Bleich HL, Slack WV. Designing a hospital information system: a comparison of interfaced and integrated systems. MD Comput 1992;9(5):293-6.
Bleich HL. Diagnostica mathematica. MD Comput 1992;9(1):11.
Bleich HL. The doc and the dough. MD Comput 1992;9(5):282-3.
Bleich H. George Boole, mathematical logic, and the modern computer. MD Comput 1992;9(3):136.
Bleich HL. Medical practice and statistical analysis. MD Comput 1992;9(5):281.
Slack WV. The handheld calculator. MD Comput 1991;8(1):8-10.
Slack WV. The human genome. MD Comput 1991;8(3):136-8.
Bleich HL. Classic articles in medical computing. MD Comput 1991;8(3):132, 134.
Rind DM, Safran C, Phillips RS, Slack WV, Calkins DR, Delbanco TL, Bleich HL. The effect of computer-based reminders on the management of hospitalized patients with worsening renal function. Proc Annu Symp Comput Appl Med Care 1991;:28-32.Abstract
We performed a prospective time-series study to determine whether computerized reminders to physicians about rising creatinine levels in hospitalized patients receiving nephrotoxic and renally excreted medications led to more rapid adjustment or discontinuation of those medications, and to evaluate physician acceptance of computerized reminders. Laboratory data were followed on 10,076 patients over 13,703 admissions generating 1104 events of rising creatinine levels during treatment with nephrotoxic or renally excreted medications. During the intervention period, medications were adjusted or discontinued an average of 21.1 hours sooner (p less than 0.0001) after such an event occurred when compared with the control period. This effect of the reminders was strongest for patients receiving renally excreted and mildly nephrotoxic medications. Of physicians who responded to a computerized survey, 53% said that the reminders had been helpful in the care of their patients, while 31% felt that the reminders were annoying. Seventy-three percent wished to continue receiving computerized reminders. We conclude that computerized reminders are well-accepted in our hospital and have a strong effect on physician behavior.
Bleich HL. Enemy radar, theoretical physics, and computer-assisted diagnosis. MD Comput 1991;8(5):269-70.
Slack WV, Porter D, Balkin P, Kowaloff HB, Slack CW. Computer-assisted soliloquy as an approach to psychotherapy. MD Comput 1990;7(1):37-42, 58.Abstract
Schools of talking therapy generally consider the doctor-patient relationship to be essential to the therapeutic process. Yet studies reveal that the presence of a therapist can sometimes inhibit frank disclosure and that patients will speak alone, in the absence of a therapist, about matters of importance to them. We have programmed a computer interview to facilitate soliloquy and have studied its effectiveness. Encouraged by the computer, subjects talked into a microphone first about anxiety-provoking circumstances and then about relaxation. Both mean heart rate and State anxiety scores fell significantly between the beginning and the end of the interview.
Slack WV. A brief treatise on the academic committee. MD Comput 1990;7(5):282-4.
Slack WV. An invasion of mercy. MD Comput 1990;7(4):196-7.
Slack WV. Neural networks in plants?. MD Comput 1990;7(1):6-8.
Slack WV. Type 1 and type 2 administrators. MD Comput 1990;7(2):69-70.
Safran C, Porter D, Rury CD, Herrmann FR, Lightfoot J, Underhill LH, Bleich HL, Slack WV. ClinQuery: searching a large clinical database. MD Comput 1990;7(3):144-53.Abstract
We designed a user-friendly computer program that permits physicians to use clinical and demographic descriptors to search a hospital's clinical database for purposes of patient care, teaching, and research. For example, the user can identify all admissions in which diabetic ketoacidosis was diagnosed, the serum bicarbonate level was under 12 mmol/liter, and the length of stay exceeded 7 days. Once particular admissions have been identified, all data stored in the computerized record can be displayed. Authorized persons can also request the patient's complete medical record for further study. Over a 5-year period, 895 doctors, nurses, medical students, and hospital administrators used Clin-Query to search the clinical database of Boston's Beth Israel Hospital 3724 times. They displayed detailed information on 72,489 patients and requested the complete medical record 5477 times. Responses to a computer-based questionnaire indicated that 16% of the searches were performed for patient care, 38% for clinical research, 16% for teaching and education, 12% for hospital administration, and 18% for general exploration. We conclude that physicians and allied personnel will repeatedly examine and analyze aggregate clinical information when they are provided with the appropriate tools.
Safran C, Herrmann F, Rind D, Kowaloff HB, Bleich HL, Slack WV. Computer-based support for clinical decision making. MD Comput 1990;7(5):319-22.Abstract
Although computers are now commonly used for financial purposes in hospitals and physicians' offices, most physicians do not routinely use them in patient care. And in hospitals where laboratory data are provided on computer terminals, the displays are often difficult to use and programs that offer assistance in interpreting the data are usually unavailable. We have developed decision support programs that are widely used with the clinical computing system at our hospital. This paper describes the programs and how the clinicians use them.
Slack WV. The computer and the doctor-patient relationship. MD Comput 1989;6(6):320-1.
Slack WV. Remembrance, thanks, and welcome. MD Comput 1989;6(4):183-5.
Slack WV. The soul of a new system: a modern parable. MD Comput 1989;6(3):137-40.