RESUMO
Providing a full range of problems to be managed in a model family practice unit is the goal of selective enrollment of patients at the Medical University of South Carolina. A computerized problem-oriented medical record is used to help distribute families with selected chronic diseases equitably to residents. Attention to the demographics of each resident's practice panel can help influence the distribution of health problems which a resident may experience at the model unit. Knowledge of the demographics of families at the model unit can help determine how representative they are of the surrounding community. Reallocation of families to new resident physicians when their old resident physicians complete training is logically planned. Work loads of resident physicians are monitored to adjust family assignments in their practice panels. The patient enrollment process is responsive to resident and faculty input regarding deficiencies in the health care experiences of the resident.
Assuntos
Medicina de Família e Comunidade/educação , Internato e Residência/organização & administração , Pacientes , Demografia , Grupos Diagnósticos Relacionados , Internato e Residência/métodos , Registros Médicos Orientados a Problemas , Modelos Teóricos , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/organização & administração , Fatores Socioeconômicos , South CarolinaRESUMO
Febrile convulsions occur in 3.4 percent of children but are rarely a harbinger of epilepsy. However, children who have two or more uncomplicated, noncomplex or "simple" febrile convulsions should receive anticonvulsant therapy. Phenobarbital is recommended for children who have a single febrile convulsion that is unilateral or focal and lasts more than 15 minutes. It is also recommended for cases involving multiple convulsions in one day, a physical or neurologic abnormality or a subnormal or suboptimal developmental history.
Assuntos
Convulsões Febris , Convulsões , Pré-Escolar , Epilepsia/diagnóstico , Epilepsia/epidemiologia , Humanos , Lactente , Masculino , Fenobarbital/uso terapêutico , Prognóstico , Convulsões Febris/complicações , Convulsões Febris/tratamento farmacológico , Convulsões Febris/epidemiologia , Convulsões Febris/etiologiaRESUMO
An interactive on-line clinical information system is in operation within the residency of the Department of Family Practice at the Medical University of South Carolina in Charleston. This approach eliminates some of the traditional sources of error in collecting clinical information. Particular attention is given to flexibility of data presentation: data may be segregated by time, by disease entity, by age and sex of the patient, by physician, by year of residency, and by disease class. The responsiveness of this on-line technology allows the production of complete, up-to-date practice reports within 24 hours of a request.
Assuntos
Medicina de Família e Comunidade , Prontuários Médicos , Sistemas On-Line , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Diagnóstico , Feminino , Humanos , Lactente , Recém-Nascido , Internato e Residência , Masculino , Registros Médicos Orientados a Problemas , Pessoa de Meia-Idade , Morbidade , Fatores Sexuais , Estatística como Assunto , Fatores de TempoRESUMO
A computer-administered interview on life events (CAI-LEV) was developed for use by patients in the waiting room of the model family practice unit at the Medical University of South Carolina, Charleston, South Carolina. Computer printouts of CAI-LEV are immediately available for doctor/patient communication, so that CAI-LEV fits into ongoing patient flow and care. Throughout a three-month study, confidentiality of information was protected by the use of numbers for patient responses to questions in 16 areas covering a wide range of possible life events. The adept physician can utilize the printout to assess stress in the patient's current situation, to focus quickly on any particular area of concern, or to initiate a counseling session. Of some 250 completed interview, 93 have been reviewed by residents and faculty after in-depth utilization during patient care. Of these 93 physician-evaluated interviews, 40 percent yielded important new information, while in 22 percent of the cases, doctor/patient communication was improved.
