學(xué)生公寓管理系統(tǒng)-外文翻譯

1、學(xué)生公寓管理系統(tǒng)外文翻譯)外文翻譯 本科畢業(yè)設(shè)計(jì)（1本科畢業(yè)設(shè)計(jì)（2本科畢業(yè)設(shè)計(jì)（3原文:The anesthesia information management system for electronicdocumentation: what are we waiting for？ERIC LAIMS and reasons for its useFor many hospital administrators and chief executive officers, the operating room is a black box. Patients may have common

2、diagnoses and undergo common surgical procedures， but they often have diverse outcomes and different costs associated with their care 。 The reasons for the disparity are often multifaceted and not well defined. The current medical records system lacks the ability to define and compare outliers, ther

3、eby hindering analysis. Furthermore, many medical centers must maintain the high level of care in their practices without effecting change （operating at fixed costs), while reimbursement continually decreases relative to inflation (capitated markets). An potentially can bridge this economic gap by p

4、roviding critical datauseful for scheduling， operating room use, material management, and improved use of resources in a declining reimbursement environment。The electronic revolution enters this environment。 As a medical specialty, anesthesiahas always embraced new technologies， such as the automate

5、d blood pressure cuff， invasive monitoring, and monitors that record physiologic trends。 Early anesthesia record-keepers were able to data from monitors， and anesthesiologists were able to create an electronic record instead of a paper record 。 The layout of the electronic record was similar to that

6、 of the customary paper record， thereby providing a format that was familiar to the Anesthesiologist。With an AIMS， in addition to physiologic data, other information such as surgical time， cost of medication, resources used, and quality assurance data can be recorded. Many departments have described

7、 their experiences with these systems and reported the corresponding cost efficiencies that resulted from electronic data collation and the use of a simulation model 。 Moreover， electronic systems can search for patient allergies or identify improper drug dosages or contraindications. The system can

8、 verify provider attendance during procedures， asrequired bythe Health Care Financing Administration inthe UnitedStates。 Inaddition, some systems （institutionally orcommerciallydeveloped）offer a preoperative data entry system thatcan storeanesthetic histories and physical examination findings, and m

9、ay be used to review preoperative laboratory data and medical histories。The ergonomics of newer AIMS have improved as computer technology has advanced； in contrast to the traditional keyboard method of data entry， barcoded materials and data entry with a touch screen or mouse are now available， and

10、voice-activated systems are being refined。Electronic delivery systems allow the caregiver to administer medication without manually documenting the entry. These systems are electronically linked to the anesthesia equipment at the point of care, but departments can also use them to document anesthesi

11、a procedures in variouslocations 。Monitoring equipment typically sends data in a unique and proprietary format through its RS232 ports. Newer monitors adhere to a common standard (e.g 。 ， universal serial bus USB）, and todays AIMS can collate and analyze data. Many ofthese physiologic monitors are l

12、inked via a network （e。g., localarea network orintranet)to servers that retain backup copies of thedata. Duplicatecopies ofdata are required for the missioncriticalfunction of theoperatingroom。The United States Institute of Medicine Guidelines for an electronic health record system The Institute of

13、Medicine in the United States issued a report in 2003 that detailed the key capabilities of an EMR system 。 It should provide: (1) longitudinal collection of patient data； （2) immediate access by authorized users; (3） information to aid in decisionmaking throughout the continuum of patient care; and

14、 support for efficient healthcare deliveryThe guidelines furtherdivided the EMR into primary and secondary applications . Patient care， management， support processes, financial and administrative processes, and patient self-management are considered1本科畢業(yè)設(shè)計(jì)（論文）外文翻譯primary applications。 Secondary appl

15、ications include education, regulation, research，public health， and policy support。Primary application of an AIMS would omit patient selfmanagement， but otherwise would comply with the guidelines described above。Similarly， secondary applications would also include education, regulation， and research

16、 。 If an AIMS had a greater role, one could argue favorably about its role in public health and policy support. public policy and public health are affected by the issue of what types of providers administer anesthesia 。 Aspects of anesthesiology that are important to public health （for example, whe

17、ther changes in the of care occur when anesthesia is administered by a physician, a nurse anesthetist， or a physician and nurse anesthetist as a team， as performed in the United States and some European countries） can be analyzed using data from an AIMS. Furthermore, the role of the anesthesiologist

18、 assistant is evolving， and an AIMS may help define The increased accuracy in documentation that would result from the use of an AIMS will be necessary to determine policy support of an anesthesia care team。The Institute of Medicine has recommended time lines for the implementation of electronic med

19、ical record keeping. Guidelines for implementing an electronic system to record health data, results management, and order entry， as well as improve electronic communication, decision support， patient support， administrative processes， and population health management reporting, are slated for compl

20、etion by the year 2010 。 The United States government has also supported an aggressive time line. Will this happen？ Or will skeptics still rule the playing field ？Advantages of an AIMSThe patient record is extremely important and must be carefully chronicled with every anesthetic procedure 。 The ane

21、sthetic record is used for patient care during anesthesia administration and in the post anesthesia care unit (PACU), the intensive care unit (ICU）, and the postsurgical ward. The recorded information is used for billing， tabulating patient statistics， and reviewing previous anesthetic procedures。 F

22、inally， advances in quality improvement methods assist in peer review and legal defense。There are many advantages of an AIMS， including (1) capturing data in real time; （2) alerting the anesthesia provider of deviations from preset physiologic limits； （3） communicating with various patient databases

23、; and (4) generating an accurate, understandable record at the end of the procedure. In certain instances， the EMR has enabled the identification of missing or incorrect data and thereby led to qualityimprovement 。 A study of manual and automated documentation during anesthesia procedures showed tha

24、t， with an AIMS， 18 。 7% of anesthesia administrations had recorded adverse events versus 5 。 7 of administrations documented manually. Additional advantages of EMRs over manual records include immediate and simultaneous data access for authorized users, error checking， recovery of files from backup

25、 sources, definitions of billing and patient care for database entry， and integration of records into a searchable patient database . Table 1 provides example functions of an AIMS 。 Moreover, an AIMS can overcome problems with illegible handwriting and transcription errors.Nevertheless, electronic r

26、ecordkeeping systemsdo fail from time to time， although that frequency is not documented. Everyone must be prepared to document manually if the AIMS is unavailable。1。Automated collection of physiologic data from the operating room in flowsheet format （a timehonored format designed by Harvey Cushing，

27、 circa 1900s）2。Mission-critical functionality3。Emergency provisions for charting 4。Database for queries and analysis 5。Electronic billing6。Cost analysis7。Ability to print hard copies (black and white or color; 1- or 2 sided pages)8.Electronic signature (e.g.， authentication by biometric characterist

28、ic or password）9。Secure data entry， storage, transfer, and access 10.Audit trails11.Preoperative and postoperative documentation12。Procedure documentation (e.g。， central venous pressure， epidural anesthesia， spinal anesthesia, regional block anesthesia)5本科畢業(yè)設(shè)計(jì)（論文）外文翻譯13。Ability to use in remote area

29、s distant from the operating room (e。g.， endoscopy suite, radiology suite， emergency department）14.Full integration with other systems in the medical center （or well interfaced)Total integration of an AIMS into the hospital information network Hospital administrators must consider merging an AIMS in

30、to the mainbody of the information network as a totally integrated system instead of an interfaced system. First, data should have seamless passage from one area or specialty to another. For example, after echocardiography performed in the cardiology suite images should be instantly accessible by th

31、e anesthesia provider evaluating the patient for surgery. Similarly the anesthesia provider should be able to access laboratory data, consultations， pulmonary function test results and patient history at anytime。Second， the resources required to support an integrated system are reduced when compared

32、 with maintaining an interfaced system because the information management team can be centralized with the mission to keep the whole system functioning 。 Otherwise, each proprietary system would require product-specific technology specialists for service. For AIMSs, which have a missioncritical func

33、tion, the technical support staf would need to be available on a 24-h basis， resulting in high personnel costs。Third， if a fully integrated medical system is supported by a large medical informatics vendor， future upgrades and improvements can reasonably be assured 。 Some vendors offer real-time dat

34、a acquisition that can be integrated with other aspects of the hospital information system, but many vendors do not. However， if products from multiple vendors are used in a noninte-grated system， upgrades may be dif,cult or impossible。 For example, a newly acquired piece of operating room equipment

35、(e 。 g.， a system to record and view radiographic studies or transesophageal echocardiography images) may be only partially supported by a company for integration into its monitoring system 。 The AIMS vendor would need to create a driver to help interpret the data recorded by this device or to import data。 Ensuring timely access to data can be a concern， but such problems can be solved by sharing data within networks only on an intermittent basis。 Networks currently are designed with a gigabit ne