the participating home. Results Of participating nursing homes, 94.6% (142/150) had resident and medication records uploaded. Facilitating an upload for one pharmacy took an average of 15 min. A total of 17,722 resident profiles were extracted, representing 95.6% (17,722/18,537) of the homes’ residents. For these, 546,535 medication records were extracted, of which, 28,053 were identified as antipsychotics or benzodiazepines. Of these, 8.17% (2291/28,053) were modified during validation and verification stages, and 4

  9. The RAFT network: 5 years of distance continuing medical education and tele-consultations over the Internet in French-speaking Africa.

    PubMed

    Geissbuhler, Antoine; Bagayoko, Cheick Oumar; Ly, Ousmane

    2007-01-01

    Continuing education of healthcare professionals is a key element for the quality and efficiency of a health system. In developing countries, this activity is usually limited to capitals, and delocalized professionals do not have access to such opportunities, or to didactic material adapted to their needs. This limits the interest of such professionals to remain active in the periphery, where they are most needed to implement effective strategies for prevention and first-line healthcare. Telemedicine tools enable the communication and sharing of medical information in electronic form, and thus facilitate access to remote expertise. A physician located far from a reference center can consult its colleagues remotely in order to resolve a difficult case, follow a continuous education course over the Internet, or access medical information from digital libraries or knowledge bases. These same tools can also be used to facilitate exchanges between centers of medical expertise: health institutions of a same country as well as across borders. Since 2000, the Geneva University Hospitals have been involved in coordinating the development of a network for eHealth in Africa (the RAFT, Réseau en Afrique Francophone pour la Télémédecine), first in Mali, and now extending to 10 French-speaking African countries. The core activity of the RAFT is the webcasting of interactive courses. These sessions put the emphasis on knowledge sharing across care professionals, usually in the form of presentations and dialogs between experts in different countries. The technology used for the webcasting works with a slow (25 kbits/s) internet connection. Other activities of the RAFT network include visioconferences, teleconsultations based on the iPath system, collaborative knowledge bases development, support for medical laboratories quality control, and the evaluation of the use of telemedicine in rural areas (via satellite connections) in the context of multisectorial development. Finally

  10. User Manuals for a Primary Care Electronic Medical Record System: A Mixed Methods Study of User- and Vendor-Generated Documents

    PubMed Central

    Dow, Rustam; Barnsley, Jan; Tu, Karen; Domb, Sharon; Jadad, Alejandro R.; Lemieux-Charles, Louise

    2015-01-01

    Research problem Tutorials and user manuals are important forms of impersonal support for using software applications including electronic medical records (EMRs). Differences between user- and vendor documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tutorials and user manuals. Research question What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Literature review Effective design of tutorials and user manuals requires careful packaging of information, balance between declarative and procedural texts, an action and task-oriented approach, support for error recognition and recovery, and effective use of visual elements. No previous research compared these elements between formal and informal documents. Methodology We conducted an mixed methods study. Seven tutorials and two manuals for an EMR were collected from three family health teams and compared with the official user manual from the software vendor. Documents were qualitatively analyzed using a framework analysis approach in relation to the principles of technical documentation described above. Subsets of the data were quantitatively analyzed using cross-tabulation to compare the types of error information and visual cues in screen captures between user- and vendor-generated manuals. Results and discussion The user-developed tutorials and manuals differed from the vendor-developed manual in that they contained mostly procedural and not declarative information; were customized to the specific workflow, user roles, and patient characteristics; contained more error information related to work processes than to software usage; and used explicit visual cues on screen captures to help users identify window elements. These findings imply that to support EMR implementation, tutorials and manuals need to be customized and

  11. Evaluating Interest Profiles Based on Users' Judgment, Interest Change, and Class Specificity in the Context of Filtering Medical Documents.

    ERIC Educational Resources Information Center

    Quiroga, Luz M.; Mostafa, Javed

    2002-01-01

    Discusses user profiles and the performance of information filtering systems used especially with the Web and describes experiments that were conducted to investigate factors that can impact the profile acquisition process, using a medical literature collection. Examines differences between user-provided profiles, machine-built profiles,…

  12. Self-reported influence of television-based direct-to-consumer advertising on patient seasonal allergy and asthma medication use: An internet survey.

    PubMed

    Khanfar, Nile M; Clauson, Kevin A; Polen, Hyla H; Shields, Kelly M

    2008-04-01

    Direct-to-consumer advertising (DDTCA) of medications, a marketing tool used by the pharmaceutical industry to increase patient awareness of products, affects both consumer behavior and, ultimately, physician prescribing practices. Billions of dollars are budgeted each year for DTCA, and its influence is far-reaching. However, little information is available about patient-initiated physician interactions in which television-bbased DTCA has played a role in consumer behavior. The objective of this study was to explore the influence of television-based DTCA on treatment changes in patient-initiated medication use. A 68-item survey instrument consisting of dichotomous, multiple-choice, and open-ended questions was constructed and sent to a convenience sample of US residents during 3 consecutive months ending in February 2005. The survey, which was accessed through an Internet link provided in the e-mail, was designed to capture data about patient perceptions and behaviors regarding television-based DTCA of prescription medications used for seasonal allergy and asthma as well as demographic information. Inferential and descriptive analyses were performed. Key tests included Crosstabs analysis and normal approximation to the binomial test with the z score. Surveys were sent to 2500 individuals. A total of 427 valid surveys were returned for a 17.1% response rate. Of the 402 respondents (94.1%) who stated that they had seen DTCA for seasonal allergy medication, 50 (12.4%) said they had discussed the advertised medication with their physician and 22 of those discussions (44.0%) resulted in a change in treatment. Three hundred forty-two respondents (80.1%) stated that they had viewed DTCA for prescription asthma medications, and 23 of those respondents (6.7%) said that they had discussed the brand of asthma medication viewed on television with their physician. Those discussions resulted in a change in treatment for 9 respondents (39.1%). Within th his limited, self

  13. Self-reported influence of television-based direct-to-consumer advertising on patient seasonal allergy and asthma medication use: An internet survey

    PubMed Central

    Khanfar, Nile M.; Clauson, Kevin A.; Polen, Hyla H.; Shields, Kelly M.

    2008-01-01

    Background: Direct-to-consumer advertising (DDTCA) of medications, a marketing tool used by the pharmaceutical industry to increase patient awareness of products, affects both consumer behavior and, ultimately, physician prescribing practices. Billions of dollars are budgeted each year for DTCA, and its influence is far-reaching. However, little information is available about patient-initiated physician interactions in which television-bbased DTCA has played a role in consumer behavior. Objective: The objective of this study was to explore the influence of television-based DTCA on treatment changes in patient-initiated medication use. Methods: A 68-item survey instrument consisting of dichotomous, multiple-choice, and open-ended questions was constructed and sent to a convenience sample of US residents during 3 consecutive months ending in February 2005. The survey, which was accessed through an Internet link provided in the e-mail, was designed to capture data about patient perceptions and behaviors regarding television-based DTCA of prescription medications used for seasonal allergy and asthma as well as demographic information. Inferential and descriptive analyses were performed. Key tests included Crosstabs analysis and normal approximation to the binomial test with the z score. Results: Surveys were sent to 2500 individuals. A total of 427 valid surveys were returned for a 17.1% response rate. Of the 402 respondents (94.1%) who stated that they had seen DTCA for seasonal allergy medication, 50 (12.4%) said they had discussed the advertised medication with their physician and 22 of those discussions (44.0%) resulted in a change in treatment. Three hundred forty-two respondents (80.1%) stated that they had viewed DTCA for prescription asthma medications, and 23 of those respondents (6.7%) said that they had discussed the brand of asthma medication viewed on television with their physician. Those discussions resulted in a change in treatment for 9 respondents (39

  14. An Internet-based exercise as a component of an overall training program addressing medical aspects of radiation emergency management.

    PubMed

    Levy, K; Aghababian, R V; Hirsch, E F; Screnci, D; Boshyan, A; Ricks, R C; Samiei, M

    2000-01-01

    The use of ionizing radiation and radioactive materials continues to increase worldwide in industry, medicine, agriculture, research, electrical power generation, and nuclear weaponry. The risk of terrorism using weapons of mass destruction or simple radiological devices also has increased, leading to heightened concerns. Radiation accidents occur as a consequence of errors in transportation of radionuclides, use of radiation in medical diagnosis and therapy, industrial monitoring and sterilization procedures, and rarely, nuclear power generation. Compared to other industries, a small number of serious radiation accidents have occurred over the last six decades with recent cases in the Republic of Georgia, Peru, Japan, and Thailand. The medical, psychological, and political consequences of such accidents can be considerable. A number of programs designed to train medical responders in the techniques of radiation accident management have been developed and delivered in many countries. The low frequency of serious radiation accidents requires constant re-training, as skills are lost and medical staff turnover occurs. Not all of the training involves drills or exercises in which responders demonstrate learning or communication over the broad spectrum of medical response capabilities. Medical preparedness within the context of a total emergency response program is lacking in many parts of the world, particularly in Central and Eastern Europe and the Newly Independent States. This paper describes an effort to enhance medical preparedness in the context of a total program of international cooperation and conventions facilitated by the International Atomic Energy Agency. The paper concludes that novel application of telecommunications technology as part of a training activity in radiation accident preparedness can help address gaps in training in this field in which preparedness is essential but experience and practical field exercises are lacking.

  15. [Technical implementation of an EDP based process documentation system for routine use in inpatient medical rehabilitation (RehaProDok)].

    PubMed

    Kalwa, M; Greitemann, B

    2009-06-01

    Since 1994 the German Pension Fund has developed a systematic and centralized quality control system. Central components are a structural analysis of hospitals and rehab centers, a peer review instrument based on the treatment protocols and reports, and an outcome questionaire based on a follow-up 6 months after discharge from hospital or the rehab center. In order to improve the well established peer review instrument a new protocol document named RehaProDok was established. Based on a preexisting electronic report system, the new document can be generated automatically. Without additional work for the hospital or center a short discharge report for physicians is produced with this instrument. The use of ICF is strengthened by standardized use of rehab goals and its systematic input into the final report, which in turn improves patient orientation. Other quality important features (e. g. Team approach, changes in therapy protocol due to progress within of the rehab process) may be examined directly and added in the future. All technical improvements can be easily adapted to other clinical information systems.

  16. [The medical and vaccination card for children--a document for the promotion of primary preventive care in pediatrics].

    PubMed

    Hanousek, L

    1989-07-01

    The basis of a comprehensive approach to prevention of chronic diseases of childhood is a system of uniform preventive examinations which makes it possible to examine the child in the parent's presence. This system accentuates the systematic training of parents with the aim to promote health and prevent the development of chronic disease. Part of the effort to improve the health consciousness of parents is the newly developed document, the child's health and vaccination card. This card--contrary to the basic documentation of the child--is his property and is kept by his parents at home. The card provides the parents as well as class teacher with basic information on the child's health status. This information must be used by the parents and teachers for primary preventive regime provisions. By issuing these cards to all children it will be possible to do away with examinations, necessary so far, in conjunction with issuing of certificates on the child's health status before major sports contents. This will reduce the unproductive administrative work of health community doctors and health community paediatric nurses and will save the time of parents who accompanied the children attending these examinations.

  17. 76 FR 60754 - Preserving the Open Internet

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... COMMISSION 47 CFR Part 0 Preserving the Open Internet AGENCY: Federal Communications Commission. ACTION... of September 23, 2011, a document establishing rules to preserve the open Internet. Inadvertently the...) Resolve complaints alleging violations of the open Internet rules. Federal Communications Commission....

  18. Internet addiction in young people.

    PubMed

    Ong, Say How; Tan, Yi Ren

    2014-07-01

    In our technology-savvy population, mental health professionals are seeing an increasing trend of excessive Internet use or Internet addiction. Researchers in China, Taiwan and Korea have done extensive research in the field of Internet addiction. Screening instruments are available to identify the presence of Internet addiction and its extent. Internet addiction is frequently associated with mental illnesses such as anxiety, depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). Treatment modalities include individual and group therapies, cognitive behavioural therapy (CBT), family therapy and psychotropic medications. A significant proportion of Singapore adolescents engaging in excessive Internet use are also diagnosed to have concomitant Internet addiction. Despite the presence of a variety of treatment options, future research in this area is needed to address its growing trend and to minimise its negative psychological and social impact on the individuals and their families.

  19. Library resources on the Internet

    NASA Astrophysics Data System (ADS)

    Buchanan, Nancy L.

    1995-07-01

    Library resources are prevalent on the Internet. Library catalogs, electronic books, electronic periodicals, periodical indexes, reference sources, and U.S. Government documents are available by telnet, Gopher, World Wide Web, and FTP. Comparatively few copyrighted library resources are available freely on the Internet. Internet implementations of library resources can add useful features, such as full-text searching. There are discussion lists, Gophers, and World Wide Web pages to help users keep up with new resources and changes to existing ones. The future will bring more library resources, more types of library resources, and more integrated implementations of such resources to the Internet.

  20. PosMed (Positional Medline): prioritizing genes with an artificial neural network comprising medical documents to accelerate positional cloning.

    PubMed

    Yoshida, Yuko; Makita, Yuko; Heida, Naohiko; Asano, Satomi; Matsushima, Akihiro; Ishii, Manabu; Mochizuki, Yoshiki; Masuya, Hiroshi; Wakana, Shigeharu; Kobayashi, Norio; Toyoda, Tetsuro

    2009-07-01

    PosMed (http://omicspace.riken.jp/) prioritizes candidate genes for positional cloning by employing our original database search engine GRASE, which uses an inferential process similar to an artificial neural network comprising documental neurons (or 'documentrons') that represent each document contained in databases such as MEDLINE and OMIM. Given a user-specified query, PosMed initially performs a full-text search of each documentron in the first-layer artificial neurons and then calculates the statistical significance of the connections between the hit documentrons and the second-layer artificial neurons representing each gene. When a chromosomal interval(s) is specified, PosMed explores the second-layer and third-layer artificial neurons representing genes within the chromosomal interval by evaluating the combined significance of the connections from the hit documentrons to the genes. PosMed is, therefore, a powerful tool that immediately ranks the candidate genes by connecting phenotypic keywords to the genes through connections representing not only gene-gene interactions but also other biological interactions (e.g. metabolite-gene, mutant mouse-gene, drug-gene, disease-gene and protein-protein interactions) and ortholog data. By utilizing orthologous connections, PosMed facilitates the ranking of human genes based on evidence found in other model species such as mouse. Currently, PosMed, an artificial superbrain that has learned a vast amount of biological knowledge ranging from genomes to phenomes (or 'omic space'), supports the prioritization of positional candidate genes in humans, mouse, rat and Arabidopsis thaliana.

  1. Internet-based ICRP resource for healthcare providers on the risks and benefits of medical imaging that uses ionising radiation.

    PubMed

    Demeter, S; Applegate, K E; Perez, M

    2016-06-01

    The purpose of the International Commission on Radiological Protection (ICRP) Committee 3 Working Party was to update the 2001 web-based module 'Radiation and your patient: a guide for medical practitioners' from ICRP. The key elements of this task were: to clearly identify the target audience (such as healthcare providers with an emphasis on primary care); to review other reputable sources of information; and to succinctly publish the contribution made by ICRP to the various topics. A 'question-and-answer' format addressing practical topics was adopted. These topics included benefits and risks of imaging using ionising radiation in common medical situations, as well as pertaining to specific populations such as pregnant, breast-feeding, and paediatric patients. In general, the benefits of medical imaging and related procedures far outweigh the potential risks associated with ionising radiation exposure. However, it is still important to ensure that the examinations are clinically justified, that the procedure is optimised to deliver the lowest dose commensurate with the medical purpose, and that consideration is given to diagnostic reference levels for particular classes of examinations. © The International Society for Prosthetics and Orthotics.

  2. Multiple Mini-Interviews in the Age of the Internet: Does Preparation Help Applicants to Medical School?

    ERIC Educational Resources Information Center

    Moshinsky, Avital; Ziegler, David; Gafni, Naomi

    2017-01-01

    Many medical schools have adopted multiple mini-interviews (MMI) as an advanced selection tool. MMIs are expensive and used to test only a few dozen candidates per day, making it infeasible to develop a different test version for each test administration. Therefore, some items are reused both within and across years. This study investigated the…

  3. Documented intraoperative hypotension according to the three most common definitions does not match the application of antihypotensive medication.

    PubMed

    Franck, M; Radtke, F M; Prahs, C; Seeling, M; Papkalla, N; Wernecke, K-D; Spies, C D

    2011-01-01

    This observational study investigated which of the three most common definitions of intraoperative hypotension (IOH), reported in a published systematic literature review, were associated best with anaesthetists' administration of antihypo tensive medication (AHM). IOH and AHM use in anaesthetic procedures in a mixed surgical population (n = 2350) were also reviewed. The definitions were: arterial systolic blood pressure (SBP) < 100 mmHg or a fall in SBP of > 30% of the preoperative SBP baseline; arterial SBP < 80 mmHg; a fall in SBP of > 20% of the preoperative SBP. Accuracy of predicting AHM using these three definitions was 67%, 54% and 65%, respectively. Prediction by a new fourth definition, using an optimal threshold of minimal SBP falling to < 92 mmHg or by > 24% of preoperative baseline, was 68% accurate. In multivariate logistic analysis, age, volatile versus intravenous anaesthetics, medical history of arterial hypertension and all four definitions of IOH were associated with intraoperative AHM, however IOH was not associated with postoperative in-patient stay. The three original definitions correlated poorly with the anaesthetist's judgement about applying AHM. Anaesthetists make complex decisions regarding the relevance of IOH, considering various perioperative factors in addition to SBP. Age, physical status and duration and type of surgery showed better correlations with postoperative in-patient stay than IOH.

  4. [Medication rule for treatment of functional dyspepsia: an analysis of traditional Chinese medicine literature based on China National Knowledge Internet].

    PubMed

    Xiao, Hong-ling; Wu, Yuan-jie; Wang, Xiang; Li, Yi-fang; Fang, Zheng-qing

    2015-10-01

    By retrieving the clinical research literature of treatment functional dyspepsia by traditional Chinese medicine (TCM) from January 2004 to December 2014 based on China National Knowledge Internet (CNKI), we would establish a TCM decoction database for treating functional dyspepsia in this study. One hundred and sixty-four literature were included, involving 159 prescriptions, 377 medicines, in a total of 1 990 herbs. These herbs can be divided into 18 categories according to the effectiveness; and qi-regulating herbs, blood circulation herbs, and antipyretic herbs ranked top three ones according to the frequency of usage of the herbs, whose medicine usage frequency accounted for 51.81%. Usage frequency of 16 herbs was over 30, and Atractylodes, Radix, Poriaranked top three according to the usage frequency. Medicinal properties were divided into 9 kinds according to the frequency statistics, and the top three were warm, flat, and cold. Taste frequency statistics were classifiedinto 9 kinds, and the top three were acrid, sweet, and bitter. In frequency statistics of the meridian tropism of herbs, it was classifiedinto 11 kinds, and the top three were spleen, stomach, lung. The analysis can provide a reference for treatment and study of TCM of functional dyspepsia.

  5. [Importance of computer-based procedures. Planning and documentation in orthopedic surgery].

    PubMed

    Basad, E

    1999-03-01

    The demand for efficiency in OR management and increase in the necessity of surgical documentation require the use of software applications in hospitals. A client-server based OP-planning and documentation system has been in use in the department of orthopedic surgery in Giessen University since 1992 and is being continuously further developed. Aside from the lawful requirements, the demands of clinical doctors have been especially considered. The main functions are management of non medical patient data, scheduling and documentation of operations with coding of diagnoses and therapy, tissue banking, implant inventory, on call scheduling, storage of medical video images, clinical word processing and e-mail. With an integrated web-server, MedXS has the capabilities to offer functions accessible over any webbrowser (Netscape, Internet-Explorer) in the internet or intranet. Through the usage of this application clinical procedures could be more efficiently realized and better agreeing positions with the insurance companies could be reached.

  6. Medical ethnobotany of the Zapotecs of the Isthmus-Sierra (Oaxaca, Mexico): documentation and assessment of indigenous uses.

    PubMed

    Frei, B; Baltisberger, M; Sticher, O; Heinrich, M

    1998-09-01

    The Zapotec inhabitants of the Sierra de Oaxaca foothills (Mexico) live in an area of great botanic diversity. In daily subsistence and in response to illness, plants play a major role. An inventory of the Zapotec medicinal ethnobotany was carried out during 17 months of fieldwork. A total of 3611 individual responses concerning medicinal and non-medicinal uses for 445 different species of plants were documented. For the subsequent semi-quantitative analysis of data, the uses were grouped into ten categories and the responses for each species were summed up in each of these ten groups to yield rank-ordered lists. For the high rank-ordered and, hence, culturally important species, an assessment of the therapeutic potential was conducted using ethnobotanical, phytochemical and pharmacological data in the literature. Studies confirming the attributed properties or a scientific explanation of therapeutic use, as well as toxicological data, are still lacking for many of these species. The quantitative approach described will be the basis for future studies on the pharmacology and phytochemistry of Zapotec medicinal species. Finally, these data should also serve as a basis for biodiversity conservation and community development.

  7. Indian Council of Medical Research Consensus Document for the Management of Non-Hodgkin's Lymphoma (High Grade)

    PubMed Central

    Doval, Dinesh Chandra; Bhurani, Dinesh; Nair, Reena; Gujral, Sumeet; Malhotra, Pankaj; Ramanan, Ganpati; Mohan, Ravi; Biswas, Ghanshyam; Dattatreya, Satya; Agarwal, Shyam; Pendharkar, Dinesh; Julka, Pramod Kumar; Advani, Suresh H.; Dhaliwal, Rupinder Singh; Tayal, Juhi; Sinha, Rupal; Kaur, Tanvir; Rath, Goura K

    2017-01-01

    This consensus document is based on the guidelines related to the management of Non Hodgkin's Lymphoma (High grade) in the Indian population as proposed by the core expert committee. Accurate diagnosis in hematolymphoid neoplasm requires a combination of detailed history,clinical examination, and various investigations including routine laboratory tests, good quality histology section (of tumor and also bone marrow aspirate/biopsy), immunostaining, cytogenetic and molecular studies and radiology investigations. The staging system used for adult high grade lymphomas is based on the Ann Arbor system and includes various parameters like clinical, haematology, biochemistry, serology and radiology. Response should be evaluated with radiological evaluation after 3-4 cycles and at the end of treatment based on criteria including and excluding PET. Treatment of high grade lymphomas is based on histologic subtype, extent of disease, and age of the patient. Autologous stem cell transplantation after high dose chemotherapy is effective in the treatment of relapsed NHL. Newer RT techniques like 3 dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) can significantly reduce radiation doses to surrounding normal tissues in lymphoma patients. Patients should be followed up every 3 to 4 months for the first 2 years, followed by 6 monthly for the next 3 years and then annually. PMID:28469337

  8. Indian Council of Medical Research Consensus Document for the Management of Non-Hodgkin's Lymphoma (High Grade).

    PubMed

    Doval, Dinesh Chandra; Bhurani, Dinesh; Nair, Reena; Gujral, Sumeet; Malhotra, Pankaj; Ramanan, Ganpati; Mohan, Ravi; Biswas, Ghanshyam; Dattatreya, Satya; Agarwal, Shyam; Pendharkar, Dinesh; Julka, Pramod Kumar; Advani, Suresh H; Dhaliwal, Rupinder Singh; Tayal, Juhi; Sinha, Rupal; Kaur, Tanvir; Rath, Goura K

    2017-01-01

    This consensus document is based on the guidelines related to the management of Non Hodgkin's Lymphoma (High grade) in the Indian population as proposed by the core expert committee. Accurate diagnosis in hematolymphoid neoplasm requires a combination of detailed history,clinical examination, and various investigations including routine laboratory tests, good quality histology section (of tumor and also bone marrow aspirate/biopsy), immunostaining, cytogenetic and molecular studies and radiology investigations. The staging system used for adult high grade lymphomas is based on the Ann Arbor system and includes various parameters like clinical, haematology, biochemistry, serology and radiology. Response should be evaluated with radiological evaluation after 3-4 cycles and at the end of treatment based on criteria including and excluding PET. Treatment of high grade lymphomas is based on histologic subtype, extent of disease, and age of the patient. Autologous stem cell transplantation after high dose chemotherapy is effective in the treatment of relapsed NHL. Newer RT techniques like 3 dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) can significantly reduce radiation doses to surrounding normal tissues in lymphoma patients. Patients should be followed up every 3 to 4 months for the first 2 years, followed by 6 monthly for the next 3 years and then annually.

  9. Teaching basic medical sciences at a distance: strategies for effective teaching and learning in internet-based courses.

    PubMed

    Ertmer, Peggy A; Nour, Abdelfattah Y M

    2007-01-01

    In recent years, the Internet has become an effective and accessible delivery mechanism for distance education. In 2003, 81% of all institutions of higher education offered at least one fully online or hybrid course. By 2005, the proportion of institutions that listed online education as important to their long-term goals had increased by 8%. This growth in available online courses and their increased convenience and flexibility have stimulated dramatic increases in enrollment in online programs, including the Veterinary Technology Distance Learning Program (VT-DLP) at Purdue University. Regardless of the obvious benefits, distance learning (DL) can be frustrating for the learners if course developers are unable to merge their knowledge about the learners, the process of instructional design, and the appropriate uses of technology and interactivity options into effective course designs. This article describes strategies that we have used to increase students' learning of physiology content in an online environment. While some of these are similar, if not identical, to strategies that might be used in a face-to-face (f2f) environment (e.g., case studies, videos, concept maps), additional strategies (e.g., animations, virtual microscopy) are needed to replace or supplement what might normally occur in a f2f course. We describe how we have addressed students' need for instructional interaction, specifically in the context of two foundational physiology courses that occur early in the VT-DLP. Although the teaching and learning strategies we have used have led to increasingly high levels of interaction, there is an ongoing need to evaluate these strategies to determine their impact on students' learning of physiology content, their development of problem-solving skills, and their retention of information.

  10. Assessing abuse potential of new analgesic medications following market release: an evaluation of Internet discussion of tapentadol abuse.

    PubMed

    McNaughton, Emily C; Black, Ryan A; Weber, Sarah E; Butler, Stephen F

    2015-01-01

    Research on substance abusers in treatment suggests that tapentadol, a prescription analgesic, may have relatively low abuse potential. Messages posted by recreational drug abusers on online forums were examined for amount of discussion and endorsement for abuse of tapentadol and comparator drugs. Internet messages posted between January 1, 2011 and September 30, 2012 on seven drug-abuse web forums were evaluated. Proportions of posts and unique authors discussing tapentadol were compared with eight comparator compounds. Postcontent was coded to compare endorsement for abuse of tapentadol with two comparators, one drug with high desirability for abuse and one with low desirability for abuse. A total of 1,940,121 messages posted during the study period were copied from selected web forums. The proportion of all posts discussing tapentadol (proportion = 0.0003) was significantly lower than any of the comparator compounds (range of odds ratios from 16.6 to 104.3; P < 0.001). The proportion of unique authors was also lower. Posts coded for endorsement (N =  2,117) yielded an endorsement ratio (Ero) of 2.14 for tapentadol, which was significantly lower than the highly desirable for abuse oxymorphone (ERo = 5.08; P = 0.0011) and was as low as tramadol (ERo = 1.66), which has a long-established profile of low abuse and desirability for abuse. Recreational abusers posting on web forums appear to be less interested in abusing tapentadol when compared with other, selected prescription analgesics based on the amount of discussion (i.e., fewer posts and authors mentioning tapentadol). Endorsement of the product for abuse was also low. Wiley Periodicals, Inc.

  11. Teaching medical student geriatrics competencies in 1 week: an efficient model to teach and document selected competencies using clinical and community resources.

    PubMed

    Atkinson, Hal H; Lambros, Ann; Davis, Brooke R; Lawlor, Janice S; Lovato, James; Sink, Kaycee M; Demons, Jamehl L; Lyles, Mary F; Watkins, Franklin S; Callahan, Kathryn E; Williamson, Jeff D

    2013-07-01

    The Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation published geriatrics competencies for medical students in 2008 defining specific knowledge and skills that medical students should be able to demonstrate before graduation. Medical schools, often with limited geriatrics faculty resources, face challenges in teaching and assessing these competencies. As an initial step to facilitate more-efficient implementation of the competencies, a 1-week geriatrics rotation was developed for the third year using clinical, community, and self-directed learning resources. The Wake Forest University School of Medicine Acute Care for the Elderly Unit serves as home base, and each student selects a half-day outpatient or long-term care experience. Students also perform a home-based falls-risk assessment with a Meals-on-Wheels client. The objectives for the rotation include 20 of the 26 individual AAMC competencies and specific measurable tracking tasks for seven individual competencies. In the evaluation phase, 118 students completed the rotation. Feedback was positive, with an average rating of 7.1 (1 = worst, 10 = best). Students completed a 23-item pre- and post-knowledge test, and average percentage correct improved by 15% (P < .001); this improvement persisted at graduation (2 years after the pretest). On a 12-item survey of attitudes toward older adults, improvement was observed immediately after the rotation that did not persist at graduation. Ninety-seven percent of students documented completion of the competency-based tasks. This article provides details of development, structure, evaluation, and lessons learned that will be useful for other institutions considering a brief, concentrated geriatrics experience in the third year of medical school.

  12. Availability and quality of illegitimate somatropin products obtained from the Internet.

    PubMed

    Vida, Róbert György; Fittler, András; Mikulka, Ivett; Ábrahám, Eszter; Sándor, Viktor; Kilár, Ferenc; Botz, Lajos

    2017-02-01

    Background Growth hormones are widely available on the Internet for those who want to enhance their physical performance and improve body satisfaction. Illegitimate websites market somatropin injections without medical prescription and encourage misuse. Customers potentially put their health at risk when purchasing parenteral medications online. Objective The objective of our study was to evaluate the online market of no-prescription somatropin products and to analyse and document Internet pharmacy characteristics, distribution and pharmaceutical quality. Setting Websites indexed in Google promoting somatropin for sale direct to patients. Method Websites promoting the sale of growth hormone products were identified and analysed from June to August 2014. Internet vendor sites were evaluated to identify possible patient and medication safety concerns. Website characteristics, delivery time, storage conditions, packaging and attached product information were assessed. Investigation of the somatropin content was achieved using capillary electrophoresis with UV detection and electrospray ionization mass spectrometry. Main outcome measure Accessibility and quality of somatropin injections. Results Seventeen individual Internet vendor websites distributed somatropin products directly to patients, majority (94%) did not require a valid medical prescription before dispensing the products. Majority (70%) of Internet pharmacies displayed no medical information and none (0%) of the vendors displayed any regulatory body logo. All online samples had significantly (p < 0.001) lower somatropin concentration than labelled. Conclusion Our results clearly illustrate that prescription only biologic drugs are widely available online and can be easily accessed by anyone. Unprofessional distribution and handling is likely to cause degradation and possible patient safety concerns.

  13. Lead Poisoning and Anemia Associated with Use of Ayurvedic Medications Purchased on the Internet--Wisconsin, 2015.

    PubMed

    Meiman, Jon; Thiboldeaux, Robert; Anderson, Henry

    2015-08-21

    On April 30, 2015, the Wisconsin Division of Public Health (WDPH) was notified by a local health department of an elevated blood lead level (BLL) in a female patient aged 64 years. All Wisconsin laboratories are required to provide BLL testing results performed on any state resident to WDPH, and WDPH and local health departments are statutorily mandated to investigate any single BLL ≥20 µg/dL or BLLs that are persistently ≥15 µg/dL. Review of medical records revealed that the patient had developed progressive fatigue and shortness of breath during a period of multiple weeks that prompted inpatient medical evaluation. Hemoglobin level was 8.3 g/dL (normal range for age and sex of patient = 12.5-15.0 g/dL), and peripheral blood smear showed normochromic, normocytic red blood cells with basophilic stippling. A BLL was obtained and found to be 85.8 µg/dL. Urine toxic metals tests revealed mercury and aluminum levels in the normal range. Combined methylated and inorganic urine arsenic levels were slightly elevated at 53.3 µg/L (normal = <18.9 µg/L). The patient was discharged for outpatient lead chelation therapy with oral meso-2,3-dimercaptosuccinic acid.

  14. Internet Policy

    NASA Astrophysics Data System (ADS)

    Lehr, William H.; Pupillo, Lorenzo Maria

    The Internet is now widely regarded as essential infrastructure for our global economy and society. It is in our homes and businesses. We use it to communicate and socialize, for research, and as a platform for E-commerce. In the late 1990s, much was predicted about what the Internet has become at present; but now, we have actual experience living with the Internet as a critical component of our everyday lives. Although the Internet has already had profound effects, there is much we have yet to realize. The present volume represents a third installment in a collaborative effort to highlight the all-encompassing, multidisciplinary implications of the Internet for public policy. The first installment was conceived in 1998, when we initiated plans to organize an international conference among academic, industry, and government officials to discuss the growing policy agenda posed by the Internet. The conference was hosted by the European Commission in Brussels in 1999 and brought together a diverse mix of perspectives on what the pressing policy issues would be confronting the Internet. All of the concerns identified remain with us today, including how to address the Digital Divide, how to modify intellectual property laws to accommodate the new realities of the Internet, what to do about Internet governance and name-space management, and how to evolve broadcast and telecommunications regulatory frameworks for a converged world.

  15. Can Online Consumers Contribute to Drug Knowledge? A Mixed-Methods Comparison of Consumer-Generated and Professionally Controlled Psychotropic Medication Information on the Internet

    PubMed Central

    Cohen, David

    2011-01-01

    more consumers posting on professionally controlled websites reported symptom improvement (32.7% or 72/220 versus 21.4% or 47/220, P = .008). Professional descriptions more frequently listed physical adverse effects and warnings about suicidal ideation while consumer reviews emphasized effects disrupting daily routines and provided richer descriptions of effects in context. The most recent 20 consumer reviews on each drug from each website (n = 80) were comparable to the full sample of reviews in the frequency of commonly reported effects. Conclusion Consumer reviews and professional medication descriptions generally reported similar effects of two psychotropic medications but differed in their descriptions and in frequency of reporting. Professional medication descriptions offer the advantage of a concise yet comprehensive listing of drug effects, while consumer reviews offer greater context and situational examples of how effects may manifest in various combinations and to varying degrees. The dispersion of consumer reviews across websites limits their integration, but a brief browsing strategy on the two target medications nonetheless retrieved representative consumer content. Current strategies for filtering online health searches to return only trusted or approved websites may inappropriately address the challenge to identify quality health sources on the Internet because such strategies unduly limit access to an entire complementary source for health information. PMID:21807607

  16. [The path from science to the practicing surgeon. Engagement of documentation of the Swiss Academy of Medical Sciences for providing evidence-based medicine].

    PubMed

    Bleuer, J P

    1999-01-01

    The flood of information that comes along with the rise of electronic media has changed the expectations towards the Documentation Service of the Swiss Academy of Medical Sciences (DOKDI): Evidence Based Medicine (EMB) in particular not only demands procurement of information, but also a selection regarding quality and relevance: The question arising out of the clinical situation requires an answer correct in its content and helpful in the specific situation. Getting an idea of what evidence exists about the correctness of a certain procedure through critical lecture is an ideal often obstructed by lack of time and methodical problems in the practice; therefore, one often has to rely on evidence acquired through others and consult e.g. the Cochrane Library. DOKDI commits itself to the development of systematic reviews as well as to the dissemination of evidence found by using its experience in the documentation with electronic media and by providing the corresponding infrastructure. In addition to these activities, the Academy has spoken a grant for the training of EBM-Tutors. During a weekly workshop held in Oxford, clinicians will be trained as EBM-Tutors. This will allow an increasing number of EBM-Workshops held in Switzerland in the future.

  17. Drug interaction databases in medical literature: transparency of ownership, funding, classification algorithms, level of documentation, and staff qualifications. A systematic review.

    PubMed

    Kongsholm, Gertrud Gansmo; Nielsen, Anna Katrine Toft; Damkier, Per

    2015-11-01

    It is well documented that drug-drug interaction databases (DIDs) differ substantially with respect to classification of drug-drug interactions (DDIs). The aim of this study was to study online available transparency of ownership, funding, information, classifications, staff training, and underlying documentation of the five most commonly used open access English language-based online DIDs and the three most commonly used subscription English language-based online DIDs in the literature. We conducted a systematic literature search to identify the five most commonly used open access and the three most commonly used subscription DIDs in the medical literature. The following parameters were assessed for each of the databases: Ownership, classification of interactions, primary information sources, and staff qualification. We compared the overall proportion of yes/no answers from open access databases and subscription databases by Fisher's exact test-both prior to and after requesting missing information. Among open access DIDs, 20/60 items could be verified from the webpage directly compared to 24/36 for the subscription DIDs (p = 0.0028). Following personal request, these numbers rose to 22/60 and 30/36, respectively (p < 0.0001). For items within the "classification of interaction" domain, proportions were 3/25 versus 11/15 available from the webpage (P = 0.0001) and 3/25 versus 15/15 (p < 0.0001) available upon personal request. Available information on online available transparency of ownership, funding, information, classifications, staff training, and underlying documentation varies substantially among various DIDs. Open access DIDs had a statistically lower score on parameters assessed.

  18. Variables associated with seeking information from doctors and the internet after exposure to direct-to-consumer advertisements for prescription medications.

    PubMed

    Fogel, Joshua; Teichman, Chaim

    2014-01-01

    This study examines variables associated with seeking information from doctors, the Internet, and a combination of both doctors and Internet after exposure to direct-to-consumer advertisements. Data were analyzed from 462 college students. Younger age, women, and health insurance were associated with greater odds for doctor; women, subjective norms, intentions, and greater time since seen doctor were associated with greater odds for Internet; and African American, Hispanic, subjective norms, intentions, and health insurance were associated with greater odds for both doctor and Internet. Marketers of direct-to-consumer advertisements can use these findings for tailoring and targeting direct-to-consumer advertisements.

  19. Improving the effect of FDA-mandated drug safety alerts with Internet-based continuing medical education.

    PubMed

    Kraus, Carl N; Baldwin, Alan T; McAllister, R G

    2013-02-01

    The US Food and Drug Administration (FDA) requires risk communication as an element of Risk Evaluation and Mitigation Strategies (REMS) to alert and educate healthcare providers about severe toxicities associated with approved drugs. The educational effectiveness of this approach has not been evaluated. To support the communication plan element of the ipilimumab REMS, a Medscape Safe Use Alert (SUA) letter was distributed by Medscape via email and mobile device distribution to clinicians specified in the REMS. This alert contained the FDA-approved Dear Healthcare Provider (DHCP) letter mandated for distribution. A continuing medical education (CME) activity describing ipilimumab toxicities and the appropriate management was simultaneously posted on the website and distributed to Medscape members. Data were collected over a 6-month period regarding the handling of the letter and the responses to pre- and post-test questions for those who participated in the CME activity. Analysis of the answers to the pre- and posttest questions showed that participation in the CME activity resulted in an improvement in correct answer responses of 47%. Our experience shows that there are likely distinct information sources that are utilized by different HCP groups. The ready availability of a brief CME activity was utilized by 24,063 individuals, the majority of whom showed enhanced understanding of ipilimumab toxicity by improvement in post-test scores, educational data that are not available via implementation of standard safety alert communications. These results demonstrate that improvement in understanding of specific drug toxicities is enhanced by a CME intervention.

  20. Internet International.

    ERIC Educational Resources Information Center

    Woodard, Colin

    1995-01-01

    The unexpectedly rapid expansion of the Internet in Eastern and Central Europe is having a significant effect on institutions of higher education, still suffering from decades of isolation. The benefits include global access to information and cost-effective communications. A number of international efforts are under way to expand Internet access,…

  1. Internet Policy

    DTIC Science & Technology

    1999-11-17

    activities. F. Responsibilities 1. The CIO shall: a. Approve, for the OIG, DoD, policies implementing laws and guidelines on Internet use . IGDINST 4630.2 3 b...Provide leadership to manage Internet use within the OIG, DoD. c. Authorize monitoring. d. Oversee the promulgation of policies and guidance to ensure

  2. Medical and social egg freezing: internet-based survey of knowledge and attitudes among women in Denmark and the UK.

    PubMed

    Lallemant, Camille; Vassard, Ditte; Nyboe Andersen, Anders; Schmidt, Lone; Macklon, Nick

    2016-12-01

    Until recently, limited options for preserving fertility in order to delay childbearing were available. Although egg freezing and successful thawing is now possible, it remains unclear to what extent women are aware of the availability of this technique, their attitudes towards its use, or the circumstances under which this technique may be considered. An online cross-sectional survey was designed to investigate knowledge and attitudes of women in Denmark and the UK on egg freezing and their potential intentions regarding the procedure. Data was collected from September 2012 to September 2013 and the responses of 973 women were analyzed. In total, 83% of women reported having heard of egg freezing, and nearly all considered it acceptable for medical indications, whilst 89% considered it acceptable for social reasons. Overall, 19% expressed active interest in the procedure, and 27% expressed possible interest. Key factors found to positively influence attitudes to accepting the procedure were reassurance that it would not affect future fertility and greater than 50% chance of achieving a live birth. Characteristics significantly associated with intention to freeze eggs were being single, age under 35 years, childlessness, and a history of infertility. In this group, risk and cost were less important considerations. This study indicates that there is widespread awareness and support of the availability of eggs freezing for reproductive planning. Reassurance regarding its efficacy appears more important than its potential adverse effects on their health or that of future children, or the costs of the procedure. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  3. [Detailed data collection regarding the utilization of medical services, morbidity, course of illness and outcomes by episode-based documentation in general practices within the CONTENT project].

    PubMed

    Laux, G; Rosemann, T; Körner, T; Heiderhoff, M; Schneider, A; Kühlein, T; Szecsenyi, J

    2007-05-01

    Billing data for individual patients from General Practice surgeries can be used to analyse primary care utilisation. Making these data available for research and controlling purposes of the German health care system is vital for health services research. Due to the predominant billing purposes, German routine data are unlikely to yield a realistic and differentiated picture of primary care. The General Practice morbidity research network CONTENT (CONTinuous morbidity registration Epidemiologic NeTwork) was established as part of the primary care research grant of the German Federal Ministry of Research and Education. As opposed to other available German routine health care data, the project is designed around episodes of care as the ordering principle of primary care. An episode-based registration integrates the elements reason for encounter, result of the encounter and medical procedure across the quarterly billing timeframe. The use of the International Classification of Primary Care (ICPC) in the CONTENT project supports a specific adaptation to documentation in primary care. As opposed to the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD), ICPC was especially developed for primary care purposes. An episode-based registration and an appropriate classification are prerequisites for a realistic and detailed picture of morbidity and services provided in primary care. An existing electronic medical record (EMR) was extended with domain-specific modules in order to meet the requirements of episode-based registration. The resulting database has already yielded analyses that were impossible to achieve from German routine health care data. Further analyses will subsequently be based on the continuously expanding database and have the potential to shed light on complex epidemiological and health economics research questions. First results point in the direction that the new mode of data collection, in contrast to routinely

  4. German Experts' Views and Ideas about Information on the Internet.

    ERIC Educational Resources Information Center

    Voigt, Kristina; And Others

    1996-01-01

    Reflects ideas about the Internet presented by four German experts: possibilities and applications of chemistry; environmental informatics and documentation on the World Wide Web; views of a research-oriented pharmaceutical company; and the commercialization of the Internet. (LRW)

  5. Information science. Going, going, gone: lost Internet references.

    PubMed

    Dellavalle, Robert P; Hester, Eric J; Heilig, Lauren F; Drake, Amanda L; Kuntzman, Jeff W; Graber, Marla; Schilling, Lisa M

    2003-10-31

    The use of Internet references in academic literature is common, and Internet references are frequently inaccessible. The extent of Internet referencing and Internet reference activity in medical or scientific publications was systematically examined in more than 1000 articles published between 2000 and 2003 in the New England Journal of Medicine, The Journal of the American Medical Association, and Science. Internet references accounted for 2.6% of all references (672/25548) and in articles 27 months old, 13% of Internet references were inactive. Publishers, librarians, and readers need to reassess policies, archiving systems, and other resources for addressing Internet reference attrition to prevent further information loss.

  6. [The current state-of-the-art of the expert evaluation of medical documentation pertaining to the cases of death from an injury inflicted in a healthcare facility in the late; post-traumatic period].

    PubMed

    Kkovalev, A V; Naletova, D M; Belyansky, K D

    2016-01-01

    This article presents a concise review of the literature data concerning the modern methods for the expert evaluation of medical documentation as an object of forensic medical examination. The authors lay special emphasis on the practical significance of this issue for the scientifically sound substantiation of the results of forensic medical expertise carried out for the elucidation of the causes of death and the relationship between the injury and the outcome of the medical aid provided for its treatment. The expert evaluation of medical documentation is equally important for the assessment of the harm to health and the cause of death as a consequence of a thermal and/or mechanical injury inflicted during the hospital stay and in the late post-traumatic period.

  7. Beyond requirements: residency management through the Internet.

    PubMed

    Civetta, J M; Morejón, O V; Kirton, O C; Reilly, P J; Serebriakov, I I; Dobkin, E D; D'Angelica, M; Antonetti, M

    2001-04-01

    An Internet application could collect information to satisfy documentation required by the Residency Review Committee. Beyond replacing a difficult and inefficient paper system, it would collect, process, and distribute information to administration, faculty, and residents. Descriptive study. An integrated residency of 18 services at a university teaching hospital with 4 affiliated institutions. Residency administrators, faculty, and residents. The application included a procedure recorder, resident evaluation of faculty and rotations, goals and objectives (stratified by service and resident level), and matching faculty evaluation of residents with these goals as competencies. Policies, schedules, research opportunities, clinical site information, and curriculum support were created. Degree of compliance with Residency Review Committee standards, number of deficiencies corrected, and quantity and quality of information available to administration, faculty, and residents. The Internet system increased resident compliance for faculty and rotation evaluations from 20% and 34%, respectively, to 100%, which was maintained for 22 months. These evaluations can be displayed individually, in summary grids, and as postgraduate year-specific averages. Faculty evaluations of residents can be reviewed throughout the system. The defined category report for procedures, which had deficiencies in the preceding 6 years, had none for the last 2 years. The Internet application provides Accreditation Council for Graduate Medical Education-validated operative logs to regulatory agencies. A Web-based system can satisfy requirements and provide processed data that are of better quality and more complete than our paper system. We are now able to use scarce time and personnel to nurture developing surgical residents instead of shuffling paper.

  8. Perceptions of document relevance

    PubMed Central

    Bruza, Peter; Chang, Vivien

    2014-01-01

    This article presents a study of how humans perceive and judge the relevance of documents. Humans are adept at making reasonably robust and quick decisions about what information is relevant to them, despite the ever increasing complexity and volume of their surrounding information environment. The literature on document relevance has identified various dimensions of relevance (e.g., topicality, novelty, etc.), however little is understood about how these dimensions may interact. We performed a crowdsourced study of how human subjects judge two relevance dimensions in relation to document snippets retrieved from an internet search engine. The order of the judgment was controlled. For those judgments exhibiting an order effect, a q–test was performed to determine whether the order effects can be explained by a quantum decision model based on incompatible decision perspectives. Some evidence of incompatibility was found which suggests incompatible decision perspectives is appropriate for explaining interacting dimensions of relevance in such instances. PMID:25071622

  9. Internet Connections.

    ERIC Educational Resources Information Center

    Lindroth, Linda K.

    1996-01-01

    Lists Internet sites related to articles in this issue. Topics include a first-grade unit on voting, student-created theme binders, techniques for student motivation, and involving parents in the middle school. (KDFB)

  10. Internet Connections.

    ERIC Educational Resources Information Center

    Lindroth, Linda K.

    1996-01-01

    Lists Internet sites related to articles in this issue. Topics include a first-grade unit on voting, student-created theme binders, techniques for student motivation, and involving parents in the middle school. (KDFB)

  11. Internet Censorship

    NASA Astrophysics Data System (ADS)

    Jyotsna; Kapil; Aayush

    2012-09-01

    Censorship on Internet has always wet its hands in the water of controversies, It is said to go in with synonym of "FILTERING THE NET" i.e. Either done to protect minors or for nationís privacy, some take it as snatching their freedom over internet and some take it as an appropriate step to protect minor, It has its supporters as well as opponents.Google has reported a whooping number of requests from Governments of U.K, China, Poland, Spain, and Canada to remove videos and search links that led to harassment, sensitive issues or suspicious people. This paper deals with the cons of censorship on internet and to make people aware of the fact that Internet is not a single body owned by an org. but an open sky of information shared equally by all. Research done has found out many unseen aspects of different people's view point.

  12. The risk and consequences of clinical miscoding due to inadequate medical documentation: a case study of the impact on health services funding.

    PubMed

    Cheng, Ping; Gilchrist, Annette; Robinson, Kerin M; Paul, Lindsay

    2009-01-01

    As coded clinical data are used in a variety of areas (e.g. health services funding, epidemiology, health sciences research), coding errors have the potential to produce far-reaching consequences. In this study the causes and consequences of miscoding were reviewed. In particular, the impact of miscoding due to inadequate medical documentation on hospital funding was examined. Appropriate reimbursement of hospital revenue in the casemix-based (output-based) funding system in the state of Victoria, Australia relies upon accurate, comprehensive, and timely clinical coding. In order to assess the reliability of these data in a Melbourne tertiary hospital, this study aimed to: (a) measure discrepancies in clinical code assignment; (b) identify resultant Diagnosis Related Group (DRG) changes; (c) identify revenue shifts associated with the DRG changes; (d) identify the underlying causes of coding error and DRG change; and (e) recommend strategies to address the aforementioned. An internal audit was conducted on 752 surgical inpatient discharges from the hospital within a six-month period. In a blind audit, each episode was re-coded. Comparisons were made between the original codes and the auditor-assigned codes, and coding errors were grouped and statistically analysed by categories. Changes in DRGs and weighted inlier-equivalent separations (WIES) were compared and analysed, and underlying factors were identified. Approximately 16% of the 752 cases audited reflected a DRG change, equating to a significant revenue increase of nearly AU$575,300. Fifty-six percent of DRG change cases were due to documentation issues. Incorrect selection or coding of the principal diagnosis accounted for a further 13% of the DRG changes, and missing additional diagnosis codes for 29%. The most significant of the factors underlying coding error and DRG change was poor quality of documentation. It was concluded that the auditing process plays a critical role in the identification of causes

  13. A pilot study to document the return on investment for implementing an ambulatory electronic health record at an academic medical center.

    PubMed

    Grieger, Dara L; Cohen, Stephen H; Krusch, David A

    2007-07-01

    Adoption rates for electronic health records (EHRs) have been slow, despite growing enthusiasm. Cost is a frequently cited obstacle to implementing an EHR. The body of literature citing a positive return on investment is largely anecdotal and infrequently published in peer-reviewed journals. Five ambulatory offices, with a total of 28 providers, within the University of Rochester Medical Center, participated in a pilot project using an EHR to document the return on investment. A staged implementation of the Touchworks EHR (Allscripts) was undertaken from November 2003 to March 2004. Measurements of key financial indicators were made in the third calendar quarters of 2003 and 2005. These indicators included chart pulls, new chart creation, filing time, support staff salary, and transcription costs. In addition, patient cycle time, evaluation and management codes billed, and days in accounts receivable were evaluated to assess impact on office efficiency and billing. The savings realized were compared with the costs of the first 2 years of EHR use to determine return on investment. Total annual savings were $393,662 ($14,055 per provider). Total capital cost was $484,577. First-year operating expenses were $24,539. Total expenses for the first year were $509,539 ($18,182 per provider). Ongoing annual cost for subsequent years is $114,016 ($4,072 per provider). So, initial costs were recaptured within 16 months, with ongoing annual savings of $9,983 per provider. An EHR can rapidly demonstrate a positive return on investment when implemented in ambulatory offices associated with a university medical center, with a neutral impact on efficiency and billing.

  14. Ngi and Internet2: accelerating the creation of tomorrow's internet.

    PubMed

    Kratz, M; Ackerman, M; Hanss, T; Corbato, S

    2001-01-01

    Internet2 is a consortium of leading U.S. universities working in partnership with industry and the U.S. government's Next Generation Internet (NGI) initiative to develop a faster, more reliable Internet for research and education including enhanced, high-performance networking services and the advanced applications that are enabled by those services [1]. By facilitating and coordinating the development, deployment, operation, and technology transfer of advanced, network-based applications and network services, Internet2 and NGI are working together to fundamentally change the way scientists, engineers, clinicians, and others work together. [http://www.internet2.edu] The NGI Program has three tracks: research, network testbeds, and applications. The aim of the research track is to promote experimentation with the next generation of network technologies. The network testbed track aims to develop next generation network testbeds to connect universities and federal research institutions at speeds that are sufficient to demonstrate new technologies and support future research. The aim of the applications track is to demonstrate new applications, enabled by the NGI networks, to meet important national goals and missions [2]. [http://www.ngi.gov/] The Internet2/NGI backbone networks, Abilene and vBNS (very high performance Backbone Network Service), provide the basis of collaboration and development for a new breed of advanced medical applications. Academic medical centers leverage the resources available throughout the Internet2 high-performance networking community for high-capacity broadband and selectable quality of service to make effective use of national repositories. The Internet2 Health Sciences Initiative enables a new generation of emerging medical applications whose architecture and development have been restricted by or are beyond the constraints of traditional Internet environments. These initiatives facilitate a variety of activities to foster the

  15. Measuring the Internet.

    ERIC Educational Resources Information Center

    Molyneux, Robert E.; Williams, Robert V.

    1999-01-01

    Examines the literature that measures characteristics of the Internet. Discusses: conclusions about the Internet measurement literature; definition of the Internet from a technical standpoint; history of Internet measurement; nature of the Internet data environment; Internet technical characteristics; information measurement and the Internet;…

  16. Measuring the Internet.

    ERIC Educational Resources Information Center

    Molyneux, Robert E.; Williams, Robert V.

    1999-01-01

    Examines the literature that measures characteristics of the Internet. Discusses: conclusions about the Internet measurement literature; definition of the Internet from a technical standpoint; history of Internet measurement; nature of the Internet data environment; Internet technical characteristics; information measurement and the Internet;…

  17. Treatment of internet addiction.

    PubMed

    Huang, Xui-qin; Li, Meng-chen; Tao, Ran

    2010-10-01

    Internet addiction (IA) is a prevalent, highly comorbid, and significantly impairing disorder. Although many psychotherapeutic approaches and psychotropic medications have been recommended and some of the psychotherapeutic approaches and a few pharmacotherapy strategies have been studied, treatment of IA is generally in its early stages. This article reviews theoretical descriptions of psychotherapy and the effects of psychosocial treatment and pharmacologic treatment. We also outline our own treatment model of IA.

  18. 49 CFR 105.35 - Serving documents in PHMSA proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Serving documents in PHMSA proceedings. (a) Service by PHMSA. We may serve the document by one of the... document by one of the following methods, except where a different method of service is specifically...), you may electronically serve documents on us. (ii) Serve documents electronically through the Internet...

  19. FES Documentation - Cancer Imaging Program

    Cancer.gov

    The FES documentation files are presented in Adobe Acrobat or Word files, either in executable or ZIP format to be maximally compatible with the computer system being downloaded into. The files are large in any format and should be downloaded with a fast Internet link.

  20. Oncology information on the Internet.

    PubMed

    Goto, Yasushi; Nagase, Takahide

    2012-05-01

    Owing to new developments in Internet technologies, the amount of available oncology information is growing. Both patients and caregivers are increasingly using the Internet to obtain medical information. However, while it is easy to provide information, ensuring its quality is always a concern. Thus, many instruments for evaluating the quality of health information have been created, each with its own advantages and disadvantages. The increasing importance of online search engines such as Google warrants the examination of the correlation between their rankings and medical quality. The Internet also mediates the exchange of information from one individual to another. Mailing lists of advocate groups and social networking sites help spread information to patients and caregivers. While text messages are still the main medium of communication, audio and video messages are also increasing rapidly, accelerating the communication on the Internet. Future health information developments on the Internet include merging patients' personal information on the Internet with their traditional health records and facilitating the interaction among patients, caregivers and health-care providers. Through these developments, the Internet is expected to strengthen the mutually beneficial relationships among all stakeholders in the field of medicine.

  1. [The planned home care transfer by a local medical support hospital and the introduction to home intravenous hyper alimentation--the making of a home care patient's instruction plan document].

    PubMed

    Shinobu, Akiko; Ohtsu, Yoko

    2004-12-01

    It is important to offer continuous medical service without interrupting everyone's various job functions at the Tama Numbu-Chiiki Hospitals in order to secure the quality and safety of home medical care to patients and their families. From 1998 up to the present, home intravenous hyper alimentation (home IVH) has been introduced by individually exchanging information that was based on items such as clinical case, doctor and caregiver in charge of the day, and introductory information. Five years have passed since we started an introduction of home IVH, and it appears that the medical cooperation of home IVH between the Minami-tama medical region and its neighboring area has been established. Then, we arranged an examination of the past 2 years based on the 57 patients who elected to choose home IVH instruction. Consequently, we created "home IVH introduction plan document" in standardizing a flow from home IVH introduction to post-hospital intervention. Since November of 2003, the plan document has been utilized and carried out to 5 patients by the end of February in 2004. This home IVH introduction plan document was able to clarify the role of medical person in connection with the patient. Therefore, we could not only share the information, but also could transfer medical care smoothly from the hospital to the patient's home.

  2. Using the Internet in Professional Development.

    ERIC Educational Resources Information Center

    Seguin, Armand

    This document contains ideas and information regarding using the Internet in the professional development of vocational education teachers. Presented first is basic information about what the Internet is and its value as a tool for professional development (including its role as a vehicle for accessing the ERIC database, taking online classes, and…

  3. Building Networks of Leaders through the Internet.

    ERIC Educational Resources Information Center

    Gabbard, Glenn

    2001-01-01

    This bulletin brings together the concepts of parent networking and the Internet. The document highlights key free or low cost features of the Internet which have proven to be useful tools in linking together networks of parents. It addresses the following six questions: (1) What if I don't have a computer? (2) How can I get Web access? (3) How do…

  4. 14 CFR 302.3 - Filing of documents.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... set at the DOT Dockets Management System (DMS) internet website. (2) Such documents will be deemed to... specified DOT DMS internet website and in this part, as applicable. Number of copies Airport Fees 9... for those electronically filed, the requirements specified at the DOT DMS internet website, and...

  5. Termination Documentation

    ERIC Educational Resources Information Center

    Duncan, Mike; Hill, Jillian

    2014-01-01

    In this study, we examined 11 workplaces to determine how they handle termination documentation, an empirically unexplored area in technical communication and rhetoric. We found that the use of termination documentation is context dependent while following a basic pattern of infraction, investigation, intervention, and termination. Furthermore,…

  6. Declassified Documents.

    ERIC Educational Resources Information Center

    Brown, Karen M.

    Journalists and other investigators are daily using declassified government documents to shed light on historical and current events, but few have discovered how to tap the wealth of documents once classified but now in the public realm. An executive order from President Reagan eliminating declassification procedures and allowing released…

  7. Declassified Documents.

    ERIC Educational Resources Information Center

    Brown, Karen M.

    Journalists and other investigators are daily using declassified government documents to shed light on historical and current events, but few have discovered how to tap the wealth of documents once classified but now in the public realm. An executive order from President Reagan eliminating declassification procedures and allowing released…

  8. Termination Documentation

    ERIC Educational Resources Information Center

    Duncan, Mike; Hill, Jillian

    2014-01-01

    In this study, we examined 11 workplaces to determine how they handle termination documentation, an empirically unexplored area in technical communication and rhetoric. We found that the use of termination documentation is context dependent while following a basic pattern of infraction, investigation, intervention, and termination. Furthermore,…

  9. Internet bullying.

    PubMed

    Donnerstein, Ed

    2012-06-01

    There is substantial literature on the impact of the mass media on children's and adolescents' health and development. The question of what role new technology plays in the media's influence is now a subject of both review and discussion, particularly regarding health risks and intervention. This article takes a brief look at online usage and the theoretical mechanisms that might make Internet access more problematic in terms of risks, compared with more traditional media such as television and film. One of these risks, known today as cyberbullying or Internet harassment, is scrutinized in detail. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Internet Sexualities

    NASA Astrophysics Data System (ADS)

    Döring, Nicola

    The term “internet sexuality” (or OSA, online sexual activities) refers to sexual-related content and activities observable on the internet (cf. Adams, Oye, & Parker, 2003; Cooper, McLoughlin, & Campbell, 2000; Leiblum & Döring, 2002). It designates a variety of sexual phenomena (e.g., pornography, sex education, sexual contacts) related to a wide spectrum of online services and applications (e.g., websites, online chat rooms, peer-to-peer networks). If an even broader range of computer networks - such as the Usenet or bulletin board systems - is included in this extensional definition, one speaks of “online sexuality” or “cybersexuality.”

  11. The Health Care Financing Administration's new examination documentation criteria: minimum auditing standards for the neurologic examination to be used by Medicare and other payors. Report from the American Academy of Neurology Medical Economics and Management Subcommittee.

    PubMed

    Nuwer, M R; Sigsbee, B

    1998-02-01

    Medicare recently announced the adoption of minimum documentation criteria for the neurologic examination. These criteria are added to existing standards for the history and medical decision-making. These criteria will be used in compliance audits by Medicare and other payors. Given the current federal initiative to eliminate fraud in the Medicare program, all neurologists need to comply with these standards. These criteria are for documentation only. Neurologic standards of care require a more complex and diverse examination pertinent to the problem(s) under consideration. Further guidance as to the content of a neurologic evaluation is outlined in the article "Practice guidelines: Neurologic evaluation" (Neurology 1990; 40: 871). The level of history and examination required for specific services is defined in the American Medical Association current procedural terminology book. Documentation standards for examination of children are not yet defined.

  12. The associations between atrial fibrillation and parameters of nutritional status assessment in the general hospital population - a cross-sectional analysis of medical documentation.

    PubMed

    Budzyński, Jacek; Anaszewicz, Marzena

    2017-01-01

    Atrial fibrillation (AF) and nutrition status abnormalities are two of the most significant epidemics in current health care. The aim of this study was to determine the relationship between the prevalence and outcome of AF, and the parameters of nutritional status among consecutive, real-life patients hospitalised in a university hospital. Analysis of the medical documentation of 4930 consecutive patients aged ≥ 18 years hospitalised for more than one day with diagnoses of cardiovascular disorders. Patients admitted with a diagnosis of AF (n = 512) compared to their counterparts without AF less frequently had an NRS-2002 score ≥ 3, normal range of body mass index (BMI), higher blood haemoglobin, and lower low density lipoprotein cholesterol (LDL-C) concentration. In logistic regression analysis, the risk of a hospitalisation due to AF was negatively related to BMI, NRS-2002 score, and the value of the difference between ideal and actual body mass. Urgent admission and having an NRS-2002 score ≥ 3 remained the only significant variables determining the risk of in-hospital death. Blood concentration of LDL-C and urgent admission were the only significant variables determining risk of 30-day rehospitalisation in the studied population. Inpatients with AF had a lower prevalence of normal body mass. Patients with an AF diagnosis had different risk factors for in-hospital death and 30-day rehospitalisation than their counterparts with diagnosis of cardiovascular diseases but without AF; however, the parameters of nutritional status played an important role in both patient groups. The obesity and cholesterol paradoxes were also observed.

  13. Internet resources available to otolaryngologists.

    PubMed

    Balatsouras, Dimitrios G; Kaberos, Antonis; Korres, Stavros G; Kandiloros, Dimitrios; Ferekidis, Eleftherios; Economou, Constantinos

    2002-12-01

    During recent years, the Internet has evolved into the largest computer network in the world, allowing access to vast amounts of information and services. Medical information is increasingly available to both patients and professionals, and ever more biomedical resources are becoming available on-line to assist in research, clinical medicine, and education. The Internet has always provided useful resources to otolaryngologists, implemented at various academic departments and national organizations or by specialists or specific medical web sites offering technical, scientific, and biomedical information. The purpose of this article is to provide as complete a list as possible of the World Wide Web sites accessible through the Internet that are of interest to otolaryngologists. It summarizes different types of resources available, including educational material, audiology sites, outcomes research, discussion lists, research laboratories, publications, medical libraries, news and medical conferences, organizations, academic departments, otolaryngological and medical resources, medical and surgical equipment and suppliers, and miscellaneous other sites of interest to otolaryngologists. This review is intended to present the wealth of the accessible information on the Internet and to promote the use of the network to otolaryngologists who do not have extensive experience in computers or telecommunications.

  14. Wonderful Wikis and Internet Forums

    ERIC Educational Resources Information Center

    Kahn, Sami

    2009-01-01

    Wikis are collaborative websites where visitors can edit anything they want, anytime they want. Essentially online "whiteboards," wikis allow groups of people to create documents and projects together. Internet forums, also known as message boards or discussion boards, are web applications that provide online discussions. Like wikis, your forum…

  15. Wonderful Wikis and Internet Forums

    ERIC Educational Resources Information Center

    Kahn, Sami

    2009-01-01

    Wikis are collaborative websites where visitors can edit anything they want, anytime they want. Essentially online "whiteboards," wikis allow groups of people to create documents and projects together. Internet forums, also known as message boards or discussion boards, are web applications that provide online discussions. Like wikis, your forum…

  16. Internet Ethics.

    ERIC Educational Resources Information Center

    Emmans, Cindy

    2000-01-01

    Focuses on the issue of ethical use of the Internet in schools, and suggests that by devising and implementing acceptable use policies, and providing students with a set of ethical guidelines, schools and libraries can deal with the situation before it becomes a problem. Discusses and the need for parents to be included in policy formation and to…

  17. Internet 101.

    ERIC Educational Resources Information Center

    Noguchi, Kay

    The Internet, a worldwide network of computer networks, is a noncommercial service with acceptable use restricted to the advancement of education and research. Although it has been in existence for quite a while, it is still new to most elementary and secondary educators in the Pacific region and elsewhere. This report is an introduction to the…

  18. Proposal of a new Internet standard for DICOM: DICOM-QR URL.

    PubMed

    Sakusabe, T; Shirchin, B; Kimura, M

    1998-01-01

    This paper proposes a new Internet standard that is combination of two standards in different domain, Internet and medical informatics. The both standards are described briefly in this paper. We describe how to combine them into a Internet standard. With a new standard, there are several advantages for medical information systems. The standard should be established by the following way of the Internet standards.

  19. Neurology on the internet.

    PubMed

    Henson, John W; Jung, Lily K

    2010-05-01

    Since the Internet's inception in 1969, neurologists have witnessed a continuous parade of innovative phases. There is tremendous potential for near-instantaneous dissemination of the latest developments in neurologic knowledge, although their value is dependent on the degree of awareness of neurologists and is limited by the reluctance of some sources to make information readily accessible. The encyclopedic nature of the Internet, with its vast resources of online information, may be diminished by issues of access, variable quality and reliability, and a lack of intelligent retrieval systems. A major hindrance, for example, is seen with restrictions on archival, but proprietary, neurologic literature. Neurologic patients and their caregivers use the Internet heavily, but for somewhat different reasons. It is important for neurologists to understand these differences. The emergence of the online Personal Health Record will become increasingly valuable as these sites evolve and more medical providers incorporate electronic applications and medical records into their practices. Online groups for neurologists with similar interests, often referred to as "networks," have the potential to catalyze the natural organizing tendencies among those seeking solutions to shared problems. Networking can function well for neurologists, neurologic patients, and for focused efforts in an area such as advocacy. These considerations are discussed in this article. Copyright 2010 Elsevier Inc. All rights reserved.

  20. Interoperable Documentation

    NASA Astrophysics Data System (ADS)

    Habermann, T.

    2011-12-01

    Documentation provides the context that adds understanding and knowledge to data. The ISO Standards for documenting data (19115, 19115-2), and services (19119) extend the range of standard documentation considerably beyond previously available approaches. They include increased utilization of technologies like UML, XML and linking and content areas like data quality and processing history. These extensions can build an emerging foundation of data interoperability into an infrastructure for interoperable understanding. This process will involve active collaboration between many environmental data providers and archives all over the world that are currently in the process of adopting and understanding how to effectively use the ISO Standards. I will describe ISO capabilities in the context of parallels between metadata tools and data interoperability approaches currently used by scientists and decision-makers. I will demonstrate how directories shared over the web, transport standards, and community conventions build the foundation for documentation access and data understanding. I will also demonstrate crosswalks and connections between ISO, THREDDS, and NetCDF documentation and some ideas and approaches to improving documentation across the entire spectrum of environmental data and products.

  1. Conflicting medication information: prevalence, sources, and relationship to medication adherence.

    PubMed

    Carpenter, Delesha M; Elstad, Emily A; Blalock, Susan J; DeVellis, Robert F

    2014-01-01

    Conflicting medication information has been defined as contradictory information about a medication topic from two or more sources. The objective of this study was to determine whether arthritis patients are exposed to conflicting medication information, to document sources of conflicting information, and to explore whether conflicting information is associated with sociodemographic factors, clinical characteristics, and medication adherence. Using an online survey, arthritis patients (N = 328) reported how often they received conflicting information about 12 medication topics as well as sources of conflicting information, demographic/clinical characteristics, and medication adherence. A linear regression model, which controlled for various demographic/clinical factors, determined whether conflicting information was associated with medication adherence. The majority of patients (80.1%) received conflicting information and were most likely to receive conflicting information about medication risks. Physicians, media sources, and the Internet were the most common sources of conflicting information. Less conflicting information (B =-0.13, p < .05), more information source use (B = 0.22, p < .01), and lower perceived regimen complexity (B =-0.17, p < .05) were associated with better medication adherence. In conclusion, conflicting medication information is pervasive, comes from a variety of sources, and may negatively affect patient health outcomes. To potentially decrease exposure to conflicting information, providers should direct patients to high-quality medication information sources.

  2. Medications

    MedlinePlus

    ... from becoming larger and causing more serious problems. Antiplatelets are medications that stop blood particles called platelets ... an angioplasty procedure. Aspirin is one type of antiplatelet medicine. (See "Aspirin: Take With Caution" ) Beta blockers ...

  3. Diabetes Self-Management Education and Medical Nutrition Therapy Improve Patient Outcomes: A Pilot Study Documenting the Efficacy of Registered Dietitian Nutritionist Interventions through Retrospective Chart Review.

    PubMed

    Marincic, Patricia Z; Hardin, Amie; Salazar, Maria V; Scott, Susan; Fan, Shirley X; Gaillard, Philippe R

    2017-08-01

    Diabetes self-management education (DSME) and medical nutrition therapy (MNT) improve patient outcomes; poor reimbursement limits access to care. Our aim was to develop methodology for tracking patient outcomes subsequent to registered dietitian nutritionist interventions, document outcomes for patients with type 2 diabetes attending an American Diabetes Association-recognized program, and obtain outcome data to support reimbursement and public policy initiatives to improve patient access to DSME and MNT. Retrospective chart review. A random sample of 100 charts was chosen from the electronic medical records of patients with type 2 diabetes completing DSME and individualized MNT, June 2013 to 2014. Data were extracted on body mass index (calculated as kg/m(2)), weight, hemoglobin A1c, blood glucose, and lipids. Mixed-model analysis of variance was used to determine differences between means for continuous variables; McNemar's tests and γ-statistic trend analysis were used to assess frequency of patients reaching glycemic targets. Significant weight loss was observed from baseline (94.3±21.1 kg) to end of program (91.7±21.2 kg [-1.6±3.9 kg]; P<0.001); weight loss in whites (-5.0±8.4 kg; P<0.001) exceeded that of African Americans (-0.8±9.0 kg; P>0.05). Significant hemoglobin A1c reduction was observed from baseline (8.74%±2.30%) to end of program (6.82%±1.37% [-1.92%±2.25%]; P<0.001) and retained at 1 year (6.90%±1.16%; P<0.001). Comparatively, 72% of patients reached hemoglobin A1c targets (≤7.0%) vs 27% at baseline (P=0.008). When stratified by diet alone and diet plus drug therapy, patients exhibited a 1.08%±1.20% (P<0.001) and 2.36%±2.53% (P<0.001) reduction in hemoglobin A1c, respectively. Triglycerides decreased from baseline 181.6±75.5 mg/dL (2.0±0.9 mmol/L) to 115.8±48.1 mg/dL (1.3±0.5mmol/L) (P=0.023). High-density lipoprotein increased from 41.4±12.4 mg/dL (1.1±0.3 mmol/L) to 47.3±12.4 mg/dL (1.2±0.3 mmol/L) (P=0.007). Retrospective

  4. Navigating physician resources on the Internet.

    PubMed Central

    Ellenberger, B

    1995-01-01

    By providing everything from electronic mail to "virtual patients," computer technology and the Internet have made enormous resources available to physicians. Science writer Beth Ellenberger gives an overview of the different levels of Internet access, as well as the e-mail addresses of some medical resources that will be useful to physicians. Images p1305-a PMID:7736378

  5. The Internet comes to home care.

    PubMed

    Anderson, R

    1998-06-01

    The Internet can provide home care agencies access to information, patients, physicians, payors, hospitals, pharmacists, durable medical equipment (DME) companies--virtually anyone participating in the delivery of care. Agencies that wish to take advantage of these capabilities need to take a hard look at what services the Internet can help them deliver.

  6. Internet censorship.

    PubMed

    1996-12-27

    The U.S. Supreme Court agreed to review a lower court ruling that found the Communications Decency Act to be an unconstitutional infringement on free speech. The judges from the U.S. District Court in Philadelphia said that parents should monitor material that children are exposed to on the Internet. AIDS groups that publish information on safer sex, HIV prevention and AIDS treatments are not responsible for censoring content.

  7. 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.

  8. The Internet and healthcare in Taiwan: value-added applications on the medical network in the National Health Insurance smart card system.

    PubMed

    Tsai, Wen-Hsien; Kuo, Hsiao-Chiao

    2007-01-01

    The introduction of smart card technology has ushered in a new era of electronic medical information systems. Taiwan's Bureau of National Health Insurance (BNHI) implemented the National Health Insurance (NHI) smart card project in 2004. The purpose of the project was to replace all paper cards with one smart card. The NHI medical network now provides three kinds of services. In this paper, we illustrate the status of the NHI smart card system in Taiwan and propose three kinds of value-added applications for the medical network, which are electronic exchange of medical information, retrieval of personal medical records and medical e-learning for future development of health information systems.

  9. Internet AIS

    NASA Astrophysics Data System (ADS)

    Filjar, Renato; Desic, Sasa; Pokrajac, Danijela; Cubic, Ivica

    2005-05-01

    Automatic Identification System (AIS) has recently become the leading issue in maritime navigation and traffic management worldwide. The present AIS solution, based on a VHF data communications scheme, provides AIS functionalities for SOLAS (AIS Class A) vessels only in a limited environment defined by radio propagation properties. Here we present a novel approach in AIS development based on current mobile communication technologies. It utilises existing mobile communications equipment that the majority of targetted end-users own and are familiar with. A novel AIS concept aims to offer a transition of AIS data traffic to mobile Internet. An innovative AIS architecture supports AIS data processing, storing and transferring to authorised parties. This enhances not only the operational area, but also provides the global AIS with data transfer security and an improved aids-for-navigation service, with all legally traceable vessels (both AIS Class A and AIS Class B) included in the system. In order to provide the development framework for Internet AIS, a set of essential four use-cases, a communication protocol and the first Internet AIS prototype have been recently developed and are briefly introduced in this article.

  10. A Randomized Double-Blind Controlled Trial Comparing Davanloo Intensive Short-Term Dynamic Psychotherapy as Internet-Delivered Vs Treatment as Usual for Medically Unexplained Pain: A 6-Month Pilot Study.

    PubMed

    Chavooshi, Behzad; Mohammadkhani, Parvaneh; Dolatshahi, Behrouz

    2016-01-01

    Research has shown that Intensive Short-Term Dynamic Psychotherapy (ISTDP) can effectively decrease pain intensity and improve quality of life in patients with medically unexplained pain. Understanding that not all patients with medically unexplained pain have access to in-person ISTDP, this study aims to investigate the efficacy of an Internet-delivered ISTDP for individuals with medically unexplained pain using Skype in comparison with treatment as usual. In this randomized controlled trial, 100 patients were randomly allocated into Internet-delivered ISTDP (n = 50) and treatment-as- usual (n = 50) groups. Treatment intervention consisted of 16 weekly, hour-long therapy sessions. The primary outcome was perceived pain assessed using the Numeric Pain Rating Scale. The secondary outcome included Depression Anxiety Stress Scale-21, Emotion Regulation Questionnaire, Mindful Attention Awareness Scale, and Quality-of-Life Inventory. Blind assessments were conducted at the baseline, posttreatment, and at a 6-month follow-up. In the intention-to-treat analysis, pain symptoms in the intervention group were significantly reduced (p < 0.001), whereas a reduction was not observed in the treatment as usual group (p = 0.651). Moreover, there were significant decreases in depression, anxiety, and stress, as well as a greater increase in emotion regulation functioning, mindfulness, and quality of life observed in the intervention group 6 months after the treatment compared with the treatment as usual condition. The results of this pilot trial demonstrate that 16 weeks of ISTDP delivered by Skype can significantly improve pain intensity and clinical symptoms of medically unexplained pain. Copyright © 2016 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.