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Recent technical advances in Internet-based client/server applications and new multimedia communications protocols are enabling the development of cost-effective, platform-independent solutions to the problem of remote access to continuously acquired physiological data. The UCLA Neurosurgery Intensive Care Unit (ICU) has developed a distributed computer system that provides access over the World Wide Web (WWW) to current and previously acquired physiological data, such as intracranial pressure, cerebral perfusion pressure, and heart rate [...]

This case study details the set-up and implementation of the PathNet autocoder (Cerner Corporation) in a busy anatomic pathology laboratory. After initial start-up, procedures were developed to improve the system's performance. Four classes of software coding errors were identified, and an index was developed to measure the number of cases between errors (CBE). Through modifications in the program, the CBE increased sharply by the end of the six-month study period [...]

To evaluate the applicability of metrics collected during routine use to monitor the performance of a deployed expert system.

Electronic medical record systems (EMRSs) currently do not lend themselves easily to cross-institutional clinical care and research. Unique system designs coupled with a lack of standards have led to this difficulty. The authors have designed a preliminary EMRS architecture (W3-EMRS) that exploits the multiplatform, multiprotocol, client-server technology of the World Wide Web. The architecture abstracts the clinical information model and the visual presentation away from the underlying EMRS. As a [...]

To explore different user-interface designs for structured progress note entry, with a long-term goal of developing design guidelines for user interfaces where users select items from large medical vocabularies.

This case report describes development and testing of a method to extract clinical information stored in the Veterans Affairs (VA) Decentralized Hospital Computer System (DHCP) for the purpose of analyzing data about groups of patients. The authors used a microcomputer-based, structured query language (SQL)-compatible, relational database system to replicate a subset of the Nashville VA Hospital's DHCP patient database. This replicated database contained the complete current Nashville DHCP prescription, provider [...]

To determine whether expert problem-solving strategies can be identified within a large number of student performances of complex medical diagnostic simulations.

Strategies for implementing instructional technology are based on recent experiences at the University of Michigan Medical Center. The issues covered include 1) addressing facilities, hardware, and staffing needs, 2) determining learners' skill requirements and appropriate training activities, and 3) selecting and customizing educational software. Many examples are provided, and nine key points for success are emphasized.