Slack WV, Safran C, Kowaloff HB, Pearce J, Delbanco TL.
Be well!: a computer-based health care interview for hospital personnel. Proc Annu Symp Comput Appl Med Care 1993;:12-6.
AbstractWe developed a computer-based health care interview for employees at an urban teaching hospital. The interview is part of the hospital-wide, integrated Center for Clinical Computing (CCC) system at the Beth Israel Hospital in Boston, and is available on 1500 terminals located throughout the hospital. The program emphasizes medical problems and patterns of living for which behavioral change is considered desirable. Conducted in private and with protection of confidentiality, the interview offers information about people and facilities available to help members of the hospital community seek better health. Between May 15, 1990, and May 14, 1992, a total of 1281 people completed the interview, and 84% indicated an interest in one or more of the health-related programs offered by the hospital. That these are difficult times in America was illustrated by the unhappiness reported by 43% of the participants, including 5% who indicated that life sometimes seemed not worth living. We hope they availed themselves of the opportunity offered by the interview to obtain help for their problems, and that other hospitals will do what Beth Israel Hospital is doing to promote well-being among its employees.
Safran C, Rind DM, Davis RM, Currier J, Ives D, Sands DZ, Slack WV, Makadon H, Cotton D.
An electronic medical record that helps care for patients with HIV infection. Proc Annu Symp Comput Appl Med Care 1993;:224-8.
AbstractWe have built a clinical workstation to help doctors and nurses care for patients with HIV infection. This knowledge-based medical record system provides medication alerts, reminders about primary care, and on-line information to support the care of patients with HIV infection. We are conducting a controlled clinical trial of this computer system in a single practice setting, which consists of 18 staff physicians, 13 nurses, and 113 residents, who cooperatively practice in four teams. Two teams of physicians are assigned to an intervention group and two teams to a control group. This paper reports preliminary results from the first year of study, January 15, 1992, through January 14, 1993. During this period 274 patients with HIV infection were followed by the general medical practice--130 in a control group and 144 in an intervention group. Physicians in the intervention group more rapidly and more completely followed primary care guidelines than did physicians in the control group. Patients in the intervention group had 2476 ambulatory or emergency visits (17.2 visits per patient) compared with 1882 visits (14.5 visits per patient) for the control patients (p < 0.01). There were 101 hospitalizations for 51 patients in the intervention group (an admission rate of 0.7) compared with 104 admissions for 54 patients in the control group (an admission rate of 0.8) (p = NS). There were 8 deaths in the intervention group (5.6%) compared with 13 (10%) in the control group (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Witschi JC, Kowaloff HB, Slack WV.
An interactive dietary interview for hospital employees. MD Comput 1993;10(4):216-24.
Slack WV.
On walking in America. MD Comput 1993;10(5):285.
Bleich HL.
Critique of an evaluation of software for searching MEDLINE. Proc Annu Symp Comput Appl Med Care 1993;:591-5.
AbstractIn a previous study, investigators at McMaster University compared 14 ways to search the MEDLINE database and concluded that the method that cost the least (the National Library of Medicine's ELHILL program) yielded the highest proportion of relevant articles, whereas the method that cost the most (PaperChase) yielded the least. There are serious defects in the study design that invalidate the authors' conclusions.
Sands DZ, Safran C, Slack WV, Bleich HL.
Use of electronic mail in a teaching hospital. Proc Annu Symp Comput Appl Med Care 1993;:306-10.
AbstractElectronic mail has been in use for almost 20 years at Boston's Beth Israel Hospital and is an integral part of the clinical information system. Through a study of usage patterns during a one-week period, we found that 1247 persons sent 7482 messages to 1302 different recipients. Each category of user (attending physician, house officer, nurse, etc.) sent the most e-mail to others of the same user category. Through an electronically administered questionnaire, we found that self-reported usage patterns had a high correlation (r = 0.6) with measured use. Sixty-six percent of respondents used e-mail daily or weekly, and 58% used it for issues of patient care; nearly all users found this useful for communicating about patient care issues. Ninety percent of respondents felt e-mail made their lives easier and 61% felt it had a humanizing influence on their lives. We conclude that the e-mail system is well-utilized by clinical personnel and felt to be useful in both patient care and nonpatient care situations.
Bleich HL.
John von Neumann. MD Comput 1993;10(3):141-4.