Swiss medical informatics最新文献

{"title":"Patientenidentifikation 2.0","authors":"P. Zehnder, Johannes Gnägi, P. Hirschi, Michael Lehmann, J. Holm","doi":"10.4414/SMI.31.329","DOIUrl":"https://doi.org/10.4414/SMI.31.329","url":null,"abstract":"Introduction Improved medication safety and prevention of adverse drug events among hospital inpatients has many facets, such as improved ordering procedures by use of CPOE (Computerised Physician Order Entry) and CDSS (Clinical Decision Support System) functions. For this study we concentrated on the correct administration of drugs to the correct patient and performed a questionnaire study to evaluate the utilisation of patient bracelets in Swiss hospitals. Methods/Results An electronic questionnaire was distributed to 264 Swiss hospitals and answers were received from 73 institutions. Fifteen (22%) of the institutions used patient bracelets for identification, and another 10 (19%) planned to do so. Fourteen (93%) of the institutions using bracelets wrote name and birthdate on the bracelet, 11 (73%) a case identifier and 8 (53%) a patient identifier. Only six (40%) used a barcode on the patient bracelet and only one (7%) radiofrequency identification (RFID). We asked all institutions how they performed patient identification during any medical contact. Multiple answers were allowed. Sixty-eight (93.2%) of the 73 institutions used oral communication, 33 (45.2%) had additional nametags fixed to the bed, 17 (23.2%) also checked the bracelet and only 2 (2.7%) used a technical device (barcode scanner) to check identity. Among the 10 who planned to introduce patient bracelets, the rate for use of barcodes was identical (4; 40%), whereas an increased use of RFID was planned by 1 (10%). The remaining 5 (50%) will use only clear text information on the bracelets. Most institutions used patient bracelets for inpatients and most started filling out the bracelet when the patient entered the nursing station. The feedback from staff was predominantly positive, although doctors seemed to be the more sceptical. Conclusion Our results demonstrate a strong interest in the topic. When both performed and planned patient bracelet introductions are included, nearly half of Swiss hospitals will use this technology. But only one will rely on RFID and a negligent minority employ technical devices to prevent patient misidentification. Thus there is a remaining gap to bridge in order to achieve better medication safety by avoiding misidentification cases.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132724543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leistungssteigerung von Patienten-Monitoring durch Compressive Sensing","authors":"T. Hofer, Stefano Bromuri, Michael Schumacher","doi":"10.4414/SMI.31.338","DOIUrl":"https://doi.org/10.4414/SMI.31.338","url":null,"abstract":"Chronic diseases like those related to the cardiovascular system are among the most common causes of death worldwide, as are chronic obstructive diseases of the lung (COPD: chronic obstructive pulmonary disease). In most cases, the disease progression can be slowed down, yet there is no way to stop it. To this end, strict therapy compliance, along with the continuous monitoring of vital parameters, appears crucial. With the development of connected terminal devices and progress made in information technologies over the past years, continuous patient monitoring is now possible without requiring costly hospitalizations. In the best-case scenario, this translates into improved, or at least not deteriorated, quality of life for the patients, with only a minor impact on their daily life. The COMPASS 1 (COntinuous multi-variate Monitoring of Patients Affected by chronic obstructive pulmonary diSeaSe) project seeks to develop a personal health system (PHS) that is capable of continuously monitoring vital parameters and compressing patient data, while ensuring interoperability and patient safety, in addition to providing prognostic information. This article presents a novel approach to combining interoperability with HL7 standards whilst simultaneously ensuring data compression via compressive sensing.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117058213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Earlier switching from intravenous to oral antibiotics owing to eReminders","authors":"P. Beeler","doi":"10.4414/SMI.31.00320","DOIUrl":"https://doi.org/10.4414/SMI.31.00320","url":null,"abstract":"The impact of electronic reminders encouraging early switches from intravenous to oral administration of antibiotics was studied in a hospital-wide, prospective, controlled trial. The reminders were displayed within electronic health records 60h after onset of intravenously administered antibiotic therapies if some patient-specific conditions were met. This intervention fostered early switching from intravenous to oral antibiotics, and thereby significantly reduced the mean duration of intravenous administration by 17%.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114364255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Privacy Preserving Interoperability for Personalized Medicine","authors":"Alevtina Dubovitskaya","doi":"10.4414/SMI.30.00310","DOIUrl":"https://doi.org/10.4414/SMI.30.00310","url":null,"abstract":"Development and implementation of a new approach for therapeutic drug monitoring and dosage individualization for the patients will significantly improve modern therapeutics. To make it possible we aim at tackling the following questions: how to achieve (semantic) interoperability and medical data integration in a distributed environment; and how to ensure privacy of the patients in case of sharing and aggregation health data for research purposes.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125834846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Die fatalen Folgen der Implementierung einer HL7-ADT-Schnittstelle","authors":"Jonas Botta, Pascal Walliser","doi":"10.4414/SMI.30.294","DOIUrl":"https://doi.org/10.4414/SMI.30.294","url":null,"abstract":"The fatal consequences of implementing a HL7 ADT interface One of our sites implemented a HL7 ADT interface for demographic patient data between the hospital information system (HIS) and the radiology information system (RIS). In the RIS, they implemented a rule that merges patient records if these have an identical patient identification number (PID). They didn’t realise that the two systems had overlapping number ranges. As a result, they performed many merges on different patients. Following the RIS, the picture archiving and communication system (PACS) also merged the patient dossiers and changed the corresponding DICOM-header. When the mistake was discovered, we managed to separate the patients in the RIS but not in the PACS. This implicates some decisions and workarounds for the daily tasks of our radiologists and for the future migration to a new RIS/PACS.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"48 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122461938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creation of computer-assisted drug prescription in a pediatric hospital: the 8 years experience of the Children’s Hospital of Geneva","authors":"G. Scala, C. Fonzo-Christe, S. Chalier, Magali Despond, C. Lovis, Bertrand Guignrd, K. Posfay-Barbe","doi":"10.4414/SMI.30.00297","DOIUrl":"https://doi.org/10.4414/SMI.30.00297","url":null,"abstract":"The University Hospitals of Geneva (HUG) had an institutional project to implement a computerised physician order entry (CPOE) system to replace verbal and handwritten prescriptions as well as transcription, in order to decrease errors and related adverse drug events. Development of CPOE was first intended for adult patients. A dedicated working group, PRESCO-PED, was created in 2006 for the development of the paediatric drug database. This group was in charge of evaluating the needs and building and maintaining a database of the most-prescribed drugs in paediatrics. PRESCO-PED included physicians representing most paediatric specialties, such as intensive care, neonatology, emergency, oncology, general paediatrics, surgery, orthopaedic surgery, anaesthesiology, infectious diseases and psychiatry, in cooperation with nurse representatives, pharmacists, and computer specialists. The drug database had to be specific to paediatrics, structured, validated by experts, and easy to update. Several drug datasets were available in the institution, such as the injectable drug administration guide of the pharmacy, nurses’ protocols, and different published references. However, all were incomplete, not structured or not directly exploitable for the database. All the variables required per drug first had to be defined: brand name, international nonproprietary name (INN), unit dose, interval, maximal unit dose, maximal daily dose, route of administration, flow rate, formulation, specific dosage according to patient’s age, gestational age, body weight, body surface index, etc. The most frequently used drugs, corresponding to 346 drug records, were each distributed  to two experts in the group, chosen according to the specialty in which the drug was mainly used. After validation by both experts, a database was compiled and verified again by PRESCO-PED. The additional aim of this database was to allow the system to suggest standard prescriptions schemes and to trigger alerts, for example when maximal doses were exceeded. The prescription of drugs in the database was then tested with mock patients by a subgroup of members of PRESCO-PED in addition to regular users, prior to implementation in a clinical setting. In order to facilitate acceptance by the end-users, in addition to drug prescription, PRESCO-PED decided to work on order sets, which simplified and accelerated prescriptions by combining in a single interface multiple orders (patient monitoring, laboratory tests, radiology, drugs, feeding and IV fluids, among others) associated with a specific clinical setting. With the same quality standards, a paediatric enteral nutrition prescription interface was also created. After 20 sessions of PRESCO-PED over a period of 10 months, all drugs and several order sets were available, with the database completed and ready for use. Drugs specific to paediatrics were easily differentiated from adult drugs in the prescription interface thanks to a characteristic pictogram.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115709204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomedizinische Informatik: Erfahrungen mit der Umsetzung eines anwendungsorientierten Bachelor-Studiengangs","authors":"Dominique Brodbeck, M. Degen, F. Pude","doi":"10.4414/smi.30.305","DOIUrl":"https://doi.org/10.4414/smi.30.305","url":null,"abstract":"Dieser Beitrag beschreibt die Erfahrungen beim Entwurf und der Umsetzung eines Medizininformatik-Studiengangs auf Bachelorstufe.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127640909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"eHealth Prescription App","authors":"D. Mahadevan","doi":"10.4414/smi.30.00325","DOIUrl":"https://doi.org/10.4414/smi.30.00325","url":null,"abstract":"With the eHealth Prescription App we created a prototype for Smartphones with the aim to remind patients to take their medicine and therefore to improve their adherence. Furthermore a concept for the eHealth Prescription App was created to describe how the App can be integrated into a prescription workflow involving doctors, pharmacies and Vivates – the eHealth platform from Swiss Post Solution AG.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"473 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123056944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"pediatric-dosages.ch: from a dosage booklet to a “clinical decision support system“","authors":"P. Vonbach","doi":"10.4414/SMI.30.323","DOIUrl":"https://doi.org/10.4414/SMI.30.323","url":null,"abstract":"Adverse drug events caused by medication errors are about three times as frequent in hospitalised children as they are in adult patients [1]. In many cases, pharmacotherapy in children requires additional know-how because of a lack of data about the use of drugs in this patient population. In Switzerland, about 50% of the drugs are prescribed off label or are unlicensed in paediatrics [2, 3]. The fact that wrong doses are amongst the most frequent medication errors in children [1, 4, 5] shows that finding the right dose is an especially demanding task for health-care professionals.","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127540849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SURgical PAtient Safety System (SURPASS) am Luzerner Kantonsspital (LUKS)","authors":"D. Heim","doi":"10.4414/smi.30.00304","DOIUrl":"https://doi.org/10.4414/smi.30.00304","url":null,"abstract":"","PeriodicalId":156842,"journal":{"name":"Swiss medical informatics","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117006666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}