Evacuation support system for improved medical documentation and information flow in the field.

PURPOSE: Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. METHODS AND MATERIALS: EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. RESULTS: A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. CONCLUSIONS: Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care will provide accurate and timely information for the management of resources during disaster response.

[A follow up of persons who received basic and/or supplemental benefits in childhood]. / Oppfølging av personer som fikk grunnstønad og/eller hjelpestønad som barn.

BACKGROUND: Consequences of chronic diseases in childhood with respect to health, educational achievement and participation in the labour force in young adult age are evaluated. MATERIAL AND METHODS: A total of 14,364 children (2.3%) of the 626,928 born in Norway 1967-76 received basic and /or supplemental benefits for at least one year of the age span 0-16 years. The more common diagnoses included Endocrine diseases (diabetes), disease classified under Mental diagnoses, Neurological diseases and Congenital malformations. All the children were followed up to the age of 27 with respect to mortality and disability pensioning and to the age of 25 with regard to education, participation in the labour force and income, and in addition national service for the men. The study was made possible through the linking of data from several national registers, performed by Statistics Norway. Before the file was released for analyses, all personal identification was removed. RESULTS: Basic and supplementary benefits in childhood predict adverse outcomes in young adult age: mortality, disability, low education, lack of gainful employment and low pensionable income. The diagnosis registered with the benefit strongly influenced the outcomes. Conscripts who had received benefits were judged to have a mean score for general ability of 4.5 compared to 5.2. Adjusted for score for general ability the proportion of those having received benefits achieving higher education was 84% of that of those that had not received benefits. After adjustment for educational attainment, the percentage gainfully employed was 11-12% less among subjects having received benefits in childhood. This negative association between having received a benefit in childhood and gainful employment in adulthood was restricted to the low educational group. INTERPRETATION: Persons with health problems in childhood did not achieve the education, employment and income they should have been capable of judged by their general ability and the education they had actually achieved.