Mayo Foundation Electronic Results Inquiry, the HL7 connection.

Rapid access to patient information is critical for care in both inpatient and outpatient settings. Ancillary systems (Lab, Microbiology, Electrocardiogram (ECG), Echocardiography, etc.) contain test result information. Mayo Foundation is piloting an Electronic Results Inquiry System (ERIS), using the Phamis Lastword database, that aggregates some of this information into a central location. The results may then be accessed by workstations or forwarded to surgical, critical care, and transplant information systems. All communications messages, except for the workstation interface, will be based on the Health Level 7 (HL7) specification, version 2.1. The specification has benefitted Mayo by shortening interface design effort and providing common messages between various computer systems. At this time, HL7 is the most practical solution for these interfaces[1]. HL7 gives all parties involved in the interfaces a "blueprint" to begin design. Unlike a formal blueprint, the specification is flexible and handles most of the needs encountered to date. The areas in which the specification was lacking were reported to the HL7 working group. These areas have been addressed by the working group to allow completion of the interfaces described here. This paper describes the HL7 interfaces to ERIS, with the ECG result and client query interfaces emphasized.

Evaluation of size and dynamics of the inferior vena cava as an index of right-sided cardiac function.

To define normal criteria of size and dynamics of the inferior vena cava (IVC) and its clinical value in assessing right-sided cardiac function, 2-dimensional (2-D) and M-mode echocardiography (echo) were performed in 175 subjects, who were classified into 3 groups: group 1-80 normal subjects; group IIA--65 patients with documented right-sided cardiac disease, and group IIB--30 patients with cardiac disease but no right-sided abnormality. The IVC was adequately imaged in 175 of 185 subjects (95%). There was good correlation between M-mode and 2-D echo (r = 0.84) and long- and short-axis (r = 0.88) measurements. The IVC diameter during expiration was: group 1-9 to 28 mm (mean 18.2 +/- 4.6); group IIA--15 to 40 mm (mean 23.1 +/- 4.8) and group IIB-8-24 mm (mean 15.6 +/- 3.7). Collapsibility index (inspiratory decrease in diameter) was: group I-37 to 100% (mean 55.8 +/- 15.9); group IIA--0 to 39% (mean 13.5 +/- 10.5); and group IIB--44 to 100% (mean 60.4 +/- 13.1). A and V waves could be measured in 120 of 151 cases (79%). Both A and V waves were less than 125% of its diameter in group I. The A wave was absent in 34 patients; 30 (88%) were in atrial fibrillation. Among 8 patients with tricuspid regurgitation, 5 (63%) had V waves greater than 125%. There was no correlation between diameter or collapsibility index and age, sex, rhythm or body surface area.(ABSTRACT TRUNCATED AT 250 WORDS)