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Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients: Materials and Methods
Typical indications for the PE rule-out protocol included symptoms of dyspnea, chest pain, or syncope, or physical signs such as a rapid pulse or low pulse oximetry reading that could not be explained by another disease process. Exclusions were hemodynamic instability (clinical signs of shock as described by Jones et al), inability to obtain a […]
Prospective Study of the Diagnostic Accuracy of the Simplify D-dimer Assay for Pulmonary Embolism in Emergency Department Patients
The ideal screening strategy to exclude pulmonary embolism (PE) in the emergency department (ED) setting would be, fast, cheap, accurate, and easy to use. The d-dimer assay (Simplify D-dimer; Agen Biomedical; Brisbane, Australia) is a single-use, individually packaged immunofiltration cartridge assay. The kits and the reagents can be stored at room temperature. The user adds […]
Applied Medical Informatics for the Chest Physician: The Challenge of Understanding Clinical Workflow
The root causes for problems with interoperability include changing information technologies, competing proprietary vendor systems, and, simply, the complexity of clinical information systems. More recently, it has been recognized that standardization will be essential to the success of the National Health Information Network. Regional Health Information Networks are now beginning to appear in many states […]
Applied Medical Informatics for the Chest Physician: Clinicians Expectation
Clinician time spent and the value perceived in the EMR remains one of the primary concerns in the United States. In more recent studies, physicians have definitely ranked EMRs toward the top of the solutions to decreasing the number of medical errors. However, it is important to understand that, even in the most optimistic investigations, […]
Applied Medical Informatics for the Chest Physician: Time Commitment
How much do EMRs cost? The firm First Consulting Group, based in California, said it would cost $210 million in one-time start-up expenditures for the 46 Massachusetts hospitals to install them or to update existing technology to a minimum agreed-on standard. However, the consultant predicted the hospitals would save $275 million annually because the systems […]
Applied Medical Informatics for the Chest Physician: Technology
It is intuitive that the introduction of an EMR into a large academic health system will differ in many ways from its introduction into a small, community, private practice office. However, what may not be as evident is that the characteristics of these different clinical environments may have more to do with success than simply […]
Applied Medical Informatics for the Chest Physician: Complexity of the EMR
The elements of achieving success in an EMR selection, configuration, and implementation are complex. The three major categories are “Winning Hearts and Minds,” “Technology,” and “Place and Time” (Fig 1). Credible leadership is essential, and, as has been demonstrated repeatedly, implementing any change in medical practice usually revolves around a group leadership model. The change […]