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e-journal of the Association of Medical Directors of Information Systems and The Improve-IT Institute

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Home > Archive > Oct 15, 2005 : Vol.8 No.20
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The Effect of Automated Alerts on Provider Ordering Behavior in an Outpatient Setting
Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed (5.6% vs. 10.9%, p = 0.03, Generalized Estimating Equations test). The provider also increased ordering of the rule-associated laboratory test when an alert was displayed (39% at baseline vs. 51% during post intervention, p < 0.001).

A trial of automated decision support alerts for contraindicated medications using computerized physician order entry
The likelihood of a patient receiving at least one dose of contraindicated drug after the order was initiated decreased from 89% to 47% (p < 0.0001) after alert implementation. Analysis of the alerts seen by housestaff showed that alert compliance was higher in male patients (57% vs. 38%, p = 0.02), increased with the duration of housestaff training (p = 0.04), and increased in patients with worsening renal function (p = 0.007).

Computer aid for decision to biopsy breast masses on mammography: validation on new cases
Using a 100% sensitivity cutoff threshold established on the training data (100% negative predictive value), the classifier correctly identified 100% of the malignant masses in the validation test set, while potentially obviating 26% of the biopsies performed on benign masses.

Seven Steps to a Business Case
1. Understand Your Business Goal; 2. Let the Numbers Talk; 3. Present Various Scenarios; 4. Consider Your Culture; 5. Give Nonfinancials Their Due; 6. Include Collateral Costs; 7. Consult Business Partners

Will the Future Be a Trillion Times Better?
"The Singularity Is Near" is startling in scope and bravado. Mr. Kurzweil envisions breathtakingly exponential progress, and he is merely extrapolating from established data. To his way of thinking, "when scientists become a million times more intelligent and operate a million times faster, an hour would result in a century of progress (in today's terms)."

Unattended PCs a menace, says Gartner
The main risk is that confidential information could be accessed and changed as a means of carrying out fraud, but the tendency of employees to send bogus or prank e-mails is also noted. A less obvious but equally damaging issue is that lax PC security offered employees gaining illegal access to data a cover of plausible deniability for their actions. There is little point in implementing some sort of sophisticated identity and access management system unless you can ensure that when people are logged in to systems, they stay at their PCs.

Automation of a problem list using natural language processing
The global aim of this project is to automate the process of creating and maintaining a problem list for hospitalized patients and thereby help to guarantee the timeliness, accuracy and completeness of this information.

Medical groups' adoption of electronic health records and information systems
This article surveyed a nationally representative sample of medical group practices to assess their current use of information technology (IT). Their results suggest that adoption of electronic health records (EHRs) is progressing slowly, at least in smaller practices. The process of choosing and implementing an EHR appears to be more complex and varied than expected.





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