The Development of Medical Record Items: a User-centered, Bottom-up Approach

Objectives: Clinical documents (CDs) have evolved from traditional paper documents containing narrative text information into the electronic record sheets composed of itemized records, where each record is expressed as an item with a specific value. We defined medical record (MR) items to be information entities with a specific value. These entities were then used to compile form-based clinical documents as part of an electronic health record system (EHR-s). Methods: We took a reusable bottom-up developmental approach for the MR items, which provided three things: efficient incorporation of the local needs and requirements of the medical professionals from various departments in the hospital, comprehensive inclusion of the essential concepts of the basic elements required in clinical documents, and the provision of a structured means for meaningful data entry and retrieval. This paper delineates our experiences in developing and managing medical records at a large tertiary university hospital in Korea. Results: We collected 63,232 MR items from paper records scanned into 962 CDs. The MR item database was constructed using 13,287 MR items after removing redundant items. During the first year of service users requested changes to be made to 235 (1.8%) attributes of the MR items and also requested the additional 9,572 new MR items. In the second year, the attributes of 70 (0.5%) of the existing MR items were changed and 3,704 new items were added. The number of registered MR items increased by 72.0 % in the first year and 27.9 % in the second year. Conclusions: The MR item concept provides an easier and more structured means of data entry within an EHR-s. By using these MR items, various kinds of clinical documents can be easily constructed and allows for medical information to be reused and retrieved as data

Web-based multimodal graphs for visually impaired people

This paper describes the development and evaluation of Web-based multimodal graphs designed for visually impaired and blind people. The information in the graphs is conveyed to visually impaired people through haptic and audio channels. The motivation of this work is to address problems faced by visually impaired people in accessing graphical information on the Internet, particularly the common types of graphs for data visualization. In our work, line graphs, bar charts and pie charts are accessible through a force feedback device, the Logitech WingMan Force Feedback Mouse. Pre-recorded sound files are used to represent graph contents to users. In order to test the usability of the developed Web graphs, an evaluation was conducted with bar charts as the experimental platform. The results showed that the participants could successfully use the haptic and audio features to extract information from the Web graphs

Database Tuning Advisor for Microsoft SQL Server 2005

The Database Tuning Advisor (DTA) that is part of Microsoft SQL Server 2005 is an automated physical database design tool that significantly advances the state-of-the-art in several ways. First, DTA is capable to providing an integrated physical design recommendation for horizontal partitioning, indexes, and materialized views. Second, unlike today’s physical design tools that focus solely on performance, DTA also supports the capability for a database administrator (DBA) to specify manageability requirements while optimizing for performance. Third, DTA is able to scale to large databases and workloads using several novel techniques including: (a) workload compression (b) reduced statistics creation and (c) exploiting test server to reduce load on production server. Finally, DTA greatly enhances scriptability and customization through the use of a public XML schema for input and output. This paper provides an overview of DTA’s novel functionality, the rationale for its architecture, and demonstrates DTA’s quality and scalability on large customer workloads. 1