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

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El Camino Hospital bids farewell to trailblazing records system
The original Management Information System, implemented in 1971 and in use ever since, was the first of its kind in the world. It tracked patient information and kept it all in once place for staff members who needed to consult it. But it was "a great big information pit" that lacked tools to help physicians, nurses and others find what they needed quickly, said CIO Mark Zielazinski. The new system will be Web-based and "smarter" - equipped with decision-support and data-mining tools. Within a couple of years, all the computerized information systems in the hospital will be integrated into the new system.

Design and implementation of GRIP: a computerized glucose control system at a surgical intensive care unit
Implementation of the computer program was uneventful and successful. GRIP treated 179 patients for a total of 957 patient-days. Severe hypoglycemia (< 2.2 mmol/L) only occurred once due to human error. With a median (IQR) of 4.9 (4.2 - 6.2) glucose measurements per day the median percentage of time in which glucose fell in the target range was 78%. Nurses rated the program as easy to work with and as an improvement over the preceding paper protocol. They reported no increase in time spent on glucose control.

Development and initial testing of a computer-based patient decision aid to promote colorectal cancer screening for primary care practice
Mean viewing time was 19 minutes. The decision aid improved patients' intent to ask providers for screening from a mean score of 2.8 (1 = not at all likely to ask, 4 = very likely to ask) before viewing the decision aid to 3.2 afterwards (difference, 0.4; p < 0.0001, paired t-test). Most found the aid useful and reported that it improved their knowledge about screening. Sixty percent said they were ready to be tested, 18% needed more information, and 22% were not ready to be screened. Within 6 months of viewing, 43% of patients had completed screening tests.

Mobile eHealth Interventions for Obesity: A Timely Opportunity to Leverage Convergence Trends
We conclude that the appropriate model for obesity and weight management is the tailored informational intervention modified according to design principles suggested by Social Cognitive Theory and the Social Marketing Model. The health behaviors to target are self-monitoring of diet and physical activity. The devices are Web-enabled “smart” cellular telephones and wireless PDAs. Given the lack of effectiveness of other interventions to prevent or treat obesity in a sustainable matter, trials of these persuasive, ubiquitous technologies are required without delay.

Going, Going, Still There: Using the WebCite Service to Permanently Archive Cited Web Pages
Scholars are increasingly citing electronic “web references” which are not preserved in libraries or full text archives. WebCite is a new standard for citing web references. To “webcite” a document involves archiving the cited Web page through www.webcitation.organd citing the WebCite permalink instead of (or in addition to) the unstable live Web page.

Effects of a web based decision aid on parental attitudes to MMR vaccination: a before and after study
A web based decision aid significantly improved parental attitudes to MMR vaccination. Residual concerns about autism and bowel disease and the rare chance of serious complications remained as attitudinal barriers to some parents.





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