In the era of primary PCI, a strategy of admitting patients to the nearest hospital should be obsolete. Instead, a prehospital diagnostic strategy should be implemented in order to: (1) refer patients directly to interventional centres, thereby eliminating delay at local hospitals; (2) alert the interventional centre, thereby reducing door to balloon times; (3) initiate adjunctive medication in...

AIMS To evaluate the ability of electronic patient medication record (ePMR) systems used in community pharmacies in England to detect and alert users about clinical hazards, errors and other safety problems. METHODS Between September 2012 and November 2012, direct on-site observational data about the performance of ePMR systems were collected from nine sites. Twenty-eight scenarios were devel...

BACKGROUND Users of electronic health record (EHR) systems frequently prescribe doses outside recommended dose ranges, and tend to ignore the alerts that result. Since some of these dosing errors are the result of system design flaws, analysis of large overdoses can lead to the discovery of needed system changes. OBJECTIVES To develop database techniques for detecting and extracting large ove...

A high resolution North Atlantic and European Wave (NAEW) model has been developed in the Met Office. It is framed in a rotated latitude-longitude grid with a space resolution of 12 km and based on the same physics as the Met Office global wave model except for a new 3 order positive-definite advection scheme and a new Sub-Range Wave Height (SRWH) output variable. The wind forcing comes from a ...

Alert correlation is a system which receives alerts from heterogeneous Intrusion Detection Systems and reduces false alerts, detects high level patterns of attacks, increases the meaning of occurred incidents, predicts the future states of attacks, and detects root cause of attacks. To reach these goals, many algorithms have been introduced in the world with many advantages and disadvantages. I...

OBJECTIVES The objective of this proof of concept study was to evaluate alerts generated by a patient-reported outcome measure (PROM)-based algorithm for monitoring patients with rheumatoid arthritis (RA). METHODS The algorithm was constructed using an example PROM score of an equally weighted mean of visual analogue scale (VAS) general health, VAS disease activity and VAS pain. Based on the ...

Current clinical data repositories primarily extract data from multiple administrative and electronic medical record (EMR) data resources (e.g., hospital and physician billing records) containing specific patient-level data including demographics, medications, laboratory results, diagnoses, and procedure codes. It overlooks the importance of EMR system-level data (e.g., medication alerts that a...

ObjectivesTo determine the prevalence of Potentially Inappropriate Medication (PIMs) and Omitted (POMs) in older patients with cancer.Materials MethodsIn this prospective observational study (hospital) pharmacists conducted comprehensive medication reviews cancer (aged ≥65 years) receiving parenteral chemotherapy and/or immunotherapy at Deventer Hospital. PIMs POMs were identified using Screeni...

OBJECTIVES Prescription of excessive doses is the most common prescription error, provoking dose-dependent adverse drug reactions. Clinical decision support systems (CDSS) can prevent prescription errors especially when mainly clinically relevant warnings are issued. We have built and evaluated a CDSS providing upper dose limits personalised to individual patient characteristics thus guaranteei...

Clinical Decision Support (CDS) systems can alert physicians about potential clinical risks and suggest suitable treatment alternatives at appropriate times in the health care process. We evaluated the frequency with which physicians overrode medication alerts and the override reasons provided. Data obtained from primary care practices affiliated with two Harvard teaching hospitals were downloa...