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A national public and private "grand challenge" initiative should be undertaken to assure the American public that the telecommunications and computing revolutions improve health care, health education, and biomedical and health services research, and secure accountability for cost, quality, and access. The initiative should focus on meeting the needs of the patient and society at large. It needs to be a national vision, but it also ought to have regional [...]

The Integrated Academic (Advanced) Information Management System (IAIMS) initiative emerged in the early 1980s to respond to trends in biomedical information, transfer and access, and to identify the implications for health sciences libraries. Three recurrent themes have emerged as being essential to the creation of IAIMs: changing the paradigm; redirecting expenditures to build reuseable infrastructure; and working across cultural boundaries. An IAIMS penetrates an organization in four stages: from creating [...]

To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services.

Refine the understanding of the desirable skills for health sciences librarians as a basis for developing a training program model that reflects the fundamental changes in health care delivery and information technology.

The Interactive Home Health Care Program is a demonstration project evaluating the use of in-home telemedicine to provide health care for elderly and disabled people. Local cable systems interconnect a base station staffed by a telemedicine nurse with a modified television in the home. Six months into the project, 38 patients are being cared for at three sites in rural Kansas. Individual patient profiles show improvement. Technical and social challenges [...]

Inappropriate utilization of diagnostic testing has been well documented. The purpose of this study was to measure the impact of presenting real time, evidence-based critiques about the appropriateness of abdominal radiograph (KUB) orders on physician decision making.

In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record [...]

To measure the accuracy of automated tuberculosis case detection.

To explore the informatic requirements in the home care of chronically ill patients.

We evaluate the ability of a microcomputer program (Automatch) to link patient records in our hospital's database (N = 253,836) with mortality files from California (N = 1,312,779) and the U.S. Social Security Administration (N = 13,341,581). We linked 96.5% of 3,448 in-hospital deaths, 99.3% for patients with social security numbers. None of 14,073 patients known to be alive (because they were subsequently admitted) was linked with California deaths, and [...]