Advertisement

Management of Clinical Problems by Physician-Computer Dialogue

  • Howard L. Bleich
Part of the Computers in Biology and Medicine book series (CBM)

Abstract

In recent years hospitals have begun using a computer program designed to help physicians manage patients with electrolyte and acid—base disorders. The program directs a dialogue during which the physician supplies clinical and laboratory information. When requested data are unavailable, the program proceeds with incomplete information. On the basis of the abnormalities detected, it then asks further questions as needed to characterize the electrolyte and acid—base disturbances. Upon completion of the interchange, the program produces an evaluation note that resembles a remotely located consultant’s discussion of the problem presented. The note includes a list of diagnostic possibilities, an explanation of the pathophysiology, therapeutic recommendations, suggestions for additional laboratory studies, precautionary measures required by the illness or the treatment, and references to the medical literature. Since additional hospitals are scheduled to begin using the program shortly, and additional computer consultation programs are under various stages of development, it seems appropriate to compare computerized and human consultation, and to consider some of the implications of this adjunct to patient care.

Keywords

Renal Tubular Acidosis Metabolic Alkalosis ETHACRYNIC Acid Serum Sodium Concentration Evaluation Note 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bleich, H. L., 1969. Computer evaluation of acid -base disorders, J. Clin.Invest. 48:1689–1696.CrossRefGoogle Scholar
  2. Bostrom, R. C., Sawyer, H. S., Tolles, W. E., 1959. Instrumentation for automatically prescreening cytological smears, Proc. I.R.E. 47:1893–1900.CrossRefGoogle Scholar
  3. Caceres, C. A., Steinberg, C. A., Gorman, P. A., et al., 1964. Computer aids in electrocardiography, Ann. N.Y. Acad. Sci. 118:85–102.CrossRefGoogle Scholar
  4. Greenes, R. A., Pappalardo, A.N., Marble, C.W., and Barnett, G. D., 1969. Design and implementation of a clinical data management system, Comput. Biomed. Res. 2:469–485.CrossRefGoogle Scholar
  5. Mazlish, B., 1967. The fourth discontinuity, Technology and Culture 8:1–15 (Winter, 1967).CrossRefGoogle Scholar
  6. Pipberger, H. V., Freis, E. D., Taback, L., et al., 1960. Preparation of electrocardiographic data for analysis by digital electronic computer, Circulation 21:413–418.Google Scholar
  7. Rosenberg, S. A., Ledeen, K. S., Kline, T., 1969. Automatic identification and measurement of cells by computer, Science 163:1065–1067.CrossRefGoogle Scholar
  8. von Neumann, J., 1958. The Computer and the Brain, pp. 63–64, Yale University Press, New Haven.Google Scholar

Copyright information

© Plenum Press, New York 1978

Authors and Affiliations

  • Howard L. Bleich
    • 1
  1. 1.Thorndike Memorial Laboratory and Department of MedicineHarvard Medical School and Beth Israel HospitalBostonUSA

Personalised recommendations