Anesthesia Information Management Systems: Evolution of the Paper Anesthetic Record to a Multisystem Electronic Medical Record Network That Streamlines Perioperative Care.

Initially devised in the 1890s, the traditional anesthetic record comprises physiological changes, crucial anesthetic or surgical events, and medications administered during the perioperative period. The timely collection of quality data facilitates situational awareness and point-of-care clinical decision making. The burgeoning volume and complexity of data in conjunction with financial incentives and the push for improved clinical documentation by regulatory bodies have prompted the transition away from paper records. Anesthesia Information Management Systems (AIMS) are specialized electronic health record networks that allow the anesthesia record to interface with hospital clinical data repositories, resulting in improvements in quality of care, patient safety, operations management, reimbursement, and translational research. Like most new technological advances, adoption was slow at first due to the challenges of integrating complex systems into daily clinical practice, questions about return on investment, and medicolegal liability. Recent technological advances, coupled with government incentives, have allowed AIMS adoption to reach an acceleration phase among US academic medical centers; widespread utilization of AIMS by 84% of US academic medical centers is expected by 2018-2020. Adoption among nonacademic US and European medical centers still remains low; information concerning Asian countries is limited to literature describing only single-hospital center experiences.

Movimiento libertario y autogestión del conocimiento en la España del primer tercio del siglo XX: la sección «Preguntas y respuestas» / Libertarian movement and self-management of knowledge in the Spain of the first third of the 20th century: «Questions and answers» section (1930-1937) of the journal Estudios

Las secciones periodísticas de preguntas y respuestas reflejan y contribuyen a las sociedades en que se publican, y pueden desempeñar roles tan diferentes como constituirse en una herramienta para mantener la normatividad social o, por el contrario, en un instrumento para el cambio de las normas sociales. En un contexto de complejas relaciones entre expertos y no-expertos dentro del movimiento libertario en la España del primer tercio del siglo XX, la sección «Preguntas y respuestas» (1930-1937) de la revista anarquista Estudios (1928-1937) se revela como un ejemplo particularmente ilustrativo de gestión multidimensional de conocimiento a través de la redefinición efectiva de la participación de muy diferentes colectivos. En este trabajo, analizamos el intercambio entre el médico Roberto Remartínez (1895-1977), coordinador de la sección, y los lectores, e identificamos las características de la puesta en práctica del ideario libertario de autogestión a través de prácticas comunicativas en las que intervienen conjuntamente expertos y no-expertos (AU)

Newspaper Q&A sections reflect and contribute to the social historical context in which they are published, and they may play roles as distinct as becoming a tool to sustain social arrangements or, conversely, being an instrument for social change. In a context of complex relations between experts and non-experts within the libertarian movement in Spain in the first third of the 20th century, the Q&A section («Preguntas y respuestas», 1930-1937) of the anarchist magazine Estudios (1928-1937) constitutes a particularly illustrative example of the multidimensional management of knowledge through the effective redefinition of the participation of quite different groups. In this paper, we analyze the exchange between physician Roberto Remartínez (1895-1977), the section coordinator, and its readers, and identify features of the implementation of the libertarian principles of self-management throughcommunication practices in which experts and non-experts jointly take part (AU)

Online trust, trustworthiness, or assurance?

Every day, individuals around the world retrieve, share, and exchange information on the Internet. We interact online to share personal information, find answers to questions, make financial transactions, play social games, and maintain professional and personal relationships. Sometimes our online interactions take place between two or more humans. In other cases, we rely on computers to manage information on our behalf. In each scenario, risk and uncertainty are essential for determining possible actions and outcomes. This essay highlights common deficiencies in our understanding of key concepts such as trust, trustworthiness, cooperation, and assurance in online environments. Empirical evidence from experimental work in computer-mediated environments underscores the promises and perils of overreliance on security and assurance structures as replacements for interpersonal trust. These conceptual distinctions are critical because the future shape of the Internet will depend on whether we build assurance structures to limit and control ambiguity or allow trust to emerge in the presence of risk and uncertainty.

Living without a data management system.

The implementation of a typical electronic data capture (EDC) system for clinical trials - encompassing data entry, validation and reporting tools - involves modeling electronic case report forms (eCRFs) for data that will be entered by investigative trial sites, providing web access for the sites to enter the data, managing a 'cleaning and locking' process (in which any queries against the data are resolved), and transmitting the final data to SAS datasets. Other clinical data not included in CRFs, such as laboratory data, are typically handled in a separate clinical data management system; this information is not directly linked back to the trial sites and therefore is inaccessible for review. Thus, activities such as seeking site feedback on out-of-range laboratory values can only be performed by manually transcribing queries from the data management system into the EDC system. As the number of studies using EDC systems escalates and the number of studies gathering data on paper diminishes, the inefficiencies of handling data across different systems are becoming increasingly apparent. This article explores the opportunities, risks and technical requirements needed for an integrated EDC environment to enable a discontinuation of the use of older data management systems.

Changes in Medical Documentation over the Last Five Decades.

In medical documentation, standardized coding schemes are used to facilitate sharing, transformation and reusability of data. First, classification systems coding schemes have been introduced. While classification systems are mainly used for statistical purposes, individual care documentation moves towards the use of nomenclatures coding schemes. The paper presents an overview of the development of coding schemes. Different coding schemes serve different purposes. Multiaxial schemes are the way of choice for comprehensively documenting complex care processes. There is a movement from mono-hierarchical classification systems to concept-based, multi-purpose and multi-hierarchical terminologies.

Computer applications in bioprocessing.

Biotechnologists have stayed at the forefront for practical applications for computing. As hardware and software for computing have evolved, the latest advances have found eager users in the area of bioprocessing. Accomplishments and their significance can be appreciated by tracing the history and the interplay between the computing tools and the problems that have been solved in bioprocessing.

Concentric circles: how laws, economics, and the healthcare environment have changed HIM.

From the early 20th century, HIM professionals have been part of the turbulent story of healthcare in America. How has the profession, and AHIMA, evolved along with the industry? The author describes the environmental changes that have shaped the profession.

Clades 25 años de investigación y acción / Clades 25 years of research and action

El presente documento entrega una retrospectiva de los 25 años de actividades del CLADES en la región. AtravÚs de una visión general intenta mostrar cußl ha sido el rol y la contribución del CLADES en el ßrea de la gestión de la información durante estos 25 años. Se destacan sus mßs importantes hitos: la investigación sobre la situación de la información en AmÚrica Latina y el Caribe; el Sistema de Información par la Planificación Económica y Social (INFOPLAN); el Programa Regional para el Fortalecimento de la Cooperación entre redes y Sistemas Nacionales de Información en AmÚrica Latina y el Caribe (INFOLAC); las herramientas en información y documentación que el Centro ha entregado en la región, y su reposicionamento en los noventa. Finalmente, se reflete a la acción del CLADES en pro del desarollo de recursos humanos a travÚs de cursos, seminarios y talleres Nacionales, en donde se ha analizado la integración de las nuevas tecnologÝas de información y la teorÝa de la organización, problemßtica conceptualizada como gestión de la información en las organizaciones.