Browsing by Author "Lapinsky, Stephen E"
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- ItemCritical care procedure logging using handheld computers.(2004-10-07) Martinez-Motta, J Carlos; Walker, Robin; Stewart, Thomas E; Granton, John; Abrahamson, Simon; Lapinsky, Stephen EINTRODUCTION We conducted this study to evaluate the feasibility of implementing an internet linked handheld computer procedure logging system in a critical care training program METHODS Subspecialty trainees in the Interdepartmental Division of Critical Care at the University of Toronto received and were trained in the use of Palm handheld computers loaded with a customized program for logging critical care procedures The procedures were entered into the handheld device using checkboxes and drop down lists and data were uploaded to a central database via the internet To evaluate the feasibility of this system we tracked the utilization of this data collection system Benefits and disadvantages were assessed through surveys RESULTS All 11 trainees successfully uploaded data to the central database but only six 55 continued to upload data on a regular basis The most common reason cited for not using the system pertained to initial technical problems with data uploading From 1 July 2002 to 30 June 2003 a total of 914 procedures were logged Significant variability was noted in the number of procedures logged by individual trainees range 13 242 The database generated by regular users provided potentially useful information to the training program director regarding the scope and location of procedural training among the different rotations and hospitals CONCLUSION A handheld computer procedure logging system can be effectively used in a critical care training program However user acceptance was not uniform and continued training and support are required to increase user acceptance Such a procedure database may provide valuable information that may be used to optimize trainees educational experience and to document clinical training experience for licensing and accreditation
- ItemElectromagnetic interference in critical care.(2006-09-22) Lapinsky, Stephen E; Easty, Anthony CMobile communication and wireless data transmission are playing an increasing role in health care Reports describing medical device malfunction related to cellular phones have raised awareness about the problem of electromagnetic interference Although initial institutional responses were to ban cellular devices in hospitals these restrictions are relaxing as the knowledge base in this area expands Medical device malfunction is extremely rare if the distance from the transmitting device is greater than 1 m This article reviews the current understanding of electromagnetic interference as it applies to the technology rich critical care environment
- ItemHandheld computing in medicine.(2003-02-21) Fischer, Sandra; Stewart, Thomas E; Mehta, Sangeeta; Wax, Randy; Lapinsky, Stephen EHandheld computers have become a valuable and popular tool in various fields of medicine A systematic review of articles was undertaken to summarize the current literature regarding the use of handheld devices in medicine A variety of articles were identified and relevant information for various medical fields was summarized The literature search covered general information about handheld devices the use of these devices to access medical literature electronic pharmacopoeias patient tracking medical education research business management e prescribing patient confidentiality and costs as well as specialty specific uses for personal digital assistants PDAs The authors concluded that only a small number of articles provide evidence based information about the use of PDAs in medicine The majority of articles provide descriptive information which is nevertheless of value This article aims to increase the awareness among physicians about the potential roles for handheld computers in medicine and to encourage the further evaluation of their use
- ItemMobile computing in critical care.(2007-03-20) Lapinsky, Stephen EHandheld computing devices are increasingly used by health care workers and offer a mobile platform for point of care information access Improved technology with larger memory capacity higher screen resolution faster processors and wireless connectivity has broadened the potential roles for these devices in critical care In addition to the personal information management functions handheld computers have been used to access reference information management guidelines and pharmacopoeias as well as to track the educational experience of trainees They can act as an interface with a clinical information system providing rapid access to patient information Despite their popularity these devices have limitations related to their small size and acceptance by physicians has not been uniform In the critical care environment the risk of transmitting microorganisms by such a portable device should always be considered
- ItemProspective evaluation of an internet-linked handheld computer critical care knowledge access system.(2004-11-29) Lapinsky, Stephen E; Wax, Randy; Showalter, Randy; Martinez-Motta, J Carlos; Hallett, David; Mehta, Sangeeta; Burry, Lisa; Stewart, Thomas EINTRODUCTION Critical care physicians may benefit from immediate access to medical reference material We evaluated the feasibility and potential benefits of a handheld computer based knowledge access system linking a central academic intensive care unit ICU to multiple community based ICUs METHODS Four community hospital ICUs with 17 physicians participated in this prospective interventional study Following training in the use of an internet linked updateable handheld computer knowledge access system the physicians used the handheld devices in their clinical environment for a 12 month intervention period Feasibility of the system was evaluated by tracking use of the handheld computer and by conducting surveys and focus group discussions Before and after the intervention period participants underwent simulated patient care scenarios designed to evaluate the information sources they accessed as well as the speed and quality of their decision making Participants generated admission orders during each scenario which were scored by blinded evaluators RESULTS Ten physicians 59 used the system regularly predominantly for nonmedical applications median 32 8 month interquartile range IQR 28 3 126 8 with medical software accessed less often median 9 month IQR 3 7 13 7 Eight out of 13 physicians 62 who completed the final scenarios chose to use the handheld computer for information access The median time to access information on the handheld handheld computer was 19 s IQR 15 40 s This group exhibited a significant improvement in admission order score as compared with those who used other resources P 0 018 Benefits and barriers to use of this technology were identified CONCLUSION An updateable handheld computer system is feasible as a means of point of care access to medical reference material and may improve clinical decision making However during the study acceptance of the system was variable Improved training and new technology may overcome some of the barriers we identified
- ItemSurgical procedure logging with use of a hand-held computer.(2002-10-21) Fischer, Sandra; Lapinsky, Stephen E; Weshler, Jason; Howard, Frazer; Rotstein, Lorne E; Cohen, Zane; Stewart, Thomas EOBJECTIVE To evaluate the feasibility of incorporating hand held computing technology in a surgical residency program by means of hand held devices for surgical procedure logging linked through the Internet to a central database SETTING Division of General Surgery University of Toronto DESIGN A survey of general surgery residents METHODS The 69 residents in the general surgery training program received hand held computers with preinstalled medical programs and a program designed for surgical procedure logging Procedural data were uploaded via the Internet to a central database Survey data were collected regarding previous computer use as well as previous procedure logging methods MAIN OUTCOME MEASURE Utilization of the procedure logging system RESULTS After a 5 month pilot period 38 of surgical residents were using the procedure logging program successfully and on a regular basis Program use was higher among more junior trainees Analysis of the database provided valuable information on individual trainees hospital programs and supervising surgeons data that would assist in program development CONCLUSIONS Hand held devices can be implemented in a large division of general surgery to provide a reference database and a procedure logging platform However user acceptance is not uniform and continued training and support are necessary to increase acceptance The procedure database provides important information for optimizing trainees educational experience
- ItemWireless technology in the ICU: boon or ban?(2008-01-16) Gladman, Aviv S; Lapinsky, Stephen EWireless communication and data transmission are playing an increasing role in the critical care environment Early anecdotal reports of electromagnetic interference EMI with intensive care unit ICU equipment resulted in many institutions banning these devices An increasing literature database has more clearly defined the risks of EMI Restrictions to the use of mobile devices are being lifted and it has been suggested that the benefits of improved communication may outweigh the small risks However increased use of cellular phones and ever changing communication technologies require ongoing vigilance by healthcare device manufacturers hospitals and device users to prevent potentially hazardous events due to EMI