Development of a web-based multifacility healthcare surveillance information system

This article describes recent work to develop a Web-based statistical surveillance information system to monitor in real time the status of the U.S. Air Force's worldwide healthcare network. The intent is to incorporate statistical and related methods in order to identify unusual events and patterns of concern in large, highly distributed organizations. The work recently received an award from Vice President Gore for reinventing government.

Automated acuity scoring within a computer based medical record

This paper describes the initial development of a completely automated acuity scoring system that resides within the TMR bedside computing system at the Duke University Medical Center, Surgical Intensive Unit. The scoring system is based upon the APACHE II acuity scoring system and provides for the recalculation of acuity scoring at 12 hour intervals through the patient's ICU course. When comparing hand calculated versus computer generated acuity scores for 19 patients, discrepancies fell into three broad categories: 1) data available to the application differed from that available to the human scorer. 2) apparent transcription errors 3) data items lost or absent from the paper record. It remains to be determined if computer generated acuity scoring provides for a more accurate representation of the patient's acuity.