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Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. Appropriate new telemedicine applications can improve future disaster medicine outcomes, based on lessons learned from a decade of civilian and military disaster (wide-area) telemedicine deployments. This manuscript reviews the history of telemedicine activities in [...]

By the year 2008, a major reorganization of health care services in the United States will have evolved from the solo- and group-practice models of the 1940s, with fee-for-service and insurer-indemnification financing and paper-based information systems, to nationwide managed care plans employing enhanced computer-based information systems.

Even though medical informatics is most often viewed from the perspective of its host disciplines in clinical and biologic medicine, it has an identity and agenda of its own. This paper is an attempt to promote discussion about the long-term role and agenda for medical informatics as a discipline into the next decade. The discussion has two main lines of argument, one about the "engineering" goals of informatics and the [...]

Since the 1970s, it has been clear that the health community needs to develop a health care system that matches a person's needs with the expertise and technology to address those needs. The logical solution is a multi-tiered system. In such a system, physicians would provide second- and third-tier services and other health professionals would provide first- and second-tier services. Medical informatics should take on the challenge of supporting the [...]

To allow exchange of clinical practice guidelines among institutions and computer-based applications.

The International Classification for Nursing Practice (ICNP) is a collaborative project under the auspices of the International Council of Nurses. The alpha version is available online for comment in preparation for the release of the beta version in 1999. The authors answer the most-frequently asked questions about the ICNP and encourage nurses in the United States to participate in the revision by sending comments and suggestions to the American Nurses [...]

Building on the work of previous authors, the Computer-based Patient Record Institute (CPRI) Work Group on Codes and Structures has described features of a classification scheme for implementation within a computer-based patient record. The authors of the current study reviewed the evaluation literature related to six major nursing vocabularies (the North American Nursing Diagnosis Association Taxonomy 1, the Nursing Interventions Classification, the Nursing Outcomes Classification, the Home Health Care Classification [...]

Adverse drug events (ADEs) are both common and costly. Most hospitals identify ADEs using spontaneous reporting, but this approach lacks sensitivity; chart review identifies more events but is expensive. Computer-based approaches to ADE identification appear promising, but they have not been directly compared with chart review and they are not widely used.

Both consumers and health service providers need access to up-to-date information, including patient and practice guidelines, that allows them to make decisions in partnership about individual and public health in line with the primary health care model of health service delivery. Only then is it possible for patient preferences to be considered while the health of the general population is improved. The Commonwealth Government of Australia has allocated $250 million [...]