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The Computerized Patient Record System is deployed at all 173 Veterans Affairs (VA) medical centers. Providers access clinical notes in the system from a note title menu. Following its implementation at the Nashville VA Medical Center, users expressed dissatisfaction with the time required find notes among hundreds of irregularly structured titles. The authors' objective was to develop a document-naming nomenclature (DNN) that creates informative, structured note titles that improve information [...]

Direct physician order entry (POE) offers many potential benefits, but evidence suggests that POE requires substantially more time than traditional paper-based ordering methods. The Medical Gopher is a well-accepted system for direct POE that has been in use for more than 15 years. The authors hypothesized that physicians using the Gopher would not spend any more time writing orders than physicians using paper-based methods.

An evident contrast exists between the generally easy way medical doctors and administrators use the term "telemedicine" and the wide variety of significantly different technologic methods and devices necessary for correctly performing specific tasks in the field. Many misunderstandings could be avoided by agreeing on the types of services that telemedicine can provide, names for those services, and descriptions of what is included in the services. This manifesto lists representative [...]

As a multidisciplinary field, medical informatics draws on a range of disciplines, such as computer science, information science, and the social and cognitive sciences. The cognitive sciences can provide important insights into the nature of the processes involved in human- computer interaction and help improve the design of medical information systems by providing insight into the roles that knowledge, memory, and strategies play in a variety of cognitive activities. In [...]

The National Library of Medicine's MEDLINE (MEDLARS Online) database was the first database to be searched nationwide via value-added telecommunication networks. Now available on the World Wide Web free of charge from the National Library of Medicine and from many other sources, it is the world's most heavily used medical database. MEDLINE is unique in that each reference to the medical literature is indexed under a controlled vocabulary called Medical [...]

Increasing data suggest that error in medicine is frequent and results in substantial harm. The recent Institute of Medicine report (LT Kohn, JM Corrigan, MS Donaldson, eds: To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press, 1999) described the magnitude of the problem, and the public interest in this issue, which was already large, has grown.

The authors present a system that scans electronic records from cardiac surgery and uses inference rules to identify and classify abnormal events (e.g., hypertension) that may occur during critical surgical points (e.g., start of bypass). This vital information is used as the content of automatically generated briefings designed by MAGIC, a multimedia system that they are developing to brief intensive care unit clinicians on patient status after cardiac surgery. By [...]

Prefetching methods have traditionally been used to restore archived images from picture archiving and communication systems to diagnostic imaging workstations prior to anticipated need, facilitating timely comparison of historical studies and patient management. The authors describe a problem-oriented prefetching scheme, detailing 1) a mechanism supporting selection of patients for prefetching via characterizations of clinical problems, using multiple data sources (picture archiving and communication systems, hospital information systems, and radiology information [...]